More on dengue
Professionally, Dengue Hemorrhagic Fever should be respected as more than an extraordinary incidence. It is a deadly epidemic (minister of health, The Jakarta Post, April 18). The Achilles heal is its prime vector, the aegypti.
When the yearly slackening in mosquito abatement, the stage has been set for the aegypties population to grow to critical proportions. The simplistic 3M plan should not be a one-time affair. To be effective, it must be implemented yearly, starting early, and continued through the rainy season. In addition, eggs and the larvae should be eliminated with cautious use of correct toxins, even chlorine or Abate added to water. Fumigation can be used with the understanding that aegypti, anopheles, and albopictus mosquitoes are increasingly resistant to DDT, Benzene hexachloride, Chordane, Heptachlor, and Methoxtchlor.
The best protection at this stage is to avoid being bitten by mosquitoes. The best prevention is an honest approach to health education.
The aegypti creates a microsize wound, injects anticoagulant and anesthetic, and sucks some nourishing blood. This is how the mosquito acquires the virus. If the mosquito already carries the virus from a previous bite, the virus is injected into the next bitten person. The first time a person is infected, it is called primary infection. If this person is bitten again, even months later, the resultant disease is dengue secondary infection.
If a person has had dengue, specific dengue antibodies attach to the outer envelope of the microbe virus. In dengue secondary infection, these antibodies are confused by the newly retrofitted dengue virus. The confused antibodies pass incorrect signals to virus hunting macrophages of the immune system. When the macrophages arrive to eat the virus, dengue is "eaten", but does not die. Dengue takes control, and through the immune system, enters every organ in the human body.
The confused immune system tries to overcome the infection by inducing fever. Fluids and electrolytes are thus lost. Hemorrhage occurs when the virus decreases coagulation control by killing off most of the thrombocytes. Death occurs from shock.
Known treatment consists of electrolytes, plasma and lowering of fever, as expertly stated by Dr. Harryanto. Experimental antiviral drugs have been tried in Latin America with mixed results. Anticoagulants have been successful in Africa to treat other hemorrhagic diseases but not dengue.
R. SCHMITT
Jakarta