The Russian caught dengue fever in Phuket and fell into a coma. What is known about the disease? Attention! coronavirus Mercedes in Thailand! Dengue fever in Thailand! zika virus! How to save money on a hotel or apartment on vacation

Bright, hot, yours - this is how many Russians imagine a holiday in Thailand. In this exotic, but already so “native” country for our compatriots all year round summer and holiday. But there are also many dangers there that tourists often don’t even want to think about. These include mosquitoes, carriers of terrible diseases.

It’s unlikely that Gerasim Grigoriev, a native of Barnaul, who last years lived in Thailand. One possibly unnoticed mosquito bite gave a man dengue fever. It's spicy viral disease, which in best case scenario accompanied by a rash, high fever and inflammation of the lymph nodes, and in the worst case, sees off to the cemetery.

Gerasim’s relatives are now in a panic looking for money for his treatment, because his medical insurance has expired, and being in a Thai hospital costs 150 thousand rubles a day.

At this time, many tourists, having read the news, thought: is it so easy that you can end up dying because of one mosquito?

Probably, it was this incident that made the officials of our Rospotrebnadzor grab their heads - the agency had already warned Russians about a dengue outbreak in South East Asia. By the way, this region includes not only Thailand, but also equally popular resorts among Russians in Vietnam, Cambodia and Indonesia (there is the island of Bali, beloved by many).

The sanitary department said that dengue fever is brought to our country quite often - over the past 6 years there have been 766 cases. In 2017 - 152.

According to the latest data from Rospotrebnadzor, last year more than 6 thousand people in Russia suffered from viral fevers, including dengue fever, which is 33% more than in 2016. Most Russians bring such “souvenirs” just from vacation - mainly from tropical countries in Asia and Africa.

Due to the modern lifestyle and the love of Russians for traveling to warm countries year-round, this disease has become quite common. The annual incidence is approximately 50 million people per year, says Irina Yartseva, DOC+ therapist.

Rospotrebnadzor delicately advised Russians to take a more responsible approach to choosing resorts, and Life figured out what dengue fever is and whether mosquitoes are really capable of causing death.

Killer mosquito

dengue fever, dengue, date disease, giraffe fever is different names one disease. Dengue used to be called bone fever or joint fever because one of the main symptoms of the disease is muscle and joint pain. Recently, doctors more often call this disease simply dengue.

According to WHO, more than 300 million people are infected with this fever every year, mainly in Asia, Africa and Latin America. The incidence usually increases during the rainy season - in each country it begins in different time(most often in May). The causative agents of the disease are considered to be mosquitoes of the genera Aedes albopictus and Aedes aegypti - they also carry the notorious Zika virus. Dengue is transmitted through the bite of female mosquitoes.

Malicious mosquitoes for the most part live within the city, namely in closed reservoirs (and next to them). Insects love heat and moisture - this explains their concentration in the tropics and subtropics. By the way, mosquitoes that carry fever also live in our country, namely in Sochi. Although there are much fewer of them there than in Thailand.

There are 4 serotypes (varieties) of dengue. If a person is attacked by one of them, then after recovery he will have lifelong immunity specifically to this type. But this will not protect it from other types of dengue. It also happens that a person becomes infected with several types of fever at once and the disease takes on an extremely severe form.

At first, the patient will feel as usual. About a week after the fatal bite, the fever will begin to manifest itself in full force. It is very important that doctors do not confuse dengue with any other disease - the same symptoms can occur, for example, even with the flu.

It is difficult to distinguish dengue fever from other types of fevers, since the symptoms are approximately similar. This can be done using a differential diagnostic test with high specificity,” said Maya Zagorets, a doctor at the Online Doctor service.

That is, simply put, you need to get tested in the hospital.

There are two types of dengue - classical and hemorrhagic. In the first case, we can assume that the patient got off easy. The main symptoms of this type of dengue are high fever, skin rash, itching, muscle and joint pain. This may also include cough, diarrhea and red eyes. Typically, the classic version of dengue fever lasts 7-10 days.

Dengue hemorrhagic fever is much more dangerous, but, in fairness, it must be said that it is much less common. This form is much more severe, and it is from it that people die - on average, the mortality rate reaches 50% of all cases.

With hemorrhagic fever, numerous bleedings are added to the symptoms of the classical version - from the nose, stomach, in women it can even begin uterine bleeding. At the same time, patients are not bothered by pain in the joints and muscles. There is an increase in the size of the liver and cervical lymph nodes. The disease is very difficult, the patient must be under the supervision of doctors who will stop the bleeding in time and relieve other symptoms. The disease begins to subside after about 10 days.

By the way, there is one interesting detail in the treatment of hemorrhagic fever.

Only paracetamol can be used as an antipyretic, since other drugs, especially aspirin, disrupt the process of platelet adhesion, thereby increasing vascular bleeding, explained therapist Irina Yartseva.

flushed out of the body pathogens which cause intoxication. Sometimes, to normalize the electrolyte balance (in other words, the level of fluid in the body), patients are given special droppers.

According to doctors, dengue hemorrhagic fever develops almost only in local residents. Mosquitoes bite them frequently, and people can be infected multiple times, with different strains of the virus.

Mosquito net instead of a bikini

The most effective methods prevention - killing mosquitoes. In cities where people get sick too often, access to closed reservoirs is usually limited. And if found high concentration They try to exterminate harmful mosquitoes and their larvae. Perhaps in the near future there will be more effective method protect yourself from the disease.

The first dengue vaccine was recently developed and approved. The manufacturer recommends it for use in people aged 9 to 45 years living in high-risk regions, said Stanislav Buholts, an infectious disease specialist at the Vitbiomed clinic. - Vaccination is carried out in three stages during the first year of life; according to research, the effectiveness of the vaccine after the third dose was 59%.

In the meantime, the main precaution is external protection against mosquitoes, that is mosquito net, closed clothing with long sleeves and repellents ( various ointments, creams, sprays against insects). Therefore, when you are packing for the tropics, do not forget to put it all in your suitcase along with a swimsuit, swimming trunks and sunglasses.

I myself have never had dengue fever (t-t-t), but some of my friends have not been so lucky. There are too many myths around this fever lately, so there is a need to write this post so that you understand what it is, whether you should be afraid, whether you need to take out insurance, and generally how to avoid it. Hope, this information will help you draw your conclusions.

Dengue fever has 4 strains (serotypes) that cause it, and 2 forms of the disease: classic Dengue fever and hemorrhagic. Hemorrhagic is more severe and dangerous form, it only happens to those who have already had one of the strains, and, unfortunately, to newborns, if the mother has already had dengue and the child has received antibodies from her. So when deciding to give birth in Thailand, take care to choose a very good hospital.

Those who have had Dengue at least once already know everything about its symptoms and treatment, and they are unlikely to read this post. Therefore, further I will write only in the context of the classical form.

Symptoms

Symptoms that confirm it will be the following: chills (temperature jumps sharply to 39-40′), headache, area behind the eyes, muscles, spine and joints (mainly knees), a rash appears on the skin. All this begins suddenly, without preliminary ailments, with rare exceptions when a person six to ten hours before obvious manifestation the disease begins headache and a feeling of being overwhelmed. Nausea, lack of appetite, swelling of the face, swollen lymph nodes, redness of the eyes and throat are also symptoms of dengue fever.

If the listed symptoms hit the mark on more than three points along with a high temperature, then there are three news for you: two good and one bad. The bad news is that about 4-7 days ago, somewhere on the veranda of a hotel or in the evening in a restaurant, you were bitten by an infected mosquito. Dengue fever is an acute viral disease, whose incubation period varies from 3 to 14 days, so many “lucky” ones experience symptoms already far from the tropics and tropical doctors. The good news is that you are not contagious to others, and Russian doctors have already learned to identify the symptoms of Dengue fever no worse than Thai ones.

Treatment

Under no circumstances should you take ASPIRIN, IBUPROFEN AND NUROFEN - this is the main thing you need to know when symptoms appear in the first days. Until you know whether you have Dengue or not, assume by default that this is it and take only PARACETAMOL to reduce the temperature.

People get sick in different ways, so on the Internet you can find how bad experience with a bunch of complications, including death, and cheerful reviews a la “it went away in a couple of days.” One is sick for 2 days, another can die for 2 weeks and then recover for another month. As a rule, the high temperature subsides after 3-4 days and then rises again for several days, 2 waves. During fever, red blood cells drop significantly in the blood, and it is from them that Dengue can be absolutely confirmed. True, a blood test can be done no earlier than 3-4 days of the course of the disease. That is, you will have already rewinded half the term by then.

There is no cure for Dengue fever; there is no cure for it at all. Whether you have it or not, be sure to go to the hospital. Although, according to some expats, there is no point in visiting a doctor at all if your symptoms are classic, and you should run to the doctors if hemorrhagic occurs. But I personally would play it safe, especially if we're talking about about the child, for them even the classical form can be difficult. So the doctor will be able to do the same blood test, tell you how to alleviate the disease, and hospitalize you if necessary. The main problem for children with high temperatures is dehydration, and sometimes this is impossible without an IV. However, an adult may also need an IV.

• The temperature is brought down with paracetamol every 4-6 hours, observing the dosage according to age and weight. Please note that paracetamol does not immediately provide a relief effect, so you can alleviate the condition by wiping with water.
• Must be permanent and drinking plenty of fluids, lots and lots of drinking. I repeat once again, do not ignore dehydration in your child, it comes unnoticed and quite quickly. If you see that the child is weakening, then immediately go to the hospital. Alternatively, force yourself to drink coconut water as a natural electrolyte. And you don’t have to buy the green coconuts themselves, you can get bottled water like this at 7-eleven, it will also work sports drinks with electrolytes.
• To avoid putting stress on sore joints - bed rest To relieve pain in the eye area - dim lights and curtains, and sleep. And to relieve aches throughout the body, Thais use papaya leaves. They buy it ready-made in a bottle at the pharmacy, or prepare it themselves - squeeze it in a juicer, make a decoction or mix it as a smoothie with honey. The taste is simply monstrous, but it is a very effective aid for Dengue.
• If a rash appears that itches terribly, use Calamine, an inexpensive but effective Thai remedy. Look at the skin more carefully; if small red dots appear, as with hickeys, it means the platelets in the blood have dropped to such a level that there is a danger of bleeding and now it is extremely undesirable to injure the skin and mucous membranes (brush your teeth only by rinsing, do not shave).

Due to nausea and lack of appetite, you will not eat, this only increases the loss of strength, and people literally walk holding onto the wall, and cannot even hold a spoon in their hands. In this regard, of course, Dengue fever is hell.

How to Avoid Dengue

Prevention

Dengue fever is transmitted by Aedes Aegypti and Aedes Albopictus mosquitoes. Mostly sources write about Edes aegypti, although when studying the topic of Dengue, I still did not understand what the difference is between egyptian and albopicus. Both are striped, both live in urban environments and easily tolerate near-zero air temperatures, breeding wherever there is water. After contracting an infection from bat, monkey or sick person, aedes remain carriers of infection until the end of their short lives.

The only effective preventive measure you can take for yourself against Dengue is use repellent frequently and mosquito repellent (available at 7-eleven), coils and fans in your hotel room or home. Every night before going to bed, inspect all the corners of the rooms and especially in the closets where these bastards like to hide. An electric fly swatter from Tesco will help you a lot with this - it’s an amazingly effective thing.

Peak danger hours are early morning and an hour after sunset, so avoid fresh water bodies and potentially dangerous areas during these hours, and carry repellent with you. Try to choose housing with mosquito nets on the windows and no swamp nearby. By the way, in good resorts they periodically do anti-mosquito treatment.

Mosquito vectors Aedes Aegypti - photo by Muhammad Mahdi Karim

Medical insurance

Another way to protect yourself from the effects of Dengue fever is to buy a normal health insurance (), which includes Dengue coverage. Look at my rating, it shows which ones are insured and which ones are not. Currently they do not cover Dengue: Consent, Gaide, VSK.

But, as I wrote above, with a short vacation it may well be that you will already be sick with Dengue at home. However, always take out medical insurance for your travels, especially for children. I know what I'm talking about.

Hospitalization for Dengue fever is not necessary, yes. But if your illness is severe or repeated, then you cannot do without a hospital, and medicine in Thailand is expensive. You can, of course, lie down in the state medical institution, but it will be a bed behind a curtain in a general ward for twenty people, with the appropriate surroundings. Or you can get sick in a separate ward of a decent hospital such as Bandon Hospital or Bangkok Hospital, with prices ranging from 5-20 thousand baht/day. You spend a week on a drip, then you work for half a year to pay off the financial gap. Insurance in this regard is a necessary thing; one hospitalization immediately takes off years of insurance.

According to data from the WHO (World Health Organization) website, a person who has recovered from Dengue receives lifelong immunity to a specific strain and partial (or temporary) immunity to some of the remaining three. If you are unlucky with the second part of the bonuses, then if you are bitten by a mosquito carrier of a different strain, you have every chance of getting sick even 2 months after recovery.

Dengue fever vaccination

For arrivals for a period of less than a year, a Dengue vaccination upon arrival does not make sense.

Since December 2015, information has been circulating on the Internet about a vaccination produced by Sanofi Pasteur based on the Dengvaxia vaccine, which supposedly protects comprehensively against all 4 strains at once. But upon closer examination of the issue, it turns out that the current vaccination against Dengue fever is not a panacea at all. On the WHO website you can find their recommendation - to use only locally, on local residents, in areas with a real epidemiological threat. As you understand, tourists do not belong to this category.

Firstly, for a full effect, vaccination against Dengue fever is done 3 times every six months: 0 months - 6 months - 12 months. That is, it will begin to work fully only in a year. Getting vaccinated upon arrival in Thailand, even if you plan to spend the winter, is a waste of time and money, because you can pay ~7,000 baht to doctors for services and a vaccine, and a week later get bitten by a stray mosquito in a nearby restaurant.

Secondly, even if you are willing to wait a year before flying to Thailand, such a vaccination is not given in Russia. Thirdly, the effectiveness of the vaccine depends on the strain (that is, it does not help against all serotypes equally) and on nuances such as age, serological status and some other scary words, from which I understood that this can be expressed as a percentage: on average 52%. That is, there is a 50/50 chance that the vaccine will work.

To summarize, the Dengue vaccination may only be of interest to Thais and foreigners whose residence period is one year or longer, which means they have a greater chance of contracting Dengue. Moreover, pick up how light form fever and hemorrhagic. In the latter case, vaccination against Dengue fever greatly helps to alleviate the complicated form, although there is also percentage Jumps a lot.

Chance of getting sick

As a summary, I would like to write to you the following: despite all of the above, you have less chance Getting sick with Dengue in the most mosquito-infested place in Thailand is different than getting the flu in a Thai subway car in winter. Dengue is a virus that occurs without snot, coughing and is not transmitted by air, unlike the flu. That is, you do not need to isolate yourself from your family or hide from your sick spouse.

The risk of complications or death with influenza is no less likely than with Dengue. It’s just that the media (and that’s where all the concerns and fears are spread) don’t like to talk about Russian scourges like tuleremic mosquitoes or encephalitis tick, and influenza epidemics have not raised ratings for a long time as much as the exotic Dengue fever, which is “raging” in Southeast Asia. As soon as you come across another panic message about a mass disease in Thailand, wave your hand at it and don’t even think about returning your tickets.

Rospotrebnadzor informs about the tense epidemiological situation regarding a number of diseases transmitted by mosquitoes.

Over the past 10-15 years, there has been a significant increase in the incidence of dengue fever in various regions. Outbreaks of this infection in 2017 were recorded in Brazil, Vietnam, Indonesia and Thailand.

There is currently an outbreak of dengue fever in Sri Lanka. A serious epidemiological situation has developed in 10 of the country’s 25 districts. The situation is particularly bad in the Western Province in the Kanutari region. In total, 48 thousand diseases with 77 deaths were registered throughout the country. Dengue fever outbreaks result from weather conditions that favor the breeding of the Aedas Aegypti mosquito. These mosquitoes are carriers viral fevers, including Dengue fever.

In recent years, the countries of Southeast Asia have been particularly popular among Russian tourists. Imported cases of dengue fever have become increasingly registered in Russia. In 2012, 63 cases were recorded, in 2013 – 170, in 2014 – 105 cases, in 2015 – 136, in 2016 – 140, in 11 months of 2017 – 152 cases.

When planning a vacation in countries with tropical and subtropical climates during the New Year holidays, it is important to check in advance with the territorial bodies of Rospotrebnadzor and with tour operators about the epidemiological situation in the country of your planned stay.

The Federal Tourism Agency asks tour operators to inform tourists about the epidemiological situation in regions of tropical and subtropical climates.

The Federal Tourism Agency also asks tourists to take into account information about the epidemiological situation in these regions when planning their trips.

Previously: 06/29/2017

The Federal Tourism Agency warned tourists about an outbreak of dengue fever in Sri Lanka

The Federal Tourism Agency calls on Russian tourists planning trips to Sri Lanka to take precautions in connection with the outbreak of Dengue fever there - 68 thousand cases of the disease have been registered.

Sri Lanka has recorded 68 thousand cases of dengue fever. The Federal Agency for Tourism (Rosturizm) urges Russian tourists planning trips to Sri Lanka to take precautions in connection with the outbreak of dengue fever there. The press service of the department reports this.

In order to prevent Dengue fever and other hemorrhagic fevers, Russian tourists are recommended to use personal protective equipment, for example, window mosquito nets and curtains. It is necessary to give preference to clothing with long sleeves, use materials treated with insecticide, and repellents. Upon returning to Russia, if the temperature rises, “inform the doctor about the fact of being in a country with a tropical climate,” writes the press service of Rostourism, citing Rospotrebnadzor.

Currently, 68 thousand cases of dengue fever have been reported in Sri Lanka, 205 of which resulted in fatal outcome. 10 of the country's 25 districts are at risk. The situation is particularly bad in the Western Province in the Kanutari region. The increase in incidence is associated with the sanitary and epidemiological situation in the region.

Dengue fever is an acute viral disease accompanied by fever, muscle and joint pain, rash, nausea and insomnia. Incorrect treatment or reinfection can lead to the development of a hemorrhagic, much more severe form of the disease with increased mortality, especially in children. Dengue, as well as chikungunya and Zika fevers, are transmitted by Aedes aegypti mosquitoes.

Dengue fever - Data from the World Health Organization (WHO)

Dengue Fever - Basic Facts

• Dengue is viral infection transmitted by mosquitoes.
• The infection causes a flu-like illness and sometimes leads to a potentially fatal complication called severe dengue.
• Behind last decades The global incidence of dengue has increased sharply.
• Currently, about half the world's population is at risk of the disease.
• Dengue is common in tropical and subtropical climates throughout the world, mainly in urban and peri-urban areas.
• Severe dengue is one of the leading causes serious illness and deaths among children and adults in some Asian and Latin American countries.
• There is no specific treatment for dengue/severe dengue, but thanks early detection and access to adequate health care, mortality rates can remain below 1%.
• Prevention and control of dengue depends on effective vector control measures, which include personal protection, sustainable vector control and chemical control.
• The dengue vaccine has been licensed by several national regulatory authorities for use in people aged 9–45 years living in endemic areas.

Dengue is a mosquito-borne viral disease that has been spreading rapidly across all WHO regions in recent years. The dengue virus is transmitted by female mosquitoes, mainly Aedes aegypti and, to a lesser extent, Ae. albopictus. This mosquito also transmits chikungunya, yellow fever and Zika infection. Dengue is widespread in the tropics, with local differences in risk depending largely on rainfall, temperature and spontaneous, rapid urbanization.

Severe dengue (also known as dengue hemorrhagic fever) was first recognized in the 1950s. during dengue epidemics in the Philippines and Thailand. Severe dengue now affects most Asian and Latin American countries and is one of the leading causes of hospitalization and death among children in these regions.

There are 4 different but closely related serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). After recovery from an infection caused by one of these serotypes, there is lifelong immunity to that particular serotype. However, cross-immunity to other serotypes after recovery is only partial and temporary. Subsequent infections with other serotypes increase the risk of developing severe dengue.

Global Dengue Burden

The true number of dengue cases is not fully reported and many cases are misclassified. One recent estimate estimates that 390 million people (95% confidence interval 284–528 million) become infected with dengue each year, of whom 96 million (67–136 million) have clinical manifestations(for any severity of the disease) 1. Another study on dengue prevalence estimates that 3.9 billion people in 128 countries are at risk of contracting dengue viruses. 2

Member states of the three WHO regions regularly report the annual number of cases. The number of reported cases increased from 2.2 million in 2010 to 3.5 million in 2015. Although the global burden of the disease is not fully known, the rollout of efforts to report all cases of dengue partly explains a sharp increase in the number of cases of the disease recorded in recent years.

Among others characteristic features This disease includes its epidemiological patterns, including the hyperendemicity of multiple dengue virus serotypes in many countries and the alarming consequences for both public health and global and national economies.

Before 1970, severe dengue epidemics occurred in only 9 countries. The disease is now endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean and the Western Region. Pacific Ocean. Most high level incidence is reported in the Region of the Americas, South-East Asia and the Western Pacific.

More than 1.2 million cases were reported in the Americas, Southeast Asia and the Western Pacific in 2008, and more than 3.2 million in 2015 (according to official data reported to WHO by member states). Recently, the number of reported cases has continued to rise. In 2015, there were 2.35 million dengue cases in America alone, 10,200 of which were severe dengue cases, resulting in 1,181 deaths.

As the disease spreads to new areas, not only do the number of cases increase, but explosive outbreaks occur. There is currently a threat of a possible dengue outbreak in Europe. In 2010, local transmission of dengue was first reported in France and Croatia, and imported cases were identified in three other European countries. In 2012, a dengue outbreak in the Madeira Islands, Portugal, resulted in more than 2,000 cases, and imported cases have been identified in 10 other European countries in addition to mainland Portugal. Among people returning from travel to low- and middle-income countries, dengue is the second most diagnosed cause of fever after malaria.

In 2013, cases occurred in Florida (United States of America) and Yunnan Province in China. Dengue also continues to affect several countries in South America, particularly Honduras, Costa Rica and Mexico. In Asia, Singapore reported an increase in cases after a gap of several years, and outbreaks have also been reported in Laos. 2014 saw an upward trend in the number of cases in the Cook Islands, Malaysia, Fiji and Vanuatu, with dengue type 3 (DEN 3) affecting the Pacific island countries after a 10-year hiatus. After a hiatus of more than 70 years, dengue has also been reported in Japan.

2015 was marked by major dengue outbreaks worldwide, with more than 169,000 cases reported in the Philippines and more than 111,000 suspected dengue cases in Malaysia, an increase in the number of cases compared to previous year by 59.5% and 16% respectively.

In Brazil alone, more than 1.5 million cases of the disease were reported in 2015, about 3 times more than in 2014. Additionally, in 2015, Delhi, India, experienced its largest outbreak since 2006, with more than 15,000 cases.

The outbreak occurred on Hawaii Island in the State of Hawaii, United States of America, where 181 cases were reported in 2015 and transmission continues into 2016. Cases continue to be reported in the Pacific island nations of Fiji, Tonga and French Polynesia.

An estimated 500,000 people with severe dengue require hospitalization each year, the vast majority of whom are children. About 2.5% of them die.

Transmission of infection

Mosquitoes are the main vectors of dengue Aedes aegypti. The virus is transmitted to humans through the bites of infected female mosquitoes. After incubation period, lasting 4-10 days, an infected mosquito is capable of transmitting the virus for the rest of its life.

Infected people are the main carriers of viruses and facilitate their reproduction, serving as a source of viruses for uninfected mosquitoes. Patients already infected with dengue virus can transmit the infection (for 4-5 days; maximum 12 days) through Aedes mosquitoes after they first show symptoms of the disease.

Mosquitoes Aedes aegypti They live in urban environments and breed mainly in artificial containers. Unlike other mosquitoes Ae. Aegypti feed during the day; Their peak biting times are in the early morning and evening before sunset. For each feeding period, the female Ae. Aegypti bites a large number of people.

Aedes albopictus, the second most important vector of dengue in Asia, has spread to North America and more than 25 countries in the European region, largely as a result of the international trade in waste tires (which provide breeding habitat) and the movement of goods (eg decorative bamboo). Ae. Albopictus easily adapt to new environments and can therefore survive in colder areas of Europe. The reasons for their spread are tolerance to temperatures below zero, hibernation and the ability to take refuge in microenvironments.

Characteristics

Dengue is a severe flu-like illness that affects both infants and early age, and adults, but rarely leads to death.

Dengue should be suspected when a high fever (40°C/104°F) is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen lymph nodes or rash. Symptoms usually last 2-7 days after an incubation period of 4-10 days after the bite of an infected mosquito.

Severe dengue is a potentially fatal complication associated with plasma leakage, fluid accumulation, respiratory failure, heavy bleeding or organ damage. Warning signs appear 3-7 days after the first symptoms along with a decrease in temperature (below 38°C/100°F) and include severe abdominal pain, uncontrollable vomiting, rapid breathing, bleeding gums, fatigue, agitation and blood in the vomit. masses. The subsequent 24-48 hours of this critical stage can be fatal; proper medical care to prevent complications and death.

Treatment

There is no specific treatment for dengue fever.

In cases of severe dengue health care doctors and nurses with expertise in the presentation and progression of the disease can help save lives and reduce mortality rates from more than 20% to less than 1%. When treating severe dengue, maintaining the patient's body fluids at appropriate levels is critical.

Immunization

In late 2015 and early 2016, the first dengue vaccine, Dengvaxia (CYD-TDV) from Sanofi Pasteur, was registered in a number of countries for use in people aged 9–45 years living in endemic areas.

WHO recommends that countries consider the use of CYD-TDV dengue vaccine only in geographical areas (national or subnational) where epidemiological data indicate high incidence. The full text of the recommendations is presented in the WHO position paper on dengue:

Other tetravalent live attenuated vaccines are in development, with Stage III clinical trials, and several other vaccine candidates (based on subunit, DNA and purified inactivated viral platforms) are at more early stages clinical development. WHO provides technical advice and guidance to countries and private partners to support research to develop vaccines and evaluate their effectiveness. The Strategic Advisory Group of Experts (SAGE) is expected to review dengue vaccine recommendations in April 2016.

Prevention and control

Currently, the only way to control or prevent the transmission of dengue virus is to control the mosquito vector through the following measures:

• preventing mosquitoes from accessing oviposition sites by controlling the condition environment and related changes;
• proper disposal of solid waste and destruction of man-made habitats;
• storing household water supplies in closed containers and emptying and washing them weekly;
• applying appropriate insecticides to water containers stored outdoors;
• usage individual funds protection such as window mosquito nets, long sleeves, insecticide-treated materials, coils and vaporizers;
• improving the participation and mobilization of individual communities for sustainable vector control;
• During disease outbreaks, emergency vector control measures may also include the use of insecticide sprays;
• Active monitoring and surveillance of vectors is necessary to determine the effectiveness of vector control activities.

Each of us thinks of a holiday in Thailand as a great way to spend time with friends in another country, because it’s always summer there, and the prices aren’t too bad. The country has become practically “native” for Russians, but few vacationers suspect the dangers that Thailand poses. The first of them is mosquitoes, carriers of dangerous diseases.

A native of Russia, Gerasim Grigoriev, went to live in Thailand several years ago and also did not think about what dangers the country could present to him. A simple mosquito bite gave him dengue fever. The disease is very serious, since the reaction can be different: either the lymph nodes become inflamed and the temperature rises, or the person dies.

Now the man is in a coma, and relatives and friends are trying to raise money for Gerasim’s treatment, since the insurance has expired, and it is simply not possible to pay more than 100 thousand a day for the hospital.

Having learned about this story, many vacationers began to wonder: is it really possible to fall into a coma from an ordinary mosquito bite?

The case with Gerasim forced the authorities to take control of the situation. Rospotrebnadzor began warning people about the dangers of traveling abroad due to an outbreak of fever in East Asian countries. Moreover, the number of countries also includes Vietnam and the island of Bali, beloved by Russians.

According to experts from the department, dengue fever has become a fairly common occurrence. Over the past few years there have been only 750 cases, but in 2017 there were as many as 150 cases!

According to Rospotrebnadzor, there was an outbreak of fever in 2017, as the number of cases reached 6,100 people! The number of patients has increased by as much as 30% compared to previous years. Interestingly, the vast majority of patients are tourists who bring fever into the country from the tropics.

Currently, tourists from Russia love to travel to warm countries such as Thailand or Vietnam. In this regard, the number of cases is only growing every year. Over the year, the total number of patients ranges from 47 to 52 million people,” says Irina Yartseva, doctor at DOC+.

Authorities and doctors advised tourists to choose countries for their holidays more carefully and learn more about the diseases that can be “acquired” there. Now let's talk about the ill-fated dengue fever and find out how mosquitoes can literally kill a person with one bite?

killer insect

Dengue fever has other names, but they characterize the same disease: giraffe fever, as well as date disease. In the past, this disease was called bone crusher, and for good reason, because the first thing you feel when infected is severe pain in bones and joints. But nowadays the disease has been renamed dengue.

According to experts, about three hundred million people are infected with fever every year. This happens most often in Africa or Asian countries. Most often, people become infected during the rainy season, when mosquitoes become most active. Considering the fact that the rainy season begins at different times in each country, this makes it difficult to choose a country for a holiday. Mosquito vectors also cause a disease called Zika virus. But fever is transmitted only by female mosquitoes through their bite.

Killer insects live in humid and warm places; these are the most favorable conditions for them. That is why infections most often occur in places near water bodies. By the way, infected mosquitoes also live in Russia, more precisely, in Sochi. But their number is insignificant when compared with Thailand.

There are 4 types of dengue disease, that is, a person bitten by a mosquito can get one of four types of fever. The interesting thing is that if you recover from one type of dengue, then for that particular type there will be lifelong immunity. But for the other 3, immunity will not work. And if a person becomes infected with several forms at once, the consequences will be severe.

At first it will be a normal bite, which will begin to manifest itself after 7 days. In this situation the most important factor is that doctors immediately diagnose correct diagnosis, since dengue fever can be easily confused even with regular flu.

The differences between fever and other diseases like the flu are so slight that it is very easy to confuse them. It is possible to find out what a person is sick with only through diagnostics and tests, says Maya Zagorets, doctor of the Online Doctor service.

Speaking in simple language, your tests will be needed at a medical facility.

Doctors divide fever into 2 types: classic and hemorrhagic. At classic man, to put it mildly, lucky. When infected, it will cause itching and pain in the joints and bones. Sometimes the eyes become red and loose stool. Recovery from this type of fever takes about a week.

The second type is much worse, although it is less common. Hemorrhagic fever can easily kill the patient. The mortality rate from dengue of the second type is about 50%.

With this type of fever, a person experiences symptoms not only of the first type of disease, but also new ones are added: constant bleeding. Bleeding may come from the nose internal organs, and in women even from the uterus! But those who are sick do not feel pain in the bones. A person's liver and lymph nodes become enlarged. Naturally, it is difficult for a person to endure such symptoms, which is why the mortality rate is so high. The sick person must be under the supervision of specialists constantly, so that they bring down the fever and stop constant bleeding. After 8-10 days, the symptoms of the disease will begin to subside.

Another interesting and very important fact in the treatment of the second type of dengue fever.

In order to bring down the temperature, doctors are required to use only paracetamol, since other drugs destroy the platelet bonding process, which only intensifies bleeding, says Irina Yartseva.

By the way, there is simply no single method of treating the disease. A sick person is placed under the supervision of doctors, where they will lower his temperature, stop the bleeding and give him painkillers. Another one important detail- a person needs to drink a lot. Different liquids will remove toxins and microorganisms from the body faster. Sometimes patients may be given a drip in order to normalize the balance of water in the body. This happens if the patient simply cannot drink a lot of fluid on his own.

As medical workers say. institutions, usually only local residents are susceptible to infection with this virus, since mosquitoes bite them much more often than tourists. Plus, they are usually infected with several types of fever at once.

Instead of a swimsuit, a protective suit.

The only solution to the problem is the complete extermination of mosquitoes. In places where contamination is most common, bodies of water are fenced off by the authorities, and special services destroy infected individuals. In our opinion, experts will soon find another, more effective solution to persistent infections.

By the way, a few weeks ago the first drug was tried to cure a patient with dengue fever. The patient's age must be from 9 to 45 years. The vaccine is manufactured with an emphasis on use by local residents, says a medical worker. institutions "Vitbiomed" Stanislav Buholts. - A person needs to inject the medicine three times. During the first year of life in dangerous places. According to doctors, after the third use, the effectiveness of the medicine is almost 60%.

But this is only the first step to solve the problem, and for now we recommend tourists only one thing - to wear less revealing outfits and not to be seen by mosquitoes when undressed. Another solution would be special ointments, creams and other products that protect killer mosquitoes. Caution is the most important thing, so you shouldn’t forget about your health even while vacationing in another country.

Dengue fever- a disease typical of Asia, with a name that is exotic for Russian perception. Meanwhile, the number of dengue cases per year around the world is 10 times less than the flu. The mortality rate is almost the same as the flu. Although in Dengue this figure can sometimes be higher and sometimes lower, BUT - a severe form of Dengue, which can lead to death, affects mainly local residents - Asians. The classic form of Dengue, which affects tourists, is usually not dangerous and has a mortality rate much lower than that of the flu. Now let’s take a closer look at what these conclusions are based on.

Of course it's terrible when someone gets sick. No one needs to get sick. But what prompted me to write this post is that the Russian media really like to harp on this topic, calling Dengue deadly dangerous disease and scaring Russian tourists. Therefore, I decided to post here all the statistics that I could find in an understandable and accessible form.

Dengue fever in Thailand- it's almost like the flu in Russia. This is simply a name that is not familiar to Russian ears, with which the media likes to intimidate our citizens who are willing to do everything unknown. During the three years of living in Thailand, 4 of my friends got sick with Dengue, one of whom did not go to the doctors, but got sick at home.

Dengue is transmitted by common mosquitoes and the disease occurs after a bite. Such a mosquito can be “met” anywhere in Thailand, but most of them are in the central regions of the country. Therefore, you need to protect yourself as much as possible from mosquito bites: there are many different sprays on sale here, and a fumigator is a great help for the home.

Symptoms of classic dengue fever are very similar to the flu or a cold, but are more severely tolerated: the temperature can rise to 39-40 degrees, cough, bone aches, chills, headache. From such high temperature a person can just sleep for several days and nothing else... A rash may appear on the body, which lasts about a week. The disease usually ends favorably, in about a week. There is no specific treatment, there are only supportive procedures (droppers, etc.). That is, Dengue is not treated, but supported by the body until it copes with the disease, but it is better, of course, to do an analysis and make sure that it is Dengue.

But there is another type of Dengue. It is precisely this that the Thais are wary of and it is precisely because of it that such a fuss is being raised in the press.

Dengue hemorrhagic fever - acute form classic dengue fever, which develops only in local residents in areas where dengue is endemic this disease. That is, if we talk about Thailand - only among Thais, or farangs who have lived in Thailand for a long time, who have repeatedly suffered from classic Dengue. This form of Dengue is severe, the rash turns into blisters, and possible gastrointestinal bleeding etc.

Now some comparative statistics on Dengue and Influenza

Flu statistics

Every year, up to 500 million people fall ill around the world. According to WHO estimates, from influenza during seasonal epidemics in the world, from 250 to 500 thousand people die annually (most of them are over 65 years old), in some years the number of deaths can reach a million. The mortality rate is about 0.2%.

Dengue Statistics

According to the latest WHO estimates, 50-100 million cases of dengue infection may occur annually worldwide. The percentage of mortality varies at different times and can reach 2.5%, taking into account those sick with hemorrhagic fever during epidemics. In 2012, the mortality rate from Dengue in Thailand was 0.1%, taking into account hemorrhagic type, which is really scary and only locals get sick with it.

Conclusion: Dengue cases around the world are 10 times less than influenza. Mortality rate is almost the same percentage. Dengue may have more, but severe form of Dengue with possible fatal Only local residents, Asians, get sick.

Some more statistics

Thailand's population is about 70 million
The population of Russia is about 140 million

Number of Dengue cases in Thailand(2012): 74,250 people (79 deaths) which is about 0.1%. The highest incidence rate occurs in the central regions of Thailand.

In Russia Every year, from 27 to 41 million cases of influenza and other acute respiratory viral infections are registered.

That is, taking into account the difference in population, there are approximately 200 times more cases of influenza in Russia than in Thailand.

Dengue in Russians returning from Thailand: In total, 584 thousand people visited Thailand in January-March 2013. Dengue was brought to Russia by about 30 people.

That is, 0.005% of all Russian tourists. It seems to me that the percentage of Thais who traveled to Russia and returned to Thailand with the flu may be higher. I couldn’t find any official statistics on these cases on the Internet. Apparently the media is not interested.

(c) Olga Salii. Copying material.

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