NY Travel Clinic

Dengue cases in Malaysia

The CDC is warning travellers that more than 35,700 cases of dengue fever have been reported in Malaysia in 2015.

Dengue is a disease caused by dengue viruses and is transmitted to humans by an infected mosquito. The Aedes aegypti mosquito is the most important vector of dengue viruses in the Western Hemisphere.  The disease can be lethal, so if you have to travel to Malaysia, it’s essential you try to prevent being infected with dengue.

Dengue hemorrhagic fever is caused by the same viruses that cause dengue fever, and is a more severe form of dengue. Itcan be fatal if it’s not properly treated

Prevention

There is no vaccine against dengue, but you can try to prevent it by protecting yourself against mosquito bites.  Avoid the outdoors at dawn, dusk and early evening.

Wear long-sleeved shirts and long pants, and hats.Use permethrin-treated clothes and gear.  Use insect repellents that contain oil of lemon eucalyptus, DEET, Picaridin, or IR3535.  If you use sunscreen, apply sunscreen first and then the insect repellent.
Use a bed net, and sleep in air conditioned rooms.

Symptoms

There might not be any symptoms.  The main symptoms of dengue are a high fever and two of the following:

  1. Severe headache
  2. Severe eye pain behind the eyes
  3. Joint, muscle and/or bone pain
  4. Nausea and vomiting
  5. Rash
  6. Bleeding from nose or gums bleed, or easy bruising

Symptoms usually begin 4 to 10 days after being bitten by an infected mosquito.  If symptoms worsen, bleeding from your nose and mouth can occur, as can severe abdominal pain, and you could have lung, liver and heart problems.  Go to a doctor IMMEDIATELY if you have a fever, or of you develop these symptoms, especially if you have severe abdominal pain or persistent bloody vomiting, red spots on the skin, or a bleeding nose or gums.  These signs can occur even if fever decreases after 3 to 7 days.

Dengue hemorrhagic fever causes a fever that lasts from 2 to 7 days, with symptoms consistent with dengue fever. When the fever decreases, warning signs can develop. The smallest blood vessels can become very permeable allowing the fluid to cause pleural effusions. This can cause shock, and possibly death without prompt treatment.

There is no specific treatment against dengue, but you must avoid ibuprofen, Naproxen, aspirin or aspirin containing drugs.  You need immediate medical help to prevent complications and dehydration.  Hospitalization is usually necessary if you develop dengue hemorrhagic fever, and you might need intravenous fluid and electrolyte replacement, and a transfusion.

If you travel to Malaysia and have a fever, it’s important to consider you might have dengue.  Be vigilant about the above symptoms, and seek medical help as soon as possible.