Opinion: Dengue fever is ‘sweeping country after country’ - and it got me

The ‘Asian tiger’ mosquito has now been spotted or become established in 30 European countries. Photo / File

OPINION

Dengue – a sometimes lethal disease spread by mosquitoes – is having a moment. The “break-bone fever” is sweeping country after country in Asia and South America, and is starting to emerge closer to home.

The stripey “Asian tiger” mosquito has now been spotted or become established in 30 European countries, including Spain, Italy and Croatia. It’s even been picked up in the UK, and some experts think warming temperatures will allow them to settle in England within a decade.

Long story short, you need to watch out for dengue – if not in the UK quite yet, then definitely while on holiday in warmer climes. Last year, a Briton caught the virus on holiday in Provence and, in 2016, 21-year-old British tourist Bob Toulson-Burke died of dengue here in Thailand.

I can’t be sure where I was bitten by an infected Asian tiger mosquito – they’re city-loving insects, but I’d just spent a long weekend in a national park where I’d been bitten to shreds.

It was the following Friday that I started to feel slightly strange.

But, unwilling to miss Bangkok’s surreal Songkran (Thai New Year) celebrations, where the entire city pours onto the streets to engage in the world’s largest water fight, I forced myself out of the flat and onto the streets. It was jubilant chaos: thousands of adults and children dousing one another with ice cold water – a welcome release from the city’s sticky heat.

Or so it should have been. But despite the temperature being in the high 30s, I couldn’t stop shivering. When my lips tinged blue, friends sent me home. I crawled into bed and stayed there for much of the next 36 hours. I was suddenly exhausted, I felt sick, and I had no appetite.

By Monday afternoon, the fever had eased enough that I slapped on some makeup and joined my team’s weekly video call. It didn’t quite work. Afterwards, my editor called me to tell me I “looked like s**t” – might I have dengue and was it really sensible to fly to northeastern Thailand tomorrow for a job, he wanted to know?

Weakness, aches and a strange red rash

The suggestion was not outlandish. The virus is now endemic in more than 100 countries, compared to nine in the 1970s, putting more than half of the world’s population at risk – including Southeast Asia, where I live. In January, Thailand, Malaysia and Singapore all warned there could be “massive outbreaks” of dengue in 2023, partly due to the serotypes circulating.

There are four strains of the virus, and having had one does not mean you’re protected against the others. Indeed, prior-exposure with a different strain can make an infection worse, increasing the risk of hospitalisation or death. This year in south and southeast Asia, strains not recently seen are spreading, meaning immunity levels are low.

But even then I didn’t twig. I dosed up with paracetamol and boarded my 7am flight. This was partly because I wouldn’t describe the aches I experienced as “bone breaking”, which I’d written a dozen times or more was the virus’ signature symptom. At this point in my dengue cycle, my joints barely ached at all – I just thought I was coming down with a bad cold.

It had also taken a while to piece together the logistics for the interview I’d arranged in Yasothon province, and the faff involved in postponing the brief trip northeast felt harder than just getting on with it. Looking back, that wasn’t my most sensible decision.

Aside from the interview, the only moment of the trip I really remember is an embarrassing incident when, deciding I’d try to speak Thai despite my frazzled brain, I attempted to ask for a banana in a Seven-11 store. After a moment of confusion when a startled shop assistant pointed at the condoms, I left with the fruit but without my dignity – it turns out the word for banana is similar to d**k in Thai.

By the time I made it back from Bangkok, I was exhausted and, after another ropey team video call, finally took time off.

Dengue is a virus transmitted by mosquitoes. Photo /echbirmingham, Flickr

The fever had passed, but my body was weak and achy, while a strange, patchy, red rash had emerged on my stomach and was spreading slowly down all four limbs. While I never threw up, I was nauseous for days and didn’t really eat. The brain fog – the symptom I probably hated most, and which definitely lasted longest – grew more intense. I texted a friend to say I felt “broken and pathetic”.

It was only at this point that I started to suspect my initial assumption – that I’d caught a cold and made it worse with an ill-advised Songkran soaking – might be wrong. Instead, perhaps my editor was right? Was the culprit a virus I’d been covering since 2018, and had written so often about?

It turned out the answer was yes: blood tests at my local hospital confirmed I had dengue, and doctors sent me home with stern instructions to rest, take paracetamol and eat – I’d lost close to 3kg in nine days. There was little else they could do, as there are still no specific drugs to treat the pathogen.

Thankfully the infection was relatively mild. I was a weak, overtired mess and insanely frustrated that my mind wouldn’t work, but it could have been far worse.

Each year about 500,000 people are also hospitalised with severe dengue, a set of debilitating symptoms including shock syndrome and internal bleeding which can kick in once the fever has passed. This can be lethal – between 20,000 and 40,000 people die from the virus annually.

If I catch dengue again, but am infected by a different serotype, it’s more likely that I’ll become severely ill. It’s an outcome I’m keen to avoid, so I plan to follow my doctor’s orders to avoid mosquitoes from here on. I’m not sure how easy that will be in Thailand, but I’ve bought a new repellent.

If you are travelling this summer in an area where dengue is prevalent it might be worth doing the same.