Bryan Betty: Dengue fever

Dengue fever is in the news right now after the death of a young Samoan boy at Starship Hospital last week. As many New Zealanders travel to the Pacific Islands, the recent outbreak means it’s something to consider. 

The other interesting fact about dengue fever is as well as being relevant to the Pacific, it’s becoming more common around the world due to climate change – increasing temperature and humidity driving mosquito population and leading to more people being infected. 

   

What is it?  

• A mosquito-spread virus. You get it when a mosquito bites you that is infected with dengue fever.  
• Unlike malaria, it’s carried by the small mosquitoes that come out during the day. Not the evening/early morning mosquitoes that typically carry malaria. 
• It’s becoming more common around the world with climate change – with hotter more humid temperatures.  
• Endemic in Pacific, which is presently going through an outbreak.  
• Can actually now be found in places like far North Queensland.  
• It could it reach New Zealand one day – possibly with climate change.  

   

What happens if you are bitten by a mosquito carrying dengue fever?  

• Symptoms occur 4-10 days after the mosquito bite.  
• Typical symptoms: High fever, severe headache, pain behind the eyes, muscle and joint aches (has been referred to as ‘break bone fever’), nausea, vomiting, and skin rash.  
• Often people recover after 1-2 weeks.  
• Severe form is called haemorrhagic fever with bleeding, cardiovascular shock, and sometimes death.  
• Typically occurs when you get an infection a second time – not the first.  

   

What can we do treat it?  

• Important: There is no vaccine to prevent the disease, once you have it there is no treatment.  
• Just treat the symptoms:  
• Paracetamol, not ibuprofen or aspirin as this can increase bleeding risk.  
• Plenty of fluids and rest.  
• A majority will get better, however, if symptoms are severe, you need to see a doctor and may need the hospital. 

   

How do we prevent it?  

• Be aware that Pacific destinations Fiji, Tonga and Samoa have had recent outbreaks.  
• Outbreaks are often every 2-5 years with year-round risk.  
• Resorts often put in place protocols to reduce/eliminate mosquitoes.  
• If mosquitoes are around, protect against getting bitten with insect repellents, long sleeve shorts/pants, and mosquito nets. 

 

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack team podcast
from News Talks.

Speaker 2 (00:11):
That'd be it was such sad news. A twelve year
old Sarmon boy died in Auckland Starship Hospital last week
after contracting dingy fever. So he'd been really sick in
some more and then was transferred to New Zealand. But yeah,
someone media confirmed I think a day after he was
flown to New Zealand that he had died. So we
want to know a bit more about dingy fever and

(00:32):
the kind of risk that it can present in this
part of the world. Doctor Brian Betty is here with
us this morning. Kilder Brian, thank you for being with us.

Speaker 3 (00:40):
Ja.

Speaker 2 (00:40):
Yeah, I mean obviously this is a really you know,
really sad case, just just twelve years old. But for
those who don't know anything about dingy fever, what actually
is it?

Speaker 3 (00:50):
Yeah, no, look at something we do need to be
aware of because we often travel to the Pacific Islands
and so it's a mosquito spread virus, so you get
it from mosquito bites. So when you get bitten, dingy
fever can happen if that mosquito is infected with dingy fever.
Now it occurs with the small mosquitos that occur during
daylight or fly around during the day. Now, this is

(01:13):
very different from mosquitos that cause malaria, which occur early
morning or early evening, So it's a daytime mosquito that
actually causes the problem. Now we know it's endemic in
the Pacific Islands, so it tends to float around the
Pacific Islands and every two to five years it tends
to be a major outbreak of it, and that's actually
happening at the moment. It's Samoa tolerant Fiji in particular.

(01:35):
Now it is becoming more common around the world with
climate change. This is what's really interesting and not talked
about at the moment. So we've seen it in more
parts of the world. In fact, you can actually get
to North Queensland now and as temperatures become warmer, more humid,
mosquitos tend to spread. Dingy fever tends to spread, and
there's about four and a half million cases a year

(01:56):
around the world at the moment. Now the question has
could have reached New Zealand one day with climate change?
The answer is actually yes, and it's probably one of
the things we don't talk about enough in terms of
the spread of these types of diseases. So, yeah, endemic
in the Pacific. It's certainly an issue at the moment
which has led to this very tragic outcome.

Speaker 2 (02:15):
So what happens if you've bitten by a mosquito that
has FEV? Do you automatically?

Speaker 3 (02:20):
Well, not always. Now, it can be asymptomatic and some
people can get very mild illness. But what can happen
is is generally the infectional start to show itself four
to ten days after the mosquito bite. Now, the typical
symptoms are very high fever, severe headache, often pain between
the eyes, and very severe muscle or joint pain. And

(02:42):
colloquially it's been referred to as break bone fever. Some
of your listers may have heard of that phrase before,
and it can cause nausea and vomiting, the skin rash. Now,
typically it will get to better, get improved, and get
better after one to two weeks. Now, however, there is
a very severe form of it called dingy hemorrhagic fever. Now,

(03:02):
this typically occurs after the second infection, so you've been
acted once. What happens the immune system gets very primed
to the dingy fever. You get a second bite in
the second infection, and the immune system overreacts to it
and you get this very dangerous condition called hemorrhagic dingy fever,
and that can lead to very severe complications and in

(03:24):
some cases death. So yes, the second one that can
often be a real real problem if you get bitten.

Speaker 2 (03:30):
So there's no vaccine to prevent the disease. What do
you do? How do you treat it?

Speaker 3 (03:36):
Yeah? Yeah, so this is really important. So no, there
is no vaccine that you can prevent it, So you
can't go and see your doctor and get a vaccine
to prevent it. Bengy fever, there's no treatment, so there's
no antiviral treatment. So the only treatment that's available is
really supportive. So in mild cases, it's things like paracetamol,
plenty of fluids, and bed rest, and the majority will

(03:57):
slowly get better. However, if the symptoms get very severe,
you end up seeing a doctor, and in severe cases
you'll end up in hospital for supportive treatment things like
fluids and oxygen and sometimes I see you and things.
So yeah, no treatment, and that's actually a very very
important thing to realize about. Dingky fever.

Speaker 2 (04:17):
Yeah, so you've just got to prevent it. How do
you do that?

Speaker 3 (04:20):
Prevention is actually the way to go. So so look,
I mean, look, if you are traveling to the sub
islands and you're going to one of the resorts and things,
the rual resorts are very good at sort of keeping
mosquitos away. So they treat the grass, the areas, no
stagnant water, They do a whole lot of things to
prevent mosquitos. So it doesn't tend to be a problem.
It's going outside of the resorts into two areas where

(04:42):
mosquitos could be about that there is an issue. So
you have to protect yourself. So that's things like insect repellents,
especially repellents with something called deep in them, which which
stops the mosquitos. Long sleeve you know, tops or pants
are really really important, and during the day actually mosquito
yets if you're in those areas. So it's prevention and

(05:03):
mosquito bites are the only thing you can do, and
that's you need to be aware of.

Speaker 2 (05:07):
Hey, thanks, Brian, I appreciate your time here. Yeah, it's
some that is fascinating and you know, it could become
even more of an issue in years to come in
New Zealand of all places, which is yeah, I concerned.
I am. There's doctor Brian Betty with us this morning.

Speaker 1 (05:20):
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