December 4, 2008 by Dr. Moy
Please Take all your precautions ASAP
It’s very important that you read, understand and pass this information to others living and visiting Sayulita and surrounding areas.
What is Dengue?
- Meet Mosquito
Dengue is an acute infectious disease caused by a virus (Denguevirus types 1, 2, 3 & 4) transmitted by a mosquito genre called “aedes”. It might produce a “no symptoms” presentation, an undifferentiated fever, a Classic Dengue Fever (CDF), an Hemorragic dengue (HD) or a Dengue Shock Syndrome (DSS).
Why should you be concerned by Dengue on these days?
Right now the season for dengue is low (it’s higher in the summer because the rainy season develops more mosquitoes) but a Dengue Alert has been promoted by the state healthcare system because of the presence of some cases in Nayarit recently.
What can we do to prevent the infection?
Clean your yard
As dengue is transmitted by a mosquito-human-mosquito cycle, the best we all can do to prevent the infecton is to: a) reduce the mosquito population and b) reduce the chances of getting bitten by mosquitoes.
As mosquitoes are developed in water we should take all necessary measures for physically and chemically cleaning all water containers exposed to the air. Mosquitoes need as less as 0.6 sq inch of exposed-to-the-air water to grow.
Using a DEET repellent is indicated, brand names available in Pharmacies and some stores in Sayulita are “Autan” & “Off”, applied every 4-6 hrs. There are also natural alternatives (citronella) as repellent but they have to be applied every 1-2 hrs, the most known brand name in the area is “Bye Bye Mosquito”.
Mosquito requires 0.6 sq inches of water to develop
You can also spray your room/house with insecticide or use the electric vaporizer known in Mexico as “plaquitas” for mosquitoes. Mosquito Nets to use around the beds are also available in some stores in sayulita.
Please take all necessary precautions to reduce dengue infection.
What are the symptoms?
Classic Dengue Fever (CDF) is also known as the “bonebreaker fever” or the “strike fever” presenting the following symptoms: sudden fever, frontal headache, muscle aches, joint pain, pain or pressure feeling behind the eyeballs that increases with eye movements and/or capillary fragility, that means that you can also have bleedings but it’s not diagnosed as an hemorrhagic dengue as the platelet count is over 100k per mm3. You should seek medical attention immediately if you present 2 or more of the symptoms mentioned above.
Please use nets around your bed
Hemorrhagic Dengue (HD) is actually a complication of CDF, in which the viral activity has destroyed part of the platelets of the patient. The diagnosis is made with a platelet count below 100k per mm3 and can be developed even 2 or 3 days after all the symptoms have disappeared. The symptoms are the same of CDF plus: abdominal pain, altered mental status, loss of consciousness, difficulty to breath, etc. Urgent hospital care is needed in case of HD as IV fluids, medications and platelet transfusion is needed to prevent a Dengue Shock Syndrome (DSS) which is the complication of an HD.
How is the diagnosis of Dengue made?
By the clinical onset of the symptoms
and laboratory tests (CBC and specific Immunology test for dengue).
What is the treatment for Dengue?
Dengue should be treated with Acetaminophen (Paracetamol) only, unless indicated by a doctor, other medications should be avoided, an increase in the amount of fluids taken and a full rest are also needed. Medical assessment is necessary to confirm or discard Dengue infection and to instate a good treatment for preventing the complications of dengue (HD & DSS)
Timelines of dengue:
Let’s start with the moment when Mosquito bites a person with Dengue virus in its active form. It takes between 8-12 days for the virus to replicate inside Mosquito to become infectious. Mosquito will have Dengue infection for the rest of its life which is of 15-30 days.
It takes 2-7 days (average of 5 days) for the virus to replicate inside the human and develop the symptoms of Dengue Fever mentioned above. The symptoms lasts between 5 to 10 days depending on several factors.
The highest peak of activity (bitting) of Mosquito is from 6am-8am and 5pm-7pm but it can bite you any time of the day.
If you think you have dengue, please contact any of the medical services available in the area as soon as possible.
Please, let’s take all the preventing actions to avoid dengue infections here in Sayulita is very easy and everyone can collaborate.
Thank you.
About Dr. Moy
hello Dr.Moi!
Do you, by chance, know what they are spraying out of the trucks at night? I would like to know what is in the air we are breathing….
Also, a year and a half ago I got Dengue Hemorrhagic – what are my chances of getting Dengue again and how severe will it be? I know there are 4 different types and you can only get each type once but am unclear as to whether DH is 2 types at once or if it is one type.
And what are the long term effects on the body after DH? Enemia?
H Tanasichuk:
I’m not too sure what a dog free beach area has to do with Dengue Fever as dogs have nothing to do with Dengue Fever.
I am thinking of traveling to Sayulita with my wife from Feb.27 to March 2. My wife is 27 weeks pregnant so we are concerned about Dengue. Would you recommend that we do not travel to tropical areas like Sayulita and risk the chance of getting Dengue Fever during this time? We were looking at staying at the Playa Escondido, which looks really great but all of the rooms are open air (with mosquito nets over the beds)…i imagine this increases the risks.
Do you have any advice for us?
Thank you so much for your time.
So far no patients have been reported in the last month, so its kind of “safe” to come to Sayulita, taking of course your own precautions.
I would recommend to apply a natural mosquito repellent, such as FLY-OUT or BYEBYE mosquito, they are good and ok to use in pregnancy (although they have to be applied very often (2-3 hrs)
I hope you enjoy Sayulita!
Saludos
I too was in Sayulita this fall and returned home with symptoms of Dengue. On November 8, 2009 my symptoms were so severe I was admitted to hospital for 9 days of intravenous narcotic anelgesia, anti-emetics and hydration. My platelet count dropped to 90,000 and white blood cell count to 1.0. This was a life threatening situation. It is now December 20, 2009 and I am still recovering at home. I was wearing insect repellant when this happened, so although individuals can make choices and attempt to reduce the risk, I believe that a community effort is necessary. Better spraying and sanitation and a dog free beach area would go a long way to increasing community protection from this terrible disease. We look forward to returning to Sayulita in February, but I am tempted to avoid it during the rainy season next year.
H Tanasichuk
Edmonton, Alberta Canada
I guess keeping stats on how many cases of Dengue fever are occuring in Sayulita is probably important. To this end I want to inform that two of us visiting Sayulita, (mid November 2009) in shorts and no bug spray, came down with Dengue fever. There is no cure for Dengue fever and you just have to ride it out, lots of rest and drinking fluids. My advice is simple don’t get bitten by mosquitos.
Thank you Dave for sharing your experience. It is indeed very important to avoid mosquito bites, although sometimes is nearly impossible. I’ve been very lucky so far as mosquitos have a very special attraction to my delicious bloody body hehehe even repellent is not effective for me. :S Saludos!
Hello Dr. Cuevas,
I want to thank you for your excellent and well written article on Dengue fever. I am sure it is no surprize to you just how much ignornance their is about this illness. In Vancouver, BC, where I received medical treatment, I bet the doctors had to go to the internet to read up on this disease. One question I would like to ask you. If you have been sick with Dengue fever once, what happens the next time, if you get bitten again. I have heard that if you have been bitten once and made sick, this will not give you any immunity against getting the disease next time. I have also heard that getting Denque fever a second time is a much more dangerous and possibly life threatening situation to be in. Can you tell me if this fact or fiction. Keep up the good work. Cheers: Dave Myles
Serology testing has confirmed acute dengue fever in the patient mentioned in my posting of 23 November 2009
Thanks a lot for posting this info Doc, we still concerned about Dengue here as it is still raining around here, so I think new cases will keep appearing. ‘ll keep posted. Saludos!
I just visited Sayulita. I am a Civil Engineer from Redwood City, Ca. Sayulita doesn’t have a medical problem as much as a sanitation engineering problem. The town has garbage everywhere. The runoff water onto the beach smells like sewer water. Horses and dogs defecate on the beach. Farm animals live in the town. To clean up l the town there must be proper garbage, water and animal control –that means getting rid of chickens, horses, farm animals etc. Changing human behavior. No dogs on the beach! In rural area these controls are not as necessary. Sayulita has grown to big to ignore these human health minimum standards. PV has done many things to improve sanitation in the last 30 years. Sayulita needs to follow their lead.
And today we are seeing another woman from Seattle who was visiting Sayalita and now has what is almost certainly dengue fever. Typical symptoms, rash, and laboratory results to this point. Of note, she was seen early in the course of her illness [about 5 days after arrival in Mexico] by Dr. Moises Cuevas, who felt this was dengue, and now, 5 days later, her course to this point bears this out.
Hola Dr. Cuevas,
Thank you for the info. since my wife is travelling to Sayulita tomorrow.
I have been working as an Emergency Room Doctor in the U.S. for the past 23 years.
We have a home in Sayulita, Nayarit.
I would like to work part-time in an Emergency Room in San Panchos or PV.
How can I obtain a medical license in Mexico?
Could you have the Emergency Room Director in San Panchos contact me?
Thank you for your help.
Jeff Audibert, M.D.
U.S. Cellphone- 479-633-4102
Pingback: Dengue Alert in Sayulita « Sayulita Doctor
thank you so much for taking the time to share this important information with us!!!
Thanks for your comments amigo!
I will translate them so everyone understands your words:
“IN GOOD TIME! GREAT ARTICLE. THE BASIS FOR PREVENTION OF DENGUE IS IN THE SOCIETY. ALL PERSONS ARE RESPONSIBLE FOR WHAT HAPPENS IN OUR COMMUNITY. WHEN THERE ARE SERIOUS PROBLEMS AND I MEAN MAJOR OUTBREAKS OF DENGUE FEVER AND HEMORRHAGIC DENGUE FEVER, IT’S BECAUSE SOCIAL PARTICIPATION IS SMALL. ITS TIME FOR A CHANGE IN US, AS PART OF SAYULITA OR NAVOJOA OR WHEREVER IT IS, THE CASE IS CERTAIN TO CHANGE ATTITUDES AND REMEMBER THAT EVERY CHANGES ARE MEANT TO IMPROVE. GRACIAS.”
EN HORA BUENA, EXCELENTE ARTÍCULO. LA BASE PARA LA PREVENCIÓN DEL DENGUE SE ENCUENTRA EN LA SOCIEDAD. TODAS LAS PERSONAS SOMOS RESPONSABLES DE LO QUE PASA EN NUESTRA COMUNIDAD. CUANDO HAY PROBLEMAS SERIOS Y ME REFIERO A BROTES IMPORTANTES DE FIEBRE POR DENGUE Y FIEBRE POR DENGUE HEMORRÁGICO, ES POR LA ESCASA PARTICIPACIÓN SOCIAL. ES TIEMPO DE PROMOVER UN CAMBIO EN NOSOTROS COMO PARTE DE SAYULITA O NAVOJOA, O DONDE SEA, EL CASO ES CAMBIAR CIERTAS ACTITUDES Y RECUERDEN QUE LOS CAMBIOS SON PARA MEJORAR. GRACIAS.
The advice above should be taken seriously. I treated 3 women [out of a group of 4 tourists] during December/January a year ago who developed dengue [confirmed by immunologic testing] on return to the US after a 9 day vacation in Sayalita. They didn’t travel anywhere else in the course of their trip.