ANN/THE STAR – Familiarity breeds contempt, as the saying goes, and with dengue being endemic in Malaysia, many seem to have grown complacent about the threat it poses.
However, the cumulative cases of dengue infections for 2022 increased by more than 150 per cent compared to the year before and dengue deaths increased by 180 per cent.
Protecting ourselves against getting this infectious disease is not difficult, but some may be misled by half-truths and misconceptions about dengue that may lead to more harm than good.
International Medical University family medicine specialist Associate Professor Dr Verna Lee Kar Mun tackles five common myths to set the record straight:
MYTH 1: YOU CAN ONLY GET DENGUE ONCE IN YOUR LIFETIME
There are four dengue serotypes and this means that a person can get infected up to four times, once with each serotype.
Total immunity is only possible if a person has been infected with each of the four serotypes.
However, it is essential to bear in mind that subsequent infections are likely to be more serious than the first, and each infection increases your chances of getting severe dengue.
As severe dengue is a serious illness that requires hospitalisation and may lead to devastating consequences such as organ failure, repeated dengue infections should definitely be avoided.
MYTH 2: AS LONG AS I DON’T FEEL SICK, THERE IS NO DANGER
There are three different stages of dengue fever.
It begins with the febrile phase, characterised by one to two days of high fever that begins suddenly.
During this time, patients are likely to have body aches, headache with pain behind the eyes, a flushed face, and sometimes, blotchy skin or rashes.
Next comes the critical phase.
Ironically, this is when the fever subsides, and many people may feel that they are getting better.
However, these one to two days are when a patient can possibly go into shock if the capillaries are leaking plasma, leading to a sudden drop in blood pressure.
It is this phase that will determine if patients get better and proceed to the recovery phase (when the patients are able to reabsorb fluids and the pulse stabilises), or get worse and suffer severe dengue.
Many viral illnesses such as dengue are self-limiting, which means they will naturally subside.
In most cases, patients only need self-care at home, and the most important thing to remember is to take plenty of fluids to prevent the dehydration that comes with plasma leakage.
Anyone who gets dengue fever should aim to drink at least three litres of water daily for the first three days.
MYTH 3: DENGUE IS JUST A COMMON MILD ILLNESS
While most people who get infected with dengue are able to recover at home, this does not mean that dengue is nothing to worry about.
An estimated one per cent of patients will experience severe dengue, also known as haemorrhagic dengue, which will require hospitalisation.
Bleeding can begin in the febrile phase, usually in the skin or gums, and if it is not managed well, the patient’s condition can worsen during the critical phase, which is when most people are admitted to the hospital.
Those with a healthy immune system usually recover in two days, but if there is inflammation affecting the organs such as the heart, liver or brain, it can take up to a week or longer if there are complications.
For people who already have low blood pressure, the symptoms may begin earlier, and women who are menstruating may experience heavier bleeding.
Other signs of severe dengue include severe pain in the abdomen, persistent vomiting, rapid breathing, and blood in the vomit or stool.
MYTH 4: I CAN ONLY TEST FOR DENGUE AFTER THREE DAYS
It is true that the initial symptoms are vague, as a fever can be a sign of many different illnesses.
But with dengue, the high fever usually comes suddenly, whereas with COVID-19, for example, the onset of fever is slower.
The S1 dengue rapid antigen test can detect dengue from the first day, so you should not delay seeking medical advice if you suddenly develop a high fever.
Remember, the febrile phase only lasts one to two days, then comes the critical phase when patients can suddenly take a turn for the worse.
MYTH 5: I DON’T NEED TO DO ANYTHING ABOUT DENGUE PREVENTION AS THERE IS ALREADY FOGGING GOING ON IN MY AREA
Efforts such as fogging help to kill adult mosquitoes, and getting rid of stagnant water in public drains and other places helps to prevent breeding sites.
However, these involve a lot of cost and manpower, and are only partially effective.
In 2009/2010, the estimated cost for these preventive efforts was MYR777 million, and it is undoubtedly higher today. Even worse is that there is evidence that mosquitoes have grown resistant to the common insecticides used in fogging.
Authorities are already testing new methods, such as the use of genetically-modified mosquitoes in hotspots.
There is also news of a new dengue vaccine being reviewed.
However, this is not a good excuse to let down our guard.
On a personal level, all of us can do something at home to help prevent mosquito bites and breeding sites.
Remember, you can quarantine a person, but you can’t quarantine a mosquito; they are everywhere.
We need to make a bigger effort to protect ourselves and our loved ones by making sure our home environment is clear of any breeding sites, covering up exposed skin and using mosquito repellents, especially during sunrise and sundown.
There is presently no cure for dengue, nor any specific treatment that can help – not even antiviral drugs.
While there is no harm in drinking fruit juices and other fluids as these can help prevent dehydration, they are not cures.