Pack your insect repellent! Dengue fever in Curacao

[kpickerell]

Bob, When were you there? We were at Habitat from Nov. 13-20. If you see a rash on your legs or back, it's probably dengue. Other symptoms are extremely painful headaches at the base of the neck or behind the eyes and high fever. If you haven't had blood work, you need to have your blood and platelet levels checked. Hope you feel better soon.

 

[swamp diver]

We leave for Belize in 2 months. We don't want a repeat!!!

There is currently an outbreak of dengue in Belize so you certainly would want to take the necessary precautions in order to prevent a second infection and finding out the serotype you were exposed to in Curacao would be beneficial.

The US hospitals normally only look for antibody to the dengue virus and don't do the serotyping. You could try emaling the ministry of health on the island and ask them for the serotype but we have had better luck in similar Caribbean dengue cases sending the question directly to the embassy in Ottawa ( or Washington) and let them find the right internal contacts for the information. If you tell them you were infected recently in Curacao and will be entering a second area with dengue they will usually respond favorably as normally many of these tourist regions underreport cases or downplay these outbreaks completely for obvious economic reasons.

In the past these outbreaks were often only of one serotype but with the spread of the disease we are seeing multiple strained outbreaks which makes the risk of complications higher fo those populations and individuals exposed to their second or thrid dengue strain.

Fortunaely there are several vaccines on the way but last time I checked were in phase 2B trials so about another couple years to market.

Your risk will be much lower if you are not in Belize City or if on a live-aboard, but even out on the Cayes there would be some risk as infected people travel back and forth from the capital. It is hard to find good information on the true risk of the complications in a healthy adult Westerner who is exposed to a second strain, but there certainly is some increased risk for dengue hemorrhagic fever.

If it was me I would likely still go but be extra careful with mosquito bite prevention, and if it looked like I was unlucky enough to contract a second infection then I'd either return home immediately where health care is better or find my way to the best hospital in the region which is usually the university teaching hospital. Odds are on a one week trip that given dengue's incubation period symptoms would not start until after one was back on home turf. For each person though this this risk assessment will be different and as a result decisions should be personalized. If you have access to a tropical disease clinic in your home town you might want to review your case with them.

The Dengue picture in Belize, not looking good | Woodshed Environment Coalition

Belize faces Dengue Outbreak - The Guardian Newspaper

 

[ronski101]

well, there goes our planned trip to Curacao. Hope they don't have any breakouts in Bonaire

 

[DandyDon]

well, there goes our planned trip to Curacao. Hope they don't have any breakouts in Bonaire

You really need to protect against it in all popular, tropical destinations...

Worldwide map: DengueMap | A CDC-HealthMap Collaboration

 

[DeputyDan]

I got the dengue in Belize and I remember exactly when I was bitten - on the hike back from the ATM Cave.

Even so - the trip was so worth it!

 

[darook]

Dengue was affecting the staff of the dive operation we were diving with when we were in Curacao in Oct. We escaped without any infection but were careful about mosquitoes. Up here in the frozen North we are safe now but in the summer we are at risk of West Nile from skeeters and Lyme disease from deer ticks. Since we live with risk a good chunk of the year I am willing to risk it to dive wonderful sites or just go outside wearing less than 10 pounds of clothes in the winter.

 

[chauncy19]

kpickerell,
have the rash, the high fever and neck pain but not headache and behind the eye pain. I have not yet had any blood work done, will have to look into that. have not really thought out any implications from Dengue just concentrating on recovering right now. Diving was great on Curacao despite rain induced visibility reduction. Although coral blanching is unnerving.

 

[chauncy19]

forgot to add was there Nov 17-Nov 30th.

 

[kpickerell]

It is affecting all of the ABC islands. I'm a travel agent, and I specialize in dive travel. While I am not a physician, I am advising all of my clients who travel to endemic areas, to see a doctor in order to at least get doxycycline or malarone and to use appropriate bug spray as a preventative. It won't keep me from traveling, but I believe that with forums such as this, we can be proactive, educated, stay safe, and tell the diving/traveling populace. Good advice from Swamp Doctor is that we need to report it to the appropriate agencies!

Even my cruise clients who believe they aren't at risk with simple stops in Belize, Mexico or Honduras need to take precautions because the shore excursions are often in jungle environments (i.e., Altan Ha, Belize zoo, ziplining, hiking, mangrove tours, cenotes, etc.)

If you believe you have contracted dengue, you definitely need to see a doctor (see Swamp Doctor's advise). My husband's blood and platelet levels were so skewed that it was affecting his liver and kidneys.

 

[DandyDon]

Such a large amount of misinformation on this thread! Read the CDC discussions and warnings, please...!

It is affecting all of the ABC islands. I'm a travel agent, and I specialize in dive travel. While I am not a physician, I am advising all of my clients who travel to endemic areas, to see a doctor in order to at least get doxycycline or malarone and to use appropriate bug spray as a preventative. It won't keep me from traveling, but I believe that with forums such as this, we can be proactive, educated, stay safe, and tell the diving/traveling populace. Good advice from Swamp Doctor is that we need to report it to the appropriate agencies!

Even my cruise clients who believe they aren't at risk with simple stops in Belize, Mexico or Honduras need to take precautions because the shore excursions are often in jungle environments (i.e., Altan Ha, Belize zoo, ziplining, hiking, mangrove tours, cenotes, etc.)

If you believe you have contracted dengue, you definitely need to see a doctor (see Swamp Doctor's advise). My husband's blood and platelet levels were so skewed that it was affecting his liver and kidneys.

You may want to read Swamp Diver's post again.

Doxycycline or malarone will not prevent Dengue. Those are prophylactics for malaria. Malarone is often prescribed for trips to other parts of the world where chloroquine no longer prevents malaria. Most of the Carribean region's malaria is still sensitive to chloroquine so that is the drug of choice for that area. Personally I would avoid doxycycline too as it seems to make one's skin more sensitive to sun burning. I think you missed all the way around, sorry.

The only prevention for Dengue is avoiding mosquito bites. The mosquito bites during the day time. There is no specific treatment apart from rest and fluids.

Correct! Cover & spray

Good post. I take Malarone, not sure if it works for dengue but I like it over doxy for malaria protection. Sorry to hear about your husband. Hope he gets better soon!

[-]Wrong drug for the area[/-] Correction: there are some benefits to using malarone to prevent malaria even in areas where chloroquine still works well, but neither have anything to do with preventing dengue.