Pack your insect repellent! Dengue fever in Curacao

[lmorin]

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

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.

Correct! Cover & spray

Wrong drug for the area

Let's repeat it so it will, perhaps, sink in. In addition to the above, neither doxycycline or malarone will relieve symptoms of Dengue. In other words, don't take either drug to combat Dengue.

 

[kpickerell]

There does seem to be some conflict since I have a board certified hematologist who recommends doxy. He said the prevention for dengue is similar to what you would do to prevent malaria. Since many of the areas we travel to are endemic for both dengue and malaria (as well as a host of other nasties), my husband now must take something. You are correct...unfortunately there is no drug that is 100% effective. Paludrine's side effect is nausea; chloroquine's is nausea and blurred vision; malarone, although free of side effects, is expensive. I use 50% sunblock (as everyone should), so I'm not as concerned about sunburn. I've used doxy for years when traveling in India, Africa, Asia and the Caribbean with no ill effects. It may not be the drug recommended by doctors for everyone. That's just what was advised in the past for me. I will mention that it wasn't prescribed just as a preventative for malaria, but so that I could avoid other things, too.

I have read the CDC's report, as well as travel adviseries from the State Department. My advice was, and still is, that travelers who are going to regions that are endemic (malaria, dengue, bot flies, whatever.) need to see a physician (one who's knowledgable of tropical diseases because there are many who are not) and take appropriate precautions.

And yes, yes, yes... cover and spray!!! I had my elderly parents with me who aren't in the best of health anyway. I shudder to think of the consequences had it been one of them affected.

 

[kpickerell]

It has never been suggested that doxy or malarone be taken to relieve symptoms of malaria or dengue. One must simply ride it out with fluids and Tylenol.

 

[DandyDon]

Excerpting some key points...

There does seem to be some conflict since I have a board certified hematologist who recommends doxy. He said the prevention for dengue is similar to what you would do to prevent malaria. Since many of the areas we travel to are endemic for both dengue and malaria (as well as a host of other nasties), my husband now must take something. You are correct...unfortunately there is no drug that is 100% effective. Paludrine's side effect is nausea; chloroquine's is nausea and blurred vision; malarone, although free of side effects, is expensive.

Okay, you might discuss this in more detail with your hematologist as there may simply be some misunderstanding. While there is some truth to "prevention for dengue is similar to what you would do to prevent malaria," I think the only similarities have to do with avoiding mosquito bites, as doxycycline and malarone have no known value at all in preventing or treating dengue. There are some sites around the internet that suggest otherwise but I think that's just false science. When in doubt, go to the CDC, then store the pages on your laptop or print them out to discuss with your doctor. I've done that with my doc, who happens to be from a part of Mexico with no mosquito problems, and he was fine with it.

I use 50% sunblock (as everyone should), so I'm not as concerned about sunburn.

I suppose you mean 50 spf? That's fine as long as it is bio-friendly sunblock. Many sunblocks sold today are horribly damaging to coral reefs.

I have read the CDC's report, as well as travel adviseries from the State Department. My advice was, and still is, that travelers who are going to regions that are endemic (malaria, dengue, bot flies, whatever.) need to see a physician (one who's knowledgable of tropical diseases because there are many who are not) and take appropriate precautions.

That is better stated than this previous statement.

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...

But with the disease subject of this thread, dengue, avoiding bites is your only hope.

 

[Dirty-Dog]

There does seem to be some conflict since I have a board certified hematologist who recommends doxy. He said the prevention for dengue is similar to what you would do to prevent malaria. Since many of the areas we travel to are endemic for both dengue and malaria (as well as a host of other nasties), my husband now must take something. You are correct...unfortunately there is no drug that is 100% effective. Paludrine's side effect is nausea; chloroquine's is nausea and blurred vision; malarone, although free of side effects, is expensive. I use 50% sunblock (as everyone should), so I'm not as concerned about sunburn. I've used doxy for years when traveling in India, Africa, Asia and the Caribbean with no ill effects. It may not be the drug recommended by doctors for everyone. That's just what was advised in the past for me. I will mention that it wasn't prescribed just as a preventative for malaria, but so that I could avoid other things, too.

I have read the CDC's report, as well as travel adviseries from the State Department. My advice was, and still is, that travelers who are going to regions that are endemic (malaria, dengue, bot flies, whatever.) need to see a physician (one who's knowledgable of tropical diseases because there are many who are not) and take appropriate precautions.

And yes, yes, yes... cover and spray!!! I had my elderly parents with me who aren't in the best of health anyway. I shudder to think of the consequences had it been one of them affected.

I suspect you may be misunderstanding some of what your hematologist has said. No medication currently available will do anything to decrease your chances of contracting denque fever if you're bitten by an infectious mosquito. Malaria, yes, but not denque.

As for your statement that malarone is "free of side effects", that is just nonsense. NO medication is free of side effects. Hell, even tap water has side effects. The reactions most commonly associated with malarone include cough, diarrhea, dizziness, headache, loss of appetite, mouth sores, nausea, vomiting, stomach cramps, and generalized weakness. Obviously, that doesn't include the reactions of people who are actually allergic to the drug. And I'm certain it's not a complete list either, it's just what I can think of off the top of my head.

 

[B Lo]

Make an appointment with an M.D. who is board certified in infectious diseases (or at least internal medicine) rather than asking armchair experts on a forum if you are truly concerned that you or someone you care about may be at risk of picking up a mosquito-borne illness.

 

[Korsu]

I have to agree with DD there is a lot of misinformation on this thread.
Malaria is a parasitic disease while Dengue is viral. While both have mosquito vectors there are two different genus of mosquitoes involved. A. aegypti (Dengue) is indeed a mosquito that bites mostly during the day.
Curacao and the ABCs have had record rainfall this season and there are no mosquito eradication efforts to speak of on the island. None the less Dengue (Break bone fever) has been present for years throughout the Caribbean and has also now been confirmed in Fla and I believe Texas. The specific mosquito is particularly drought resistant so when the dry season returns to Curacao it is unlikely that Dengue will go away. (In fact last year was very dry on the island.) The number of real vs. reported cases on the island is not at all clear. Many people get a febrile illness and are told they have Dengue and are never tested for the Ab. This is also the flu season with many foreign visitors so I think locals might call any illness Dengue. This is not to say that Dengue doesn't exist and that there aren't more mosquitoes right now but cover and spray still is the best advice. For what it's worth I have been on Curacao for three years without a major mosquito borne illness.

 

[TwoBitTxn]

Yes, Texas, as far north as Huntsville, has periodic outbreaks of Dengue.

 

[morecowbells]

In addition to seeing a hematologist, I agree with B lo that it would be wise to see an Infectious Disease MD as well. Four years ago I suffered from a brown recluse spider (nasty ba$tards)bite on my neck. For the hemolytic anemia I saw a hemotologist. However it was the Infectous Disease MD who was able to come up with a plan to get me out of the dangerous, life threatening period of this illness. Thanks for sharing your story. I admit that I have become complacent in using DEET. ALl it takes is one bite...

 

[Korsu]

Sorry for not checking all the posts for this link. Curacao Sunshine reminded me of it and the CDC is a good source for infectious disease info. (It is worth noting it again.)

Chapter 5 - Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) - 2010 Yellow Book | CDC Travelers' Health

If you are traveling to Curacao, the way to stay safe is to remain under water for as much time as possible. I have not seen a mosquito at 60 feet, so far.