Breakbone Fever: almost like the bends

It was a hot and sunny day as we entered the cooler, but humid jungle canopy to visit the ancient Oxtankah (osh-tahn-kah) Maya citadel site near Chetumal, on Mexico’s Caribbean coast. I was taking a break from diving the Mayan Coast. Some time into our hike, I glanced at my black T-shirt and noticed that hundreds of thirsty mosquitoes had attached themselves to me! I brushed them off, then borrowed some righteous bug juice to slather on my bare arms and other exposed flesh, and thought I’d be done with it.

Later that evening, I began itching scores of red welts that appeared where my T-shirt had covered me. “Ah, well, such is the price paid by fools who don’t dress for the occasion,” I thought, and applied anti-itch cream liberally.

Back at home less than a week later, I felt out of sorts: warm, headachy, and just plain achy, with noticeable joint pain. If I had been diving the day before, I’d have been worried about a good DCS hit, but I merely thought of the coughing, pasty-faced fellow passenger on the airplane and presumed I’d caught a touch of whatever he was spreading. A couple of Advil and I’d be right as rain.

But my temperature went higher, the headache dug in, and I felt big pain behind my eyes. I was exhausted. My muscles and joints all hurt. Nothing I took seemed to make it better. Finally, in a couple of days my temperature decreased a bit. Thank goodness it was going away. But the next day a rash developed on the backs of my hands. I wasn’t dying, but the idea of death seemed to be, well, less undesirable as I cowered under the sheets and tried to avoid any light because of that pain behind my eyes.

It turns out it wasn’t a gift from typhoid Charlie on the flight back. I had dengue fever, called “breakbone fever” some years ago for its joint and muscle pain. This arbovirus is transmitted by the bite of female mosquitoes of the Aedes genus that are generally tropical, bite by day, and occur most often near populated places—our discards give water places to collect and become breeding spots for mozzies.

Dengue is generally not dangerous, but can sometimes become the more serious dengue hemorrhagic fever or dengue shock syndrome, which can be fatal. Though the chances of contracting dengue hemorrhagic fever are slight for traveling divers (but 150,000 people do die from up to 100 million annual cases worldwide), as I learned, you don’t even want the common variety. There is no vaccine or cure for any form. It’s not uncommon in many areas preferred by divers, including Central America and the South Pacific. News week magazine reports that “Tahiti had tens of thousands of cases last year, several people died on Fiji of the severest form of dengue and Hawaii had its first epidemic (more than 100 cases) in 50 years. Already this year there has been an outbreak on remote Easter island.”

Preventing dengue means being aware of where the Aedes mozzies live, making good use of door and window screens, wearing light-colored clothing, long sleeves and trouser legs (perhaps impregnated with Permethrin, if the bitin’ is easy), and using a serious repellent like a thirty percent DEET solution on exposed skin (but precautions exist for children, and DEET can do a number on some plastics and synthetic fabrics).

Before traveling, check the U.S. Centers for Disease Control and Prevention Travel Web site at: http://www.cdc.gov/travel/ or you can use the toll-free number at 877-FYI-TRIP. The toll-free, fax-back number for requesting information is 888-232-3299. For more dengue information, check http://www.cdc.gov/ncidod/dvbid/dengue/index.htm. General information for protection against biting insects can be found at http://www.cdc.gov/travel/bugs.htm.