Deadly fever fears for NZ

MICHAEL FIELD
Last updated 05:00 02/03/2014

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An outbreak of dengue fever that has killed three people and swamped hospitals in Fiji may be headed for New Zealand, experts warn.

For the first time all four known serotypes of the virus are active in the region, threatening the severe and potentially deadly dengue haemorrhagic fever.

In New Zealand the latest figures (December 2013) show a 41 per cent jump in the monthly reported cases of dengue, most of them in Auckland.

Reports from around the Pacific show a dengue epidemic has potential to hit New Zealand, having already swept through northern Queensland, New Caledonia, French Polynesia and the Solomon Islands.

In Fiji, where there have been 2589 confirmed cases, the military regime claims there is "little chance" that the fever will hit its lucrative tourist belt.

Dr Mary McIntyre, of the University of Otago's Ecology and Health Laboratory in Wellington, does not rule out mosquitoes capable of spreading dengue from getting established here.

"We are creating situations that make things easier for those pests and pathogens that already cause us woe," she says.

Travel was spreading the virus and trade could bring in the mosquitoes, such a dengue's main vector Aedes aegypti.

Land use is also changing in New Zealand making it favourable for mosquitoes.

"A warmer climate means that foreign mosquitoes can move into areas that were previously too cool, where they usually replace native ones," she said, noting this had recently happened in Palmerston North.

McIntyre says if Asian tiger mosquitoes escaped biosecurity measures and became established, it could act together with the resident striped mosquito to spread dengue infection.

McIntyre says New Zealanders who get dengue abroad recover back home but are "at risk of a more serious haemorrhagic condition [if] reinfected in the future with a different strain of dengue virus".

Fiji's Ministry of Information says most of the dengue cases there have hit Suva. The main resort island of Denarau had recorded no cases.

Australian Broadcasting Corporation Fiji reporter Samisoni Pareti visited Lautoka Hospital last month where large numbers are overwhelming medical staff.

"What I saw that night was a very pitiful sight, the out-station emergency area was being taken up by patients seeking medical treatment," he said.

Widespread insecticide spraying was launched last week in Fiji's central district.

As many as 400 million people are infected by dengue annually, with 20,000 deaths in 125 countries. It has emerged as a global problem only since the 1950s and urbanisation. There are no vaccines and no drugs to control it.

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'THERE IS NO MEDICINE FOR DENGUE'

Dengue fever might sneak up on you gently at first - a bit of a sore throat, maybe a few mild dizzy spells.

A few days later you may experience the worst muscle pain of your life, you might feel your body cramping and your joints swelling. You might have hot flushes, an irritating rash or stabbing eye pain under certain types of light.

They call dengue "break-bone" fever because of the intense joint pain, but it doesn't start contorting your body until about day four. At least, that's how it happened for me.

At first I put my sore throat and intense headaches down to being in a new country, a new climate, maybe some not so sanitary mee goreng.

It was the rainy season of 2010. Jakarta was crowded, impossibly humid and in the midst of one of its worst-ever dengue epidemics.

Our guest-house cleaners sprayed mysterious chemicals around the walls to guard against mosquitoes and warned about staying clear of stagnant water.

It didn't seem to help.

I knew something was seriously wrong when my legs seized up in the street and I fainted.

I came to on my back on the busy footpath with a dozen or so locals peering down at me, muttering excitedly and fanning my face.

Embarrassed, I dragged myself to a taxi and asked for the nearest medical centre. I was told I needed immediate hospitalisation.

For seven nights I lay in a hospital bed, hooked up to a hydrating drip. A nurse had to help me shower in case I passed out.

There is no medicine for dengue, only rest and hydration. I was given papaya juice as it was believed to help.

Every night at around the same time I would jerk awake, body twisted in pain, bathed in a pool of sweat.

My bones felt like they were being wrung dry, my mind was constantly racing from the most vivid nightmares.

Every morning the doctors would come in with and give me that day's news, my platelet count was dropping again and there was nothing they could do.

A healthy person's platelet count will be somewhere above 150,000, at the worst stages of the fever my levels fell to 25,000.

Every afternoon my travel insurance company would call me to "check in" and see when I thought I might be out of hospital.

I was physically exhausted just by moving around in bed. My mind would blank and my eyes would hurt if I tried to read a book.

I watched bad television and ate hospital food, the quality of which didn't matter because I was always ravenous. I still lost about 6kg that week.

Finally, just as my platelet levels were nearing life-threatening levels and the doctors were discussing blood transfusions and medivacs to Singapore, I bounced back.

Unlike malaria, which can stay with a person for a long time, dengue is often quick and sharp. It beats you up then leaves you alone. The fever eased, the joint pain subsided and my blood tests returned to near normal levels over the next week.

Over the next month, my energy levels slowly recovered.

I now have immunity against that particular strain of dengue, unfortunately there are three other types which my body won't recognise, meaning complications if I were to be exposed to a new strain of the virus.

With reported dengue outbreaks closer to home, New Zealand has to ensure it guards against this virus. It's not an experience I would want anyone else to suffer and I certainly never want to go through it again.

- Shabnam Dastgheib is a Fairfax NZ journalist.

- Sunday Star Times

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