More on dengue
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