Dengue

Some scholars maintain that " dengue " is a Spanish adaptation of the Swahili Ki denga pepo, used to describe a cramp that seemed to seize people like a spirit. Others point out that " dengue " is also a Spanish word meaning " affection ", an unkind referrence to the mincing walk adopted by untreated victims of the disease to lessen the hellish pain in their joints. The English thus named it " Dandy fever" . Dr. Benjamin Rush, the most eminent American physican of his day (and a signer of the Declaration of Independance ) , called it " break-bone fever " when it appeared in Philadelphia in 1780 because that's whatit felt like. Yoday, dengue occurs in the United States only when brought by travelers from areas where it is endemic, like the Caribbean islands. Central and South America, Africa or Southeast Asia. In these locales, where billions of people are at risk, dengue is second only to malaria among insect-borne diseases.

Dengue fever is caused by an arbovirus transmitted mainly by bites of Aedes aegypti mosquitoes ( which can also carry yellow fever and viral encephalitis ), a variety of the common summertime pests that likes to breed in containers of still, clean water. The disease and the mosquitoe probably came out of Africa together with the slave trade and other commerce. An epidemic of more than a million cases occured in the United States in 1922 but the last epidemic outbreak of dengue fever happened in 1986in South Texas. Only a dozen or so confirmed cases appear every year in the United States. Local outbreaks can occur at any time if someone brings the virus from abroad and A.aegypti cooperates by biting the infected person, incubating the virus, then biting another person. For the most part, though dengue is found today only where goverment either can't afford or don't care about mosquitoe control. Scattered cases of dengue began to appear among the thousands of American soldiers returning from Haiti in late 1994, raising concern that virus could be introduced to wider populations.

Dengue is known for bringing on a high temperature, nausea, vomitting, horrendous headache, a rash that appears after a twenty-four-hour pause in the fever, and long covalescence but it is not deadly. Most cases are mild, treated with fluids and bed rest. There is far more serious form of the disease, called dengue hemorrhagic fever, whose incidence has been increasing since first reported from Thailand and the Philippines in the mid-1950s. It hit 10,367 people in Bangkok between 1958 and 1963, killing 694. The dengue arbovirus comes in four models ----- they are all basically Chevrolets, so to speak, with different trim ----- and if you pick up two or more of them simultaneously, you get the really bad kind of dengue. In 1981, Havana was overwhelmed by an epidemic of dengue hemorrhagic fever that struck 344,000 out of a population of 2 million and killed 158. In 1982, more than 20% of New Delhi's 5.6 million people caught the disease. More than 3,100 cases occured in Venezuela in 1990, with 73 deaths. The four types were probably once confined to seprate geographic areas but worldwide travel by infected people has mixed them together.

Another Aedes mosquito ----- A. albopictus, the " Asian tiger " ----- can also transport the dengue microbe. It arrived in Housten, Texas, for free with a shipment from Japan of used tires ----- a favorite breeding place ----- in 1985 and is now established in at least seventeen states. Though the aggresive toger has not yet been found to carry dengue in the United States, another dangerous arbovirus, eastern equine encephalitis, has been found on A. albopictus around a tire dump in Florida.