Guest opinion – Don’t Forget the Bug Spray |

Guest opinion – Don’t Forget the Bug Spray

James Kennedy, MD
WinterPark, CO Colorado

When I walked into the exam room, my patient looked very sick. “I have a fever of 104, even my eyelashes hurt. My bones feel like they are breaking. I think I picked up the flu on my way home from Costa Rica.” Hum, she had no cough and no sore throat, so there had to be more questions. “Yes, I was bitten my mosquitoes while I was there, and no, I did not take my malaria medicine. “

Malaria is a parasitic illness carried by certain mosquitoes and is common in tropical areas of the world. In parts of Africa malaria is the leading cause of death; eclipsing even HIV/AIDS, and genocide. Since the banning of DDT, malaria now accounts for about 20% of Africa deaths and up to 35% of pediatric deaths. In Central America, malaria is usually caused by the lesser form of the disease and is readily prevented and treated. Malaria infects the blood cells, bone marrow, liver and spleen. Since the parasites mature in the blood cells and breakout every two to three days, the fever often occurs with sudden ferocity every two to three days rather than every day. Our patient’s symptoms were certainly consistent with malaria but her tests were all negative.

Dengue Fever is a viral disease that is carried by the same mosquito that carries malaria and so is found in the same areas of the world. The symptoms are similar in many people, including high fever, bone pain and headache, and feeling like you going to die. Like it’s distant cousin, West Nile, this virus can have a spectrum of illness, ranging from asymptomatic infections to severe infections and even death. There is no treatment except to support the patient through the duration of the illness. All of Central America and much of northern South America is currently in the middle of a widespread epidemic of this most unpleasant disease. Our patient’s Dengue Fever titers were positive confirming our suspicion and after five miserable days she recovered fully.

These diseases are preventable. Avoidance is the major way to prevent the illness. The female mosquitoes only bite after dark, so not venturing out and using netting is almost 100 percent effective. If you have to be out, wearing long sleeves and pants and using DEET containing repellents has been shown to be safe and effective. Even child over 3 can use these safely. Taking a suitable prophylactic medication will also provide protection. The medicines used for the South American form of malaria are safe and have few side effects. There are several that can be used, and almost everyone can take one of them. Some of the more virulent strains seen in Asia, India and Africa are harder to treat and can be fatal, likewise some of the medications used to prevent or treat this form have more side effects, and can’t be used by everyone. If you are going to a mosquito infected area, please be careful and use the appropriate medications. If you believe you are infected, seek care and be sure to tell your physician that you may have been exposed. Don’t forget the bug spray.

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