My Pain Explained: Dengue Fever

When I sliced my toe on a rusty grate during last year’s Lunar New Year fireworks in Vietnam, I never thought it was the beginning of a long saga that would end with a dengue fever diagnosis.

When it happened, I immediately chose to ignore the bleeding toe and focus on New Year’s Eve fireworks instead. Breathing through the burning and the pain to watch fireworks seems like a mistake in retrospect, but nowhere near as impactful as the rest of them I made that year.

After the light show ended, I took a good look at my injury and saw that the grate had pierced my toenail and cut diagonally across the side of my toe, necessitating a tetanus shot and a lot of limping. Thankfully no stitches.

My Vietnamese friends were aghast.  The local beliefs surrounding Tet, Vietnam’s Lunar New Year, include the fact that what happens around midnight on Tet eve dictates the tone and spirit of your coming year. This is why, as I noted in my long roundup from last Lunar New Year, the person who crosses the threshold into a person’s house at midnight must be compatible with the new year’s astrological sign.

My Vietnamese friends urged me to take care during this Year of the Snake, and predicted that it would be fraught with health issues. After all, it started badly, with an inauspicious blow to my general health (and my toe). Business-wise it could be a success, they insisted, but in terms of personal wellness they were worried.

I laughed it off. When I climbed Agung and Rinjani in Indonesia in 2009, I lost several toenails and much of the skin off the back of my heel. Plus, I’m also fairly clumsy. I’ve been known to walk into walls when not looking, to trip over sidewalks, to have an alarming amount of near-misses over the course of my life.

But my friends were unrelenting. This injury was different. This was a harbinger of a trend for the coming lunar year. I would, they asserted, anxiously await the day that the Year of the Snake was over.

They were right.

This piece discusses the symptoms for dengue fever that I ignored, as well as the different serotypes of dengue, their treatment, and their prevalence worldwide. With the pandemic in the mix, dengue news took a back seat in the news for a while. As you’ll read, vector viruses like dengue or Lyme are nonetheless spreading more rapidly than prior. This is due to climate change. It’s important to be informed about dengue before you travel to traditional hotspots like Southeast Asia or parts of South America, but it may also be important to take precautions in traditionally dengue-free areas in the near to mid-term future.


how i got dengue fever in vietnam
Tet fireworks in Saigon for the year of the snake. Not pictured: bleeding toe.

How it began for me

When I created this site, I decided to do state of the union -style posts once a year, because I wanted the blog to be a place where people could learn about food—not read about my health complaints. So it is for this reason that when I started losing clumps of my hair in late February 2013, I never wrote about it.

A month later when I stopped being able to bend my hands or knees in the morning without considerable pain, or look at bright light, I didn’t mention that either. I kept up my usual schedule in Vietnam, exploring the Mekong and surrounding regions and walking around town for hours a day.

In May 2013, after flying to England to visit my family, I could barely walk down the street without feeling exhausted. Alarmingly, when my leg or arm was itchy and I scratched it, I’d develop lines of bruises, colouring the spot where nails had met skin.

As the summer went on, I sleepwalked through my existing obligations and plans—conferences, meetups, interviews and more. I found myself getting sicker and more listless. My immune system did not cooperate with anything I did; every cold or virus seemed to latch onto me stubbornly, and most of my days were obfuscated by a cloud of exhaustion.

The doctors I saw in North America or Europe were unhelpful, even infectious disease specialists. One suggested that I was just stressed. I had to tell him, “listen, as a former corporate lawyer, I know stress very well! This is not stress. Something is wrong with my body.” But I was dismissed, my symptoms were minimized, and I was told that I just “need to relax”.


In actuality, the pain and hair loss had started at a time when I was the least stressed in decades; I was in Vietnam, loving my exploration of the city and its soups. One doctor thought I had lupus, and to be fair many of the symptoms lined up, but tests for that condition gave no indication that I might have it.

As Maya Dusenbery says in her excellent book, Doing Harm, “the difference between a crazed neurotic and a seriously ill person is simply a test.” And not one doctor I saw thought to do a test for dengue, despite my being in Southeast Asia for years, where it is prevalent.

Not knowing what was going on with my body, my exhaustion and pain, and keeping it all quiet online meant that I struggled to explain why I couldn’t see friends or go to events. I spent August in San Francisco in a haze, my joints and fatigue worsening. I “looked” fine, but I was not at all fine.

dengue fever in the united states
Golden Gate Bridge on an August day.

I confided in my close friends, acquaintances, colleagues, and more, corresponding with many of them to brainstorm solutions. Before doctors ruled it out, I was connected to a woman had lupus, who shared coping strategies and foods to avoid.

And I was given the recommendation of a book that calmed my brain down considerably, Full Catastrophe Living, written for those dealing with the stress and exhaustion of chronic pain and fortuitously updated days before it was suggested to me.

By October, when I was heading to India with my mum, I felt like I was hanging on by a thread. We did have a terrific time in India, exploring the chaos and colour of Rajasthan in a few too-short weeks. But I did still get sick again and again, and much of the trip was clouded with pain. By the time I flew home to Canada, the airline stewardesses took one look at me as we boarded the plane and then cleared out the back row and insisted I sleep.

I was tired and confused and tired of being tired and confused.

And then, I figured it out.

Yep, it was a mosquito-borne virus, dengue fever

I kept going back to February when it all began. Earlier in the month I was supposed to go to the Mekong, but I woke up feeling so sick and tired that I couldn’t budge. I had a splitting headache and it felt like someone was pressing on my eyeballs; nothing relieved the pain.

I thought I had a bad flu and I postponed my visit. My “flu” cleared up a few days later for the most part, though the headache took longer to go away. A few days later, when I was visiting Vung Tau with my friends, I developed a strange rash all over my stomach.

It wasn’t itchy. It was just flat red dots, a maculopapular rash that appeared in constellations all over my torso and around my belly button. I remember my friends all gathered around me at the beach, awkwardly peering in at my stomach. (We probably confused the passersbys too).

We went with heat rash, and quickly forgot it existed. A few days later it was gone. What could have caused the rash and my flu-like symptoms and then all the tiredness, joint issues and pain?


Interestingly, that’s exactly why two of my friends were in Vietnam—they had gotten dengue in Bangkok and were in recovery on their visa run. Many months and fruitless doctor’s visits later, I Googled “dengue rash stomach” and saw exactly what was on my stomach in Vung Tau. And then I looked into what happens when you don’t take care of yourself when you have dengue. Those who have experience with it will know that the disease is not really treated per se; much like mono or glandular fever, treatment involves hospital visits, hydration, and rest. In dengue’s case, you are also supposed to monitor your white blood cells and platelets, both of which can be dangerously low when in the throes of its grasp.

I learned that when you ignore it as I did, it starts wreaking all sorts of other havoc on your immune system, on your joints and on your general state of being.

I went to a tropical diseases doctor when I was back in Vietnam and shared my thoughts. They confirmed that dengue is almost certainly what had happened, which jived with a February infection and my subsequent blood test results for antibodies, and earlier labs that showed a lower-than-normal white blood cell and platelet count.

Dengue fever is caused by a mosquito-borne virus that infects an estimated 390 million people every year. Each year it also kills about 25,000 people, leading the World Health Organization to describe it as one of the top 10 threats to global health.

“The disease is now endemic in more than 100 countries,” says the World Health Organization (WHO) in a January 2022 global dengue report, with cases having increased 30x in the last 50 years. While the viral fever is common in parts of Asia and Latin America, global warming has affected the reach of the mosquitoes that spread it. In September 2022, for example, France sounded the alarm about an outbreak of locally-transmitted dengue.

A June 2022 study also found that being infected with the virus causes you to produce a bacteria in the skin that makes you more attractive to mosquitoes. Not the kind of news anyone wants to read! Hopefully this team’s findings could help inform real-world public health strategies for controlling mosquito-borne flaviviruses like dengue and Zika, because by 2080, as many as 2.25 billion more people — or 60%t of the global population — will be at risk.

There is a race to try and find a solution, and at the bottom of this post I share a pilot project from June 2021 that provides some hope.

There are different types of dengue fever, called serotypes, that are active in different parts the of the world:

There are five dengue fever serotypes – DenV 1, 2, 3, 4 and 5. The fifth serotype was only established in 2015, but manifestation of symptoms differ depending on the type you contract (source).

I was told often in Asia that recovery from one strain of dengue may offer lifelong immunity against that strain. However, that means that while the one strain you’ve had has immunity following infection, the preexisting antibodies from prior infection make the other strains more dangerous, and more likely that they could develop into dengue hemorrhagic fever (DHF).

See symptoms of that, below.

From Science “When Dengue Strikes Twice“:

Most of the more than 50 million people sickened by dengue virus each year develop dengue fever, a weeklong bout of joint and muscle pain. But many who suffer repeat infections have it worse. They come down with dengue hemorrhagic fever and suffer massive internal bleeding and liver damage. Oddly, the virus causing dengue fever comes in four strains, and immunity to one seems to make infection by a second strain more dangerous.

The reason? Following one infection, T-cells were primed to fight a different strain than the new one attacking them. Plus, those dengue-specific CD4 T-cells rapidly self-destruct following a new infection, which leads to tissue damage.

For years, scientists thought that resulting immune system misfire / cell suicide could be a primary cause for DHF, versus the more ‘simple’ dengue fever. However, a late 2019 study cleared CD4 T-cells of any wrongdoing. “We found no evidence to support the common dogma that these T cells are responsible for turning a mild infection to a severe one,” said Yuan Tian, PhD, one of the scientists on the study.

The hunt is on still for why DHF is so severe.

In 2020, Singapore reported a spike in the DenV-3 type of dengue, which their National Environment Agency noted may signal an outbreak in the near future. The DenV-1 and DenV-2 serotypes have been dominant in Singapore for the last three decades, so the country is on alert due to the rise of DenV-3 since population immunity is low and people are more susceptible to it.

Sure enough, in 2022, Singapore has announced a “dengue emergency” — prior to June 1, when dengue season usually peaks, it had 11,000 cases – far beyond the 5,258 it reported throughout 2021. Eradicating the mosquito-borne disease is likely an impossibility, though many scientists are racing to find solutions.

How dengue virus transmits between mosquitoes and humans
How dengue virus transmits between mosquitoes and humans. Via Al Jazeera
What are the symptoms of dengue fever? They range from asymptomatic, to deadly.

Dengue’s incubation period is between 4-10 days, so it’s difficult to backtrack to exactly what mosquito bit you. In my case, I have a very good idea. I was outside on a phone call and came inside so bitten up that I almost vomited. It was less than a week later that my symptoms started.

According to the CDC, the principal symptoms of dengue are high fever, feeling general malaise (like the flu), and at least two of the following:

  • Severe headache
  • Severe eye pain (behind eyes)
  • Joint pain
  • Muscle and/or bone pain
  • Rash
  • Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)
  • Low white cell count
An overview of which human organs come under stress when you have the dengue virus
An overview of which human organs come under stress when you have the dengue virus. ViaAl Jazeera

Is there a cure for dengue fever?

There is presently no cure or “antidote” to getting dengue fever. All that one can do is manage the infection.  There is no antiviral treatment approved for dengue fever, either, but research is underway for a highly potent dengue virus inhibitor (JNJ-A07) that scientists hope can help treat the growing levels of dengue fever worldwide.

What are the symptoms of severe dengue (dengue hemorrhagic fever (DHF)?

Dengue hemorrhagic fever (DHF, or as WHO calls it “severe dengue”) is, as I mentioned above, a more deadly form of dengue first recognized in the 1950s during dengue epidemics in the Philippines and Thailand. In Asia, epidemic DHF expanded from Southeast Asian countries west to India, Sri Lanka, the Maldives, and Pakistan and east to China. (Source) Today, DHF is in most of Asia, Southeast Asia, and Latin America, and is a leading cause of hospitalization and death in those regions.

Symptoms of DHF include the above list plus:

  • Persistent vomiting
  • Severe abdominal pain
  • Rapid, shallow breathing
  • Blood in the vomit
  • Bleeding gums
  • Vascular leak syndrome
  • Skin hemorrhages such as petechiae, purpuric lesions, and ecchymoses.


The even more worrisome dengue shock syndrome is defined as dengue hemorrhagic fever plus:

  • Weak rapid pulse
  • Narrow pulse pressure (less than 20 mm Hg)
  • Cold, clammy skin
  • Restlessness.

It involves a mostly clinical diagnosis, and is associated with high mortality. (Source)

What to do if you get diagnosed with dengue fever?

Obviously do NOT do what I did and simply not get tested for it. No specific therapy has actually been shown to be effective in the treatment of any of the manifestations of dengue in a randomized controlled trial.

Great, right?

The mainstay of treatment is still careful fluid management (Source). So for treating a dengue infection:

  • Get to a hospital and get tested.
  • They will likely provide IV hydration and Tylenol.
  • Do not use any aspirin or supplements that would thin the blood.
  • Do not use NSAIDs either. This means no Advil/Ibuprofen.
  • Lots of Nuun tablets and rehydration salts.
  • Following the infection, I found going on a low-inflammation diet or auto-immune protocol diet very helpful. Please see my post about chronic pain for more.
  • There is some evidence that mast cell stabilizers and targeting the immune system itself may be helpful, see this study.
  • Avoid any medication that lowers platelet levels. These include Furosemide, NSAIDs (hence the above note about Advil), and some other medications. Best to ask your doctor to confirm.

Can you get dengue fever more than once?

Yes, you can get dengue more than once. As mentioned above, there are four serotypes (or strains) of the dengue virus: DENV-1, DENV-2, DENV-3 and DENV-4. It’s possible to get infected by each serotype, so a person can get dengue up to four times. Rarely, someone’s immune system does not produce sufficient antibodies for the strain they’ve had, and they can get the same strain again.

Compounding infections may cause something called antibody-dependent enhancement, where the next infection leads to more severe disease. This means that if someone got infected with dengue, it’s important to try and prevent another infection with a different serotype.

What are the long-term, lingering effects of contracting dengue?

While many friends have come out just fine after a dengue infection, lingering effects are very widely documented.

  • Depression and anxiety after the infection wanes (source) – likely due to systemic inflammation. See also this study about anxiety/depression and severity of dengue symptoms.
  • Epigenetic changes – much like other severe infections or viruses, geneticists have begun to look at whether your gene composition could affect the severity of the infection or whether it creates sufficient inflammation to “express” genes you may already have and create a genetic cascade.
  • Autoimmune marker changes to titers for C3/C4, rheumatoid factor (RF), C-reactive protein (CRP), antinuclear antibodies (ANA), and immune complex (IC). Source.
  • According to a survey published in 2020, patients with a history of dengue fever infection are at increased risk of developing leukemia compared with individuals without a history of dengue fever. The findings from this study were reported in Cancer Epidemiology, Biomarkers, & Prevention.
  • Developing mast cell dysfunction following dengue fever is also a long-term possibility. Dengue induces increased mast cell activity, for example patients exhibit increased levels of urinary histamine, a major granule product of mast cells. And increased histamine was found to correlate with disease severity. But for some people, their immune systems get “stuck” in that state, post-virally. This is also what scientists think is happening with some Long-COVID / PAS-C patients. I’ve written a long (12,000+ word) page on tackling mast cell issues / increased allergic reactions, here.

Is there a cure for dengue fever?

Presently, no. Despite some 50–100 million infections per year, there are no current solutions. A 2021 paper does give some hope, however. A team of scientists from the University of California, Berkeley, and the University of Michigan has found an antibody that blocks the spread of dengue fever within the body. Their findings are found in an article in Science called “Structural basis for antibody inhibition of flavivirus NS1–triggered endothelial dysfunction“.

From a GEN news article:

The dengue virus uses a particular protein, called Non-Structural Protein 1 (NS1), to latch onto the protective cells around organs. It weakens the protective barrier, allowing the virus to infect the cell, and may cause the rupture of blood vessels. The research team’s antibody, called 2B7, physically blocks the NS1 protein, preventing it from attaching itself to cells and slowing the virus’s spread. Moreover, because it attacks the protein directly and not the virus particle itself, 2B7 is effective against all four dengue virus strains.

Will this turn into a pathway toward preventing infection in the body? We don’t yet know. I’ll be keeping an eye out for further developments, and update this post if we they arise.

Dengue fever makes mosquitoes bite more

Another interesting factor in dengue’s spread is that new studies have found dengue makes mosquitoes infected with it bite more than mosquitoes who are uninfected. This biting-the-host stuff is called “blood feeding behaviour”, and blood-feeding behavior is a key factor in how mosquitoes spread the disease.

Earlier studies on how dengue virus infection changes the way mosquitoes feed haven’t been that conclusive. But in 2022, researchers took a broader, multidisciplinary approach using a variety of tools like high-resolution video to try and analyze the differences in blood-feeding with mosquitoes who had dengue, and those that did not. A study in PNAS called, Dengue virus infection modifies mosquito blood-feeding behavior to increase transmission to the host, the research team sought to understand transmission to then look at the reasons why these changes happen. And, more promisingly, if they can identify a gene or protein that causes this, they may be able to mitigate against dengue from that angle!

“We found that the dengue virus increases mosquito attraction to the mammalian host and the number of mosquito bites,” says Ashley St. John, associate professor from Duke NUS’ Emerging Infectious Diseases (EID) Programme, and senior coauthor of the study. The higher attraction to the mammalian host increases the chances of the mosquito to bite, while more bites increase the number of transmission events because each bite results in the transmission of the virus.

So essentially: dengue-infected mosquitoes are extra dangerous because they not only carry a pathogen, but spread it more via extra “bites”.

The increase in bites isn’t due to a psychological drive to infect, but rather because the mosquitoes seem to be unable to find blood vessels to feed from as easily, so they bite multiple times to try and get one, thus releasing their dengue-filled saliva into the body more than those mosquitoes who are uninfected (and can find vessels more easily).

The video below shows high-res videos that were then analyzed by computer software, to understand the ways that blood-feeding differed between dengue-mosquitoes and non-dengue mosquitoes.

(Credit: Duke-NUS Medical School)

This is especially an issue a recent research article in Science concluded that mosquitos in Southeast Asia are starting to be resistant to insecticides that countries use to help control the spread of the disease.

Where are you at risk for dengue fever?

Per the Center for Disease Control, dengue is endemic throughout the tropics, subtropics, Latin America, the Caribbean, and Southeast Asia. Presently, it occurs in more than 100 countries worldwide. Risk now includes the United States, where sporadic local cases have popped up in Florida, Hawaii, and Texas along the border with Mexico.

Although the geographic distribution of dengue is similar to that of malaria, dengue is more of a risk in urban and residential areas than is malaria. As such, the WHO estimates that over 40% of the world’s population live in areas where dengue viruses can be transmitted.

For up to date information of outbreaks in real-time, see DengueMap, but I’ve included the Asia/Oceania and Latin America maps from the CDC below.

Their full chapter on dengue is here.

where am i at risk for dengue
Dengue risk in Asia and Oceania, per the CDC.

According to the Pan American Health Organization, after almost two years of lower dengue transmission, there has been an increasing trend in both the number of reported dengue cases and the number of reported severe dengue cases since the end of 2018 and beginning of 2019. Brazil, Colombia, and Honduras account for 93% of the total number of reported cases in the Region of the Americas in that period. (source).

Dengue risk in the Americas and the Caribbean
Dengue risk in the Americas and the Caribbean, per the CDC.
Dengue risk in Africa, Europe, and the Middle East
Dengue risk in Africa, Europe, and the Middle East, per the CDC

What about Chikungunya and Zika?

Dengue, Zika, and Chikunyunya are all carried by the pesky Aedes aegypti mosquito. As is yellow fever. And of all the mosquitoes out there, this one will happily breed in even the most shallow of water sources. It is unfortunately possible to obtain more than one mosquito-borne disease from the same mosquito.

Aedes aegypti is not the only species to carry the disease, but it is likely the most efficient: It happily takes up residence in human dwellings, biting many people in a row. If it feeds on a sick person, the disease incubates in its belly, then migrates to its salivary glands. It is injected at the next bite.

After six dengue-free decades, Brazil had its first outbreak in 1981. The situation has deteriorated: Last year, 1.6 million people in Brazil were diagnosed with dengue, more than ever before. Chikungunya and Zika have infected hundreds of thousands more.

Zika Uncontained, Frontline

An American reader living in Manila for many years kindly sent me her story of both dengue and a similar disease called Chikungunya. In her words:

My experience was horrendous. Very, very similar to what you went through. The reason I am emailing you is to let you know it’s very likely you had both dengue and Chikungunya. The mosquito that carries dengue can also carry Chikungunya. If you get bit by a mosquito carrying both, you can be infected by both dengue and Chikungunya at the same time. This is what happened to me.

While both diseases have similar symptoms, the main difference is dengue can be fatal, Chikungunya isn’t. However, and this is huge — Chikungunya gives you terrible joint and muscle pains. These pains can last up to TWO years! Eventually you will recover completely though. And it can also leave you exhausted. This is all somewhat new – in fact most of us had never heard of Chikungunya before. There was an outbreak in Manila, and there has also been an increasing number of people getting both dengue and Chikungunya at the same time. Most ridiculously, there is not enough information about this.”

So, something to keep in mind if you’re exhibiting symptoms of the kind I mentioned. The rash for Chikungunya is generally on the stomach area, per what I’ve read, and joint pains ongoing. The high fever and joint and muscle pain can last for several months.

The symptoms for both diseases are quite similar, per the CDC, and it has so far been found far outside its usual locations and as far as Texas, Spain (as of August 2015), Mexico, and more, including the Caribbean where it was first detected in the Americas.

The mechanisms of infection of human cells with the virus remain very poorly understood. In September 2019, researchers have identified a protein, four-and-a-half LIM domain protein 1 (FHL1), that is required for the virus to replicate within its target cells. The study shows that FHL1 is a key factor that enables a Chikungunya infection, and allows for a target to potentially develop therapies to treat or preemptively prevent the infection/

Given that the three illnesses offer up similar symptoms, I wanted to devote a part of this post to Zika as well. The virus didn’t just appear in 2016. In fact, it’s been around for a long time. First identified in monkeys in Africa (Uganda to be exact) in the late 1940s, it spread to humans around the early 1950s. The World Health Organization documents the first case at 1952.

In recent years, with a warming planet and an increase in travel, the disease spread. In 2007, cases were reported in the South Pacific’s Yap Island with a larger outbreak on French Polynesia and in Brazil in 2013.

Zika’s symptoms are reported as quite mild — far more so than my dengue symptoms noted in this piece. Per Vox’s Zika Primer,

Zika produces very mild symptoms — rash, headaches, pain in the bones, and fever — that usually show up between three and 12 days after a mosquito bite. These symptoms usually go away within a week, and one in four people don’t even develop any symptoms after being infected with the virus. This means people don’t usually go to the doctor for Zika, and many cases go unnoticed. There’s also no vaccine or treatment for the virus, so doctors just work on controlling and alleviating its symptoms.

Prior to 2013, the disease was not in the Western media, partly because of these mild symptoms and a fairly low mortality rate (compared to, say, malaria or dengue). However, given its now-establish effects on pregnant women and microcephaly in their fetuses, the disease has become a global concern and opened up debates about women’s rights and contraception in the often-conservative countries that Zika has thus far spread.

An end to my year of travels … with dengue fever

So, after many months of not saying anything I’m writing this post to reiterate what not to do when you get dengue. Or, put another way, when in dengue-prone areas and having symptoms of the flu, if you then see a rash on your person GET THEE TO A DOCTOR.

I wish I had gone to check it out, and could have then taken care of myself properly.

Global Update from 2022: Dengue on the rise worldwide. A new hope, though, from a Wolbachia-infected mosquito pilot project.

With a warming planet, mosquitoes have proliferated, and mosquito-borne illnesses have swept across the globe. Each year seems to be a been banner year for those illnesses, with more and more mainstream news coverage about dengue, Chikungunya and Zika. Said climate scientist Winston Chow from the College of Integrative Studies at Singapore Management University, “constant weather extremes create the perfect breeding conditions for mosquitoes”. With climate changes comes more viral emergencies.

At the time of updating, I have friends in Siem Reap, Cuba, Rio de Janeiro, and Delhi who have dengue at the same time and in very disparate places. One of the hardest symptoms following dengue is the depression and anxiety that follows.

Per an August 2020 Atlantic article,

The problem will get worse. Beyond the tropics and subtropics, the species has strongholds in Florida, Texas, California, and Arizona, and at least one population has managed to survive multiple winters in Washington, D.C. One recent study projected that by 2050, thanks to the climate crisis, the North American range of Aedes aegypti will extend to Chicago; in China, its range will go as far north as Shanghai.

Given how prevalent dengue has become, as well as the additional reporting about Chikungunya and Zika, I wanted to add a few more resources:

New hope: Wolbachia-infected mosquitoes

An interesting solution for the dengue problem: instead of only looking for a vaccine to help prevent the disease, what if the mosquitoes themselves could be defanged? There have been reports of genetically-modified mosquitoes released to test if it lowers the overall dengue cases. Another example of that is a pilot project in Yogakarta, Indonesia, where the mosquitoes are purposely infected with a bacteria commonly found in the insect world.

The bacteria, Wolbachia, was first discovered in 1924 and is found in mosquitoes–just not the Aedes aegypti

From a June 10, 2021 piece by Ed Yong:

They’ve loaded the mosquitoes with a bacterium called Wolbachia, which prevents them from being infected by dengue virusesWolbachia spreads very quickly: If a small number of carrier mosquitoes are released into a neighborhood, almost all of the local insects should be dengue-free within a few months. It’s as if Utarini’s team vaccinated a few individuals against a disease, and soon after the whole population had herd immunity.


The team found that just 2.3 percent of feverish people who lived in the Wolbachia release zones had dengue, compared with 9.4 percent in the control areas. Wolbachia also seemed to work against all four dengue serotypes, and reduced the number of dengue hospitalizations by 86 percent.

While the Wolbachia strategy is not immediate, it blocks dengue infections in a few different ways that lead the mosquitoes to be less likely to carry dengue and thus transmit it to people.

In Indonesia, following this trial, scientists are breeding these Wolbachia-infected mosquitoes to try and tackle the dengue fever problem in the country. The theory is that by breeding the “good” mosquitoes, they will not transmit the virus when biting humans.

Hopeful experiment! I’ll be updating once there is more data from other regions.

Mosquito transmission of disease and lack of vaccine:

  • A November 1, 2019 episode of Bloomberg’s Moonshot investigates how scientists are attempting to modify the Aedes aegypti mosquito, the primary vector for infecting humans with dengue. After injecting the insects with a bacteria called Wolbachia, which blocks transmission of the disease to humans, the non-profit research team released them out into the world. “My hope,” Scott O’Neill, the founder of The World Mosquito Project, says, “would be that we could eliminate dengue at some point.”

  • Interesting article from the Smithsonian Magazine, about how the isolation of a single protein could help develop a vaccine for dengue. This is a different vaccine than the Sanofi one that is in development and testing stages, since it targets a protein that, if this piece is correct, could help protect against all of the dengue strains.
  • A 2019 piece in the New York Times, “The Mosquitoes are Coming for Us” goes into history as well. “The mosquito and her diseases have accompanied traders, travelers, soldiers and settlers (and their captive African slaves) around the world and have been far more lethal than any manufactured weapons or inventions.”
  • A 2019 article about how mosquitoes “slaughtered our ancestors and derailed history” in the New Yorker. “Along with smallpox and influenza, mosquito-borne diseases led, by Winegard’s estimate, to the deaths of ninety-five million indigenous inhabitants of the Americas, from a pre-contact population of about a hundred million.
  • There is currently no widespread / accepted vaccine. Previously, the Sanofi vaccine, Dengvaxia, rolled out to very problematic results. In December 2022, though, a dengue vaccine developed by Japanese drugmaker Takeda Pharmaceutical Co was authorised for use in the European Union. The vaccine, branded QDENGA, is authorized for use in those aged 4 and older to prevent any of the four serotypes of dengue. Takeda’s vaccine is based on a Dengue 2 virus, with DNA from the other three serotypes added in so it protects against all serotypes. Data from Takeda’s main trial showed that the vaccine induces immune responses (varied ones, depending on the person’s immune system) against all four dengue types.

COVID-19 and Dengue Fever

The novel coronavirus 2019 (Covid-19) is caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), and at the time of this update in December 2022 is still a global pandemic, despite some reporting that suggests it’s “over”. (It’s definitely not over.)

The pandemic has further weighed on countries where dengue fever is already an endemic population threat, primarily in tropical and subtropical regions of the world.

Both COVID-19 and dengue share some symptoms, and this has led to diagnostic challenges in quite a few countries. Moreover, cross-reactivity of the body’s immune response to each of these infections is something on scientists’ radar, since the concern is that pre-existing DENV antibodies might affect the body’s ability to clear COVID-19.

A September 18, 2020 study review called “Covid-19 and dengue: Double punches for dengue-endemic countries in Asia,” examines the current state of the data here. An excerpt:

Clinical symptoms of Covid-19 include cough, muscle aches, fatigue, skin rash, and petechiae, making it challenging to differentiate Covid-19 from other endemic viral infections in the region, such as dengue, and thus potentially leading to misdiagnosis. In addition, a study in Singapore reported the possibility of serological cross-reactivity between SARS-CoV-2 and DENV, raising the question of overlapping immunological cascades between Covid-9, dengue, and other arboviruses.

Pathophysiological similarities between dengue fever and COVID-19.
Pathophysiological similarities between dengue fever and COVID-19.Source

In March 2022, a study review summarized treatment for dengue and covid-19 co-infection, alongside an overview of the existing literature on the topic. “Regardless of whatever infection the first symptom points to,” says the article, “confirmation diagnosis of both COVID-19 and dengue should be mandatory, particularly in dengue-endemic regions, to prevent health deterioration in individuals treated for a single infection.”

Worldwide incidence of both dengue fever and covid-19, as of March 2022. Source.
Worldwide incidence of both endemic areas of dengue fever, and cases of covid-19, as of March 2022. (The countries with the 31 co-infections of C19 and dengue mentioned in the review article are also on there, primarily in South America, South Africa, and South Asia. Source.)

The frustrating part is, of course, that there is not much to be done other than prevention.

Dengue led to Mast Cell Activation Syndrome (MCAS) for me

The fatigue, the hair loss, the joint pain, and the depression and anxiety are all quite devastating but from my non-scientific poll of many friends who have gotten it, vary from person to person.

For me, with an existing autoimmune condition (celiac), the infection was really difficult. For others, they had a few months of problems but are fine now. I never got “back to normal”.

It has been several years, and the infection plus my stubborn unwillingness to stop traveling and rest longer-term led to an inflammatory immune condition called mast cell activation syndrome, which is similar in symptoms to long covid descriptions. I even had what people are calling “covid toe” for years.

I now have many new reactions to foods, smells, even the sun. I go into anaphylaxis on the regular. Vascular changes abound, and I have become intolerant to hot or very cold weather, to the point where my circulation is affected and I lose feeling in my extremities as they swell.

At the time I initially wrote this piece in 2014, I thought I’d get back to normal. Instead, my immune system got wonkier and wonkier, I got a lumbar puncture to rule out certain conditions, and ended up with a spinal CSF Leak that is still ongoing in 2022.

The immune issues? It’s a condition called mast cell activation syndrome, something we are also seeing post-virally with Covid-19. Some patients following a C19 infection are “stuck” in this hyperinflammatory state. I wrote a very long resources page for this condition given that it is more and more prevalent. You can check it out here.

I did return to Southeast Asia, and then moved to Oaxaca, in Mexico, before my life fully went off the rails health-wise.

So if you get sick with some of these symptoms, I urge you to please get tested for dengue fever, and take more time to rest than you might want.


129 thoughts on “My Pain Explained: Dengue Fever”

  1. Wow! That always worries me because I’m SO allergic to mosquitos, I can’t even go outside without getting eaten alive. Using DEET doesn’t work for me, I get bitten anyway. The only thing I have found really useful is this lemon/eucalyptus natural spray that I have. It works really good.

    But thats really scary, glad you are ok and getting better!

  2. WOW! I have been living in SE Asia for nearly three years and I have thankfully been fine. I will be sure to look out for these symptoms. It’s so easy to let little things like a headache or a simple rash to get swept under the rug. People like us who travel often don’t let these things bother us too much, we have tough skin. But you never know what bigger problem you could face if you don’t care for yourself. I am glad you are better.

  3. Wow, I didn’t realise you could go so long without being diagnosed with Dengue fever – it’s pretty prevalent here in KL at the moment (ominous sign on the way to work warning how many dengue fever cases there’ve been since the start of January just in my street), so extra paranoid now…

    Take care of yourself!

    1. Hey Hannah, I think in the initial infection time I ought to have gone to a doctor but genuinely just thought it was the flu and that was when I would have been diagnosed. Unfortunately the doctors I saw after didn’t put the links together despite knowing I was in a dengue-prone area. So it’s their best guess, and the doctor seemed certain, but it was too long after the initial infection to get a 100% firm diagnosis.

  4. I can’t imagine traveling as much as you still managed to do in your condition. Thanks for sharing your story. Maybe it will help someone who would have otherwise avoided seeking a doctor.

  5. Jodi, Your narration/photos are awesome, and keep up the good work! I do understand your decision to not write it on a blog. IMO, you may not be paranoid enough when it comes to things like this where the consequences are not immediate/apparent(unlike physical safety). Take care, and again your website is really awesome!

    1. Hey Rich, I did look into it, of course — but was misdiagnosed (or told it wasn’t anything to worry about). I was plenty aware of consequences and quite frustrated about not getting answers. I think the post is clear on that front. The only thing I was not doing was writing about it publicly, but it was hard to do so with no real path of what was causing the symptoms. Glad you like the site.

  6. I hope you’re feeling a lot better, no accidents or diseases during Tet, I hope. Dengue is a serious disease from where I come from (Manila, Philippines). It would suck if I developed dengue in the middle of traveling.

  7. Hi, Jodi! I can only imagine what you have been through… I come from a city in the middle of Amazon rain forest, so dengue is a pretty common disease, often mistaken by a heavy flu – the difference usually lies on how much exausted and how long this situation lasts: dengue is always worse. People with dengue can’t make it from the bedroom to the bathroom without being helped by someone else, so I must ssay, you’re a really strong girl. But, as far as I am concerned, dengue can only be fatal if you get it a second time (or third, forth…). That’s what we call hemorrhagic dengue. So stay safe :)

    1. There are 4 types of dengue. if you get infected again it will be much worse and your chances of developing hamorrhagic fever increases. With dengue alone I spent several days in the hospital and it took me months to recover. My son was very ill and caught every cold for about a year. Asthma symptoms and allergies also get pretty bad. Be vigilant with he insect repellent, you need to avoid catching it again.

      1. Just ran across your post — had no idea — terribly sorry you got Dengue. I wouldn’t wish it on my worst enemy. I had it last year in Belize, which had a massive outbreak (at one point there were 24 active cases on my “block” which is a tiny plot on the beach in reality). Have to agree with what Indira said — in Belize I think there are two types and if you contract the same strain you did before you are immune, but if you catch a different strain, it is much worse.

        It’s quite possible you had hemorrhagic the first time around as a rash is often a big indicator of that. Any existing health problems can increase your risk for it the first time around. Because of my health issues, I had a much higher risk of catching it the first time around and they did blood tests on a daily basis to monitor for internal bleeding. I had injured my back and ended up with sciatica on top of Dengue, which made it a worse nightmare as the worst of the pain settled in my back and other weak spots.

        I’m still dealing with the fall out of Dengue and related issues since August so it’s definitely a long road to recovery with this mess. I started drinking fresh coconut water the first day I got it and my fever was over pretty fast, but the lethargy and loss of appetite lingered for a few months. I lost nearly 20 lbs in 5 weeks.

        The important thing with Dengue is obtaining a quick diagnosis. People need to be aware that they need to go to the doctor at the sign of first symptoms, otherwise they have to a do a different test after 3 days with the fever to diagnose it correctly. And you are not contagious as soon as you are showing symptoms, but apparently the few days leading up after the bite, you can infect others if a mosquito bites you and then someone else. I spent quite a while talking to the government health officials who were tracking each case on my island.

  8. Wow, how utterly petrifying! My partner and I are moving to South Korea next year and will be traveling SE Asia for a lot of the time, I am so glad I came across this as I hadn’t even considered something like this being an issue!

  9. That’s quite a scary tale Jodi. I’ve had dengue twice, and I know what you’ve gone through. You must have a very strong constitution to be able to power through the way you did. Both times I had dengue, I was very ill and there was no going anywhere. On my last RTW I contracted dengue in SE Asia, and made it as far as New Zealand before I crashed. I didn’t know what I had, but the doc thought dengue or malaria. The test came back dengue, and the doc also said: “BTW, did you know that you’ve had it before?” Looking back, I now know that I had dengue hemorrhagic fever that I caught in Belize. I spent a week in the hospital, and believe it or not, the doctors never diagnosed what I had. So your advice to “Get thee to a doctor” is good, but I would also advise if you’ve been to a dengue area, let the doctor know. Next week, I’m off to Mexico for a week, and since I’ve had two of the four types of dengue, you can bet that I’ll be hosing down with mozzie spray. ~James

  10. Oh gosh … yes Dengue can really be a pain in the ass. My friend got it last year in Thailand, and she was like you just too stubborn to go to the hospital. She spent almost a whole week in bed before she was to weak to go to the bathroom and I finaly could persuade her to go and see the doctor. So really, be reasonable the next time… :D

  11. I hope you get back to 100%. I would be very similar to what you did and just ignore it unless I was completely incapacitated. Luckily I never got seriously ill. I knew somebody who got dengue and it sounded like one of the worst things you could get. I keep this story in mind in future

  12. cynthia brownsmith

    Starting over in Saigon for the new Lunar New Year will definitely bring relief. It sounds awful. Why on earth do women just power through misery while showing up with a smile and carrying on. I hope you will find your great energy again. I love your blog.

  13. Jodi,

    Look into blood ozone therapy. It will kill pretty much any pathogen in your system. I have been battling chronic fatigue and this has helped me somewhat. Good luck!

  14. Steven Garrett

    Sounds like yo had one heck of a year! Jeez talk about bad ju-ju! I really hope things are better for you now.

  15. Such a pity you didn’t see a doctor while you were in Asia initially, as most would have diagnosed dengue fever quite quickly whereas a western doctor is largely unlikely to look for that. That way at least you would have known you needed to take care of yourself. :)

    I’ve lived in Bangkok for 12 years and traveled all over SE Asia. I’ve never had dengue, or any other illness for that matter, but I have two Thai friends that caught dengue in the middle of Bangkok (yes, those darned mosquitoes can give it to you right in the middle of a city as well).

    Luckily, dengue is rarely fatal, but for anyone planning on visiting Thailand they should be aware it does exist everywhere here and tourists do get it. This year we’ve had some of the highest number of cases in decades, so if anyone feels the first signs of any symptoms, take some time off, sleep, eat and relax and take care of yourself (there’s not much a doctor can do actually, unless you are internally bleeding and then it’s blood transfusions).

    Fascinating blog, btw.

  16. You need to be careful around dengue fever. There are 3 types of dengue and chances are less that you will get another one of same type but if you ever get then it can be more fatal than the first one. Mosquitoes don’t survive harsh winters or full summers, they are mostly around in Spring and Autumn or temperatures ranging 15C to 30C. So, if you are traveling to regions with known dengue outbreaks and temperatures are mild then it would make sense to carry a mosquito repellent with you – however, with that being said.. I don’t think you can hide from a mosquito.
    Above is from my experience after living Pakistani side of Punjab, outbreak is same at Indian side of Punjab as well. So, best to visit here in either high summers or full winters.

  17. This sounds HORRIBLE. I am glad you are okay, and I LOL’ed at the post’s URL, but I am off to check out vaccination options for Dengue for our trip in the fall. I can’t imagine going through this!

    1. There are no vaccination options — that’s the kicker. There’s no prevention right now, other than avoiding mosquitoes. And the same mozzie that transmits dengue can (if infected) transmit chikungunya.

  18. Hey Jodi, So sorry to learn that you’ve been sick – and I completely understand the (often bizarre) situation of carrying on with work in social media while masking the big things going on in life. Strange business – you’ve handled it with great grace!

  19. Hi Jodi,

    Thanks for the informative AND interesting post.

    I am a Canadian living in Vung Tau and with all the insects, rodents and sharp, rusty pieces of metal around combined with my regular attire of T-shirt, shorts and flip flops [not to get into other cultural and environmental hazards] I am often considering my general well being.

    Although there are ways to decrease exposure to dengue the instances of one hearing about anyone coming into contact are rare so I don’t usually bother due to laziness and the unwillingness to compromise my overall comfort. Somewhat risky and absurd, I know.

    More importantly, though, was the question of how does one know they have it and what does one do if they suspect they do? For some reason I never proactively researched it assuming, I suppose, I’d leave it until circumstances necessitated it. Absurd, I know.

    This is just a long way of saying thank you for taking the time to present it as such; I hope the remainder of 2014 proves to be significantly healthier.


    *Found my way here via the T-shirt article on Saigoneer

    1. Hey Yuri, welcome to the site. It was nice of Saigoneer to post the t-shirt – glad they liked it!

      I’ve got several friends here in Saigon who have contracted dengue in town. Blood tests are a good way of finding out, though one friend had to go to two separate doctors are the first said he didnt have it and the second said he most definitely did.

      Be safe in Vung Tau and eat some Banh Khot for me!

  20. That’s a very scary experience, I do hope you’re better now.

    I caught dengue during the end of March. All of a sudden I found myself with this extremely high fever & chills. So off to the doc I went. My GP said to keep an eye out if the fever persists as he would need to do a blood test to check for dengue.

    2 days later (usually I don’t get fevers that last longer than a day), the fever was there, but lower. Me being me, did not realise it. I also went off to work that day.

    Got home, was so tired, and slept for a while, and off to the clinic I went. Again. Blood test done; results come in that night: negative (platelet count was 170,000, which is still normal).

    I was getting more upset as I was miserable & tired and nothing made sense.

    The weekend came, my fever was there, though I was walking about but sleeping frequently and not eating/drinking properly.

    Monday morning comes. Doc insists again on another blood test. 3 hours later I get a call confirming it’s dengue & to get myself to the hospital ASAP. Platelet count was 90,000.

    Spent 4 days in hospital, hooked to an IV. Fever in and out, I didn’t feel like eating, but forced myself to eat small bites. Slept so much it felt unnatural. Blood was drawn every day 2-3 times to monitor platelets. This time my platelets had dropped to 45,000 from 90,000.

    When I was discharged my platelets had risen to 92,000 but I felt so tired and crappy. I was working on my thesis and was so upset at myself because I didn’t have the energy to concentrate.

    It’s been 3.5 weeks & despite my blood test showing a normal platelet count, I still get tired faster than usual. I have been advised to extend my candidature as time is so so scarce.

    I felt like crying when it hit me that I might have to extend my period of study because it’s such a mess and I am so behind. But if I’m being realistic, it’s probably the best thing to do. I hate using sickness or personal tragedies as excuses, but I probably don’t have a choice.

    I just wish this fatigue would go away so I can go back to do doing things normally. I used to workout 4-5 times a week, intensely. Right now? It’s been almost a month and the thought of those hard workouts make me tired & I find myself curling up under the covers, sleeping it off.

    It’s so unpleasant, this annoying dengue. Ugh.

    1. Hi, thanks for sharing some of your story as well. From those I’ve spoken to with dengue, many have felt exhausted for months afterwords, even though their platelet and WBC are back to normal. Best of luck with your thesis and I hope you find rest and respite shortly. -J.

  21. Hi Jodi
    I’ve just come across your site on bloglovin’, and how interesting that the second post I read is this! I suffered a similar effect following a mosquito bite, known in Australia as Ross River Fever. For the first time in many years, I’d caught the common cold, and with my immune system down, the mosquito’s timing was perfect. I developed every classic symptom. As a full-time rep on the road, my first indication was feeling a searing pain in my upper thoracic spine whilst driving (oh, it’s all the driving I’ve been lately, I thought). That same afternoon, the glands in my groins and armpits were like golfballs – ok, that’s strange. That evening, a full blown rash had painted my skin. The following morning, my ankle joints and wrists were awfully stiff and quite painful (not to mention weak as water). Touching anything stung. 48hrs after that initial stabbing pain in my upper back, I struggled to move. Picking up the kettle was a two handed job. Driving? Forget it. A blood test revealed Ross River Fever. An interesting point to note is that it is common in Queensland and Western Australia, but no so in Victoria. Clearly these carriers travel far. The symptoms seemed to disappear for about a month after this initial bout, but then all of a sudden, they returned. Whatever was going on in my ankles had just decided to tell me again. Getting out of bed and putting weight on my feet was a monumental effort and excruciating. Sometimes it would take ten minutes, crawling to get to the bathroom (not ideal first thing in the morning!) I don’t think I’ve suffered as much as some, and am grateful that I am young and fit (couldn’t imagine an elderly person dealing with it), but it took around nine months for my joints to really get back to normal, and for the extreme tiredness to clear up. Even now, two years on, my fingers can be suspect. The best advice is to protect yourself from mosquitoes and ensure you seek treatment for any cuts asap! Great site by the way, and congrats on your many years as a digital nomad. Looking forward to reading more of you posts :) Cheers, Anna

    1. Off to Google this mosquito borne illness — wow, that sounds awful. I’m glad you’re doing better but after a year + on my end I’m still having join trouble so I can imagine your frustration with the same. Be well and let’s hope to both avoid mozzies in the future.

  22. Jodi, I’m so glad I found this post exactly when I needed it. I can’t imagine feeling as awful as I imagine you did for as long as you did. I have felt awful for 3 weeks and that’s been long enough!

    After seeing three doctors in Hanoi (and having the first two tell me – just like you – that I was “just stressed”), it took an infectious disease specialist to tell me my sodium and potassium levels were completely out of whack.

    I had many of the same symptoms you did, and have spent the past weeks thinking I had everything from kidney disease to cancer. It’s so terrifying not knowing, and even worse to have a medical doctor look at you and tell you it’s all in your head.

    Thanks for sharing your experience. For some reason getting sick while traveling felt like some kind of failure – why can everyone else backpack through all of these countries and be fine, while I spend three weeks sweating in Cambodia and end up with sodium levels so low I could’ve DIED?

    I appreciate you sharing your story, it’s comforting to know I’m not alone.

    1. Hi Rebekhah, I’m so sorry to hear you’ve been sick, and yes it’s profoundly frustrating to be ill when others seem just fine. My immune system still hasn’t fully recovered and I find myself getting sinus infections or the flu when friends seem immune. It’s definitely a pain, but seeing it as failure isn’t helpful to your psyche or your body…the reality is it could happen to anyone and I’m just glad that you have figured out what it was. It’s worse, still, that so many doctors were quick to tell both of us it was just stress — really ridiculous. I hope you’re well on the way to recovery now.

  23. Thanks for this information..was quite ill a week after I came back from a Singapore-Cambodia-Thailand trip, I had no idea what it was, my lymph nodes just swelled up under my throat, and it was painful to eat, plus I had a high fever and the doctors said there was a lot f bacteria in my blood hence put on antibiotics, it is great to check out what we may carry when we leave these exotic locations…great blog btw

  24. Chao Jodi!
    As an avid independent traveler who has visited over 40 countries, including some of the most remote locales in S. America, Africa and Asia (deserts, rainforests, jungles, etc), I had never been afflicted with any major illnesses (parasites are another story, much easier to get, almost 100% of time tourists have something without realizing it because most parasites are benign and their infections progress very slow and usually harmless. Still need to do rouine checkup as a precaution as against dangerous types) as a result of my prolong travel until last summer in Cambodia, around the Angkor ruins during the rainy seasons. As a medical scientist with extensive laboratory experience, I was well informed and prepared (DET sprays, net,etc.) very attuned with my body physio rhythms. Hence, I came as a great shock to learn that I got dengue. Like most people I initially thought the usual symptoms were those of a flu. When they persists for a third day, I knew it was time to seek professional help even though I loathe hospital as your chance of getting another nastier bugs are quite real. Hospital recommend that I stay overnight but I already knew the blood results and there were no treatments other than lots of rest. Low fatality for first bites are 3% but can increase up to 30% if one is bitten subsequently by one of the FOUR different subspecies (you are naturally immune from the subtype that bit you!), developing Dengue Hemorrhagic Fever. Caveat: survivals after subsequent bites can have serious lasting internal damages to vital organs! That said, the dangers are relative so don’t let it scare you from traveling to tropical regions. Statistically, a tourist is much more likely injured/killed from other dangers like traffics, tainted foods/waters, etc. Most locals seem nonchalant about it and nearly everyone got it hen they are children! Enjoy reading your blog, keep up the good work and stay safe! From Saigon district 1 chowing down a brothy aromatic spicy Hue’sbeef noodles soup with fresh shrimp spring rolls apartif at Nhu Lan bakery–all for three buck$

  25. Hi Jodi,
    I enjoy reading your posts and following your adventure. Love your work and you are an inspiration.
    But after reading this post, i couldn’t resist. I recall on your post on duct tape where you mentioned, Jodi 1 Mozzie 0 ..perhaps its time to revise that scoreline Jodi 1 Mozzie 1 .. Might even be T shirt in the future ? :)

    All the best


  26. Yeap, i am currently in my 4th day of dengue, for the second time. And both times i had it, i treated it like it was just a heavy flu whilst being in another country. But this time i also had a flu…
    I consider myself as being very lucky, and as a westerner, how are we to know if we have it unless we have researched it?
    immensely high fever, 2degrees above 37 becomes very dangerous, both times i have come .3 of a degree away from 39…
    One thing i must say, whatever you are feeling ill from, of you don’t feel like drinking water, drink it.
    I drank at least a glass of water every hour of every day and will continue for the next day or 2.
    and my food was watermelon, coconut water and lanzones (A Filipino fruit) all quite watery…
    Fever has gone but i still feel pretty crap, but please DO NOT take any of this a sure advice to getting better though, it is just what i did to stay hydrated and slightly fed, what has worked for me, may not work for you, though of course the water YES, drink it…
    Stay safe, see your doctor before going on holiday anywhere and talk to them about your worries of dengue and how to prevent it…

  27. Thank you so much for your detailed and interesting account of the illness. I’m living in costa rica and contracted the illness around 6 weeks ago. Although I felt ‘well’ within the 21 days that the doctors said it would take if I rested and stayed hydrated etc, I still suffer from occasional joint pain in my hips that will just come like a wave when I’m not expecting it. It comes with a heavy fatigue and I have to lie down. I had a busy week only recently – working lots so staying up late and waking up early, trying to jog for my mental health every other day (which I’d been building up to gradually) And at the end of the busy week I was suddenly overcome with exhaustion. I slept 12 hours three nights in a row and did nothing physical at all for those three days and only today do I feel more like ‘myself’. After reading this I think I have probably suffered with the depression and anxiety too. There is nothing one can ‘take’ or anything that you’d want to take to make it go away, I think it takes a lot of patience and time and support and it comes in waves.

    1. Hi Seth, sorry to hear you’ve contracted dengue and that you are having trouble in the way you’ve described. I think it is quite common and it’s unfortunate that doctors are not often (from my account and others — circumstantial I know) warning people about the depression that may follow. There are some studies about inflammation and depression, and so what might help as you get on your feel is to remove inflammatory foods from your diet. I am not a doctor but it is a tool that was offered to me via the functional medicine doctor I saw following my visit to a traditional doctor, as well as to take turmeric supplements, a natural anti-inflammatory.

    2. Have been back week and a day. Had to stay another 8 days just to fly It is so horrible, although, I was treated very quickly when I was found. I was staying extra days after my friends returned. I was in Nosara and had heard a women had contracted it horribly year before. Never thought about this at all. Feel ridiculously ignorant now. Please read the mental health ascerbates as I have my own systemic and this threw it into a major talespin… again, another thing I didn’t even know until returning. I will be quite messed up for a while and letting myself heal with limited activities or any stress. But has the activity helped? I am fitness instructor, love the outdoors and that alone usually transforms me, the depression so bad haven’t been able to even force myself. my email bmsheehan18 @ icloud if you want send my note offline. Thanks

      Dec 16, 2018

  28. Hi Jodi,
    I just stumbled across your blog whilst googling dengue recovery. I am in Singapore and currently suffering from dengue, about 5 days in so far. The fever has passed but feeling completely exhausted and unable to do anything but lie in bed. Hoping it won’t be long til I’m 100%, feeling fed up
    Thanks for sharing your experiences x

    1. Hi Joanne, I’m so sorry to hear. I hope you get better soon and that your symptoms do not last as long as mine did! By not resting I made it a LOT worse for myself.

      Be well,

  29. Horrible “too many letters”blah-blah, absolutely impossible to read then you have dengue and 40+ temperature.

    1. Jodi, can you tell me how you think understanding you needed help and getting to a medical facility would have vastly improved your current state of health?

      I was telling my doctors that I was aching and having migraines for the first time. Was sick with the flu. Chills and shaking. And slowly my joints began aching more and more and becoming more and more stiff. Mind you I have a history of pain and issues with my joints but this time it has noticeably worsened. My first check up since my visit back to the states I don’t remember testing for dengue. I’m about to go back home again for about a month before coming back to Saigon. I’m sitting here paranoid with the outbreak that’s occurred staring at three new bites living next to the river.

      I’m about to go back and ask for a test of my kidneys and for heavy metals Etc. And continue to have these recurrent issues with a burning sensation in the back of my head and this awful joint pain. I just got over another bout. Of being severely ill. So any hindsight and advice you have would be greatly appreciated. Especially if I want to approach my doctor in a way she doesn’t think I’m crazy yet honestly relays to her the seriousness of the potential illnesses I face here in vietnam and trying to be on top of getting the care I need in treating and being preventative. Thanks for your post.

      1. Hi Cher, I don’t know how to help specifically but I do sympathize with the anxiety about medical care but also feeling like you’re not being heard by medical professionals. I was told it was “stress” for a good part of my symptoms. Perhaps test for dengue antibodies, and chikunyunya? Have you also tested your EBV levels just to know what they are? Immune system issues have brought on mono for some friends. I wish I could be more helpful, but you have my sincere compassion at how frustrated you must be because I remember it well.

  30. Reading this on my first evening post-discharge from an Indonesian hospital where I was treated for Dengue. 4 days admitted.

    The 2 days leading to my realization of having it were the worst of my life… First thought I just had some flu & self-medicated from the pharmacy. Then rested up because–wait for it–I was in Java to climb Kawah Ijen volcano to see the blue flame sulphur mine & had to try!

    Long story short I wound up on my knees 1000m from the top, vomiting & ill like never before. Spent a torturous 7 hours getting back to Bali & a decent hospital.

    I was lucky, realized on day 2. Don’t mess with it! Curious to see how things go from here…

    1. Hi Chris, I’m so sorry to hear about your terrible bout with dengue. I hope it gets better for you! Keep in mind a lot of us have issues with depression (temporarily) after, so if you’re feeling bleak it could be in part because of that. I’ve also found some of the food that are more inflammatory (nightshades, caffeine, alcohol, chilies) are best being cut out during times where my body has an inflammation response, but I realize what works for me might not work for everyone. Best of luck to you!

  31. Hi Jodi. Thanks so much for sharing. I am recovering from my second dengue infection which I caught in Bali four weeks ago. I rushed to hospital in Bangkok (medical care there is excellent) and was admitted for six days. I was discharged nearly three weeks ago. The issue now is my painfully slow recovery. I’ve been very fatigued, have nerve pain in my legs, itchy eyes (and sometimes general itching). I guess patience is the answer! I’m taking curcumin (tumeric extract), eating raw garlic and eating lots of nutritious, healthy meals to aid my recovery and help my immune system. I’m also a bit afraid of returning to S E Asia again but most of my family live in Thailand so I guess I will need to invest in good repellent!

  32. Wow, this really hit deep for me. I have been on the internet searching for something that matches my circumstances for a long time. Weirdly enough I started losing significant amounts of hair last year around this time. I went to the doctor and they ran a bunch of tests to see if I had lupus too. None of the tests confirmed Systemic lupus.

    Later In the year I traveled to Ghana and Started feeling off by the end of my trip. I thought I was just tired because of the other meds I was on. I was also cold but sweating all the time, but brushed it off because I couldn’t put a finger on what was wrong. Keep in mind I was on global health trip with my university and one of the doctors on the trip is head of infectious diseases in my state, and even he thought I was okay. Despite that, I know how my body is personally, and I am tough as F*ck, something was seriously wrong. I have never thrown up in the absence of alcohol ever. I simply just don’t throw up or get headaches, or even get tired really. Your description of the symptoms is exactly what I felt, even down to the weird bruising and stuff. When I got home I was at the tail end of it, I finally checked myself into a hospital, and about a week later they told me I had dengue.

    But like your experience, it didn’t really end there. My hair started falling out a ridiculously rapid pace like I am talking about handfuls in the shower. I still felt really tired and exhausted all time, it was really hard to get out of bed. I thought this was all a side effect of the medicine that took for hair loss. On top of all that I started to feel I depressed for the first time in my life. I am generally pretty happy, but for some reason, I just wasn’t. I felt like my life was a bunch of sand that I was holding in my hands, and no matter how hard I tried, I just couldn’t hold it all.

    I don’t feel that way anymore, but I did get diagnosed with discoid lupus that only affects the skin. I’m really interested in your anti-inflammatory advice, I honestly felt like my hair loss spiked during my dengue experience.


    1. Hi Brad, I sent you an email also, but it is normal that during times of stress on your body (or right after) you have more significant hair loss. At least that is what they told me :) I’m so sorry to hear about how you’ve been feeling.

  33. Dilisha Amarasekera

    Hi Jodi,
    I found the post about your Dengue experience really surprising and it was a miracle that you survived the way you did. Here in Sri Lanka, where I live, Dengue is taken very seriously as it has caused many deaths, especially many child deaths. It’s as if no family is left behind without atleast one case of Dengue. Hence, I thought I’ll share my Dengue experience and whatever little things we do here in Sri Lanka so that, at least no one here would ignore the signs and would seek medical help immediately. Dengue is serious, pls don’t ignore it. On the 26th of November while I was at work, I felt myself burning up and my body getting weaker and weaker. When I came home and checked my temperature, it was 104 degrees Celsius. I went to the doctor immediately. I usually take a blood test whenever I get fever, just to check whether the blood count has gone down. Because that’s one of the signs of Dengue. Not all Sri Lanakans do that. But I do that just to be on the safe side. But this time the doctor said that it was unnecessary. He asked to do a test if the fever doesn’t go down in two days. So I took the prescribed antibiotic and the fever went away. But I noticed that I was still feeling very weak and I needed to sleep all the time. Four days after getting fever I noticed some red spots in my hand and arms. They were not big, was the size of a regular mosquito bite. I ignored them at first, but I was still getting weak and I couldn’t stand and wait for few minutes without feeling dizzy. I went to the hospital and took a Dengue test. It came positive. I was hospitalized immediately. There is no medicine for Dengue. So it is very important that you monitor the fluid circulation in your body to check whether fluids have been accumulating in your body. If Dengue is not taken care of properly, it will cause:
    damage to the lymphatic system
    damage to blood vessels
    bleeding from the nose
    bleeding from the gums
    liver enlargement
    circulatory system failure (See Therefore, make sure that you are well rested until your blood count rises upto the normal range. Or else it might cause serious complications. Green Apple, Green grapes and ‘Polos’ (a type of Jackfruit) is considered very good for Dengue patients as it help raise the blood count. The first 7 days after getting fever is considered critical. So make sure that you do not even walk more than few steps during that time if any of you ever get Dengue. I sincerely hope not. Hope this was helpful. Stay free from Mosquitoes! :)

    Dilisha Amarasekera

  34. Thanks for validating. Just got back from Costa Rica and almost died from the Severe Dengue Fever, problably heading to Shock version. I don’t remember getting bit, had faint rash but vomited my own body weight I am hardly exaggerating. Initially, I thought it was the water and got Gravos and something else from Nosara Pharma. Didn’t touch the nauseau but added to the vomitting. The non english speaking gardener saved me. Had over 6 IVs in 2 days. Hell on wheels and boom, get back to states and Riddled with depression, major anxiety to round things out. Man it is not to be taken lightly and I presented as reinfected dengue patient.. I don’t know, but it was so so bad, basically unconscious for 3 days in and out before the gardener stepped up. It should be a huge tale of caution. I wear bug spray to cocktail parties, that’s how vigiliant . And this was previous. I will defintely develop a higher version of my already fear of insects. Live in Maine, been paranoid of ticks for decades Thanks for listening…

  35. Thanks Jodi, Happy New Year..Christmas Day was first day the malaise lifted and was actually back to my my self, both physically and mentally. thanks so much. The infectious doctor here in Maine said based on my labs, the antibodies and Total CBC I probably DIDN’t have Severe Dengue Fever. I can’t even imagine anything worse, so that was a surprise but thanks for asking. Hope you’re feeling better too. I have to say, knock on wood, no lingering joint pain and screaming headaches tailed off right around Christmas also.

  36. shirley grace faulkner

    Hi folks I am glad I have found this thread about dengue people i know gave never heard of it neither have i until recently. My experience has been going on since last October unfortunately. I was badly bitten on the leg in my garden of august of last year in the summer by mosquitos. My leg became swollen and sore. I was given anti-histamine’s and a cream to help heal the infection by my gp.. It took about 3 to 4 weeks for the bites to heal completely. In the october I began to feel unwell headaches dizziness sweating. I went back to my gp and also told her how tired felt i could hardly do everyday tasks like making beds and other household chores as i got so exhausted. He said he thought i had a flu like virus and post viral fatigue. Some blood tests where done and it was low vitamin d levels which added to my tiredness. A supplement was advised. But in the meantime they had another look at my blood tests and found skeeters syndrome and dengue infections had been present in my body. I had had an adverse reaction to the mosquito bites unfortunately. I was also told to take magneism supplement and vitamin b12 which i now do. The gp said the malaise may last another 6 months. Pace yourself try to rest as much as you can. I said i have felt low with the illness as i am a very active person i walk for at least 2 hours everyday but now i can only.manage half an hour as if i do more i have to lie down afterwards as i feel so exhausted. I thought skeeter syndrome and dengue infections only exsisted in hot countries but he said because of global warming Europe is getting more cases of the illnesses carried by.mosquitos. My recovery is going ok but i am 75 and it may take longer. I hope i never get either again i have felt so awful since last October.

  37. I had been infected by dengue fever 2 times consecutively. What I can say is your body need to be dehydrated all the time. The first dengue I have my platelets were very low on the second day of fever, so when I went back I drink 2 litres of water and the next day suprisingly my platelets count increased so much. You don’t need isotonic drink or drink papaya leaf juice, you just need a lot of WATER. The second time, I had dengue haemorrhagic fever, this was the bad one. Took more than 2 weeks to recover, generally I don’t took medicine such as paracetamol. So in order to reduces high fever, I just used cold patch at the back my head and it is also good to relief your headaches. I took bath everytime my body temp is high. More importantly, never skip your meal even thought you lost your appetite. It will be troublesome for your recovery. Another thing, avoid drinking water more than 2.5 L because it can cause your organ to swollen. I did get hepatitis after 11 days of fever. My calcium level drop so much, thanks to God ,I’m lucky that I have high dense calcium in my bones and I was saved from getting dengue shock syndrome. Drink a lot of water and please avoid taking carbonated isotonic and caffeine. Just drink plenty of plain water and pray a lot. Don’t move a lot, take a rest

  38. Vertigo and dizziness caused me broken bones and head injuries. I tried everything but nothing worked. Then I gained perfect balance when I learned some head exercises.

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