Dengue fever

Wednesday, February 25, 2009

Fun with Tropical Diseases

I thought that I should at least give you some background in the amazing world of tropical diseases, from my own experiences of course. It never ceases to amaze me how many stomach problems I develop on any typical trip to the Philippines. For instance, it took me all of 4 days here on this trip to be back on antibiotics. Four days! I mean, come on, that is ridiculous. For the most part I try to stick to bottled water as much as possible. When we are surveying mountain sites, the pristine river water is just fine, and it is usually the city water that gives me problems. Stomach problems aside, you have the constant worry of infections as well. Numerous scratches, mild wounds, and rashes are just a few of the wonderful side effects of field biology. As long as you can keep the wounds clean and dry they will heal quickly. Of course, in an environment of 2 million percent humidity, and heat that can only be matched by actually standing on the sun, it is often difficult to do this. We do the best we can though. Prior to my first expedition in 2004, I was aware of all of the possible diseases I could catch and be vaccinated for. The vaccination process took several months and was incredibly expensive. I had to receive vaccines for typhoid fever, rabies, Japanese encephalitis, tetanus, flu, hepatitis – the list went on and on. In addition to the shots you can get ahead of time, there are areas where the most dangerous viruses and diseases are mosquito born. Everyone has heard of Malaria, and luckily, you can protect yourself while traveling by taking one of several anti-malarial medications. However, what I was never aware of prior to my first expedition was Dengue Fever, and I bet you can’t guess what the first illness I encountered in the Philippines. It was 2004 and I had been in the Philippines for my first month of Asian fieldwork…ever. It started in Bohol Island. Fever. Chills. I didn’t know it at the time but I had caught Dengue Fever five days earlier on a small island elsewhere in the archipelago (Dengue has an incubation period). The “fever” is actually a mosquito born virus that comes in four strains (flavors, if you will) here in the Philippines. The mosquito is larger than most people are used to, has white stripes, and occurs more often than not in cities and towns rather than in the forest. Oh yeah, it is diurnal, meaning it attacks its victims during the day. Now, I am not saying these harbingers of doom are the size of cars; they are noticeably bigger.

The way it works is a lamok (that’s Tagalog for mosquito) bites an individual already infected with the early stages of the virus. Then it finds someone else to bite. So not only was I unlucky enough to get bitten in broad daylight, probably while walking down the street in my town, but the insect had been one of the infected. I spent the next eight days in a hospital bed, on an IV, and close to needing a blood transfusion. The blood’s platelet count usually drops significantly with the virus, sometimes to a point that a person will actually experience internal bleeding. Just so you know, a normal platelet count is between 150,000-400,000. My count had gone from 155,000 on day three to 115,000 that evening, and by day six was down to 58,000. The fever is a continual 103 degrees for the duration of the virus. It is not all bad; the hallucinations can at least be an adventure. One night in particular I remember having to capture the dragon each time I wanted to fall asleep. Finally on day 8 my fever broke. My body slowly stopped aching and my platelet count started to rise again. Now I find that when I see a mosquito I jump back and start swatting at the air. What a wimp, huh?