Dengue nightmare for Sydney family
Despite a lingering lethargy, he and Nicole are over the disease.
Six weeks after he, his wife Nicole, and their youngest daughter Cosima contracted dengue fever in Thailand, Julian Lee is a worried man.
However, as nightmarish as their first brush with dengue was, what’s worrying the Fairfax journalist is the realisation that another encounter could be much more serious.
That’s because, as Julian Lee now knows, a subsequent infection of the mosquito-borne disease – especially with another one of the four strains – carries the risk of developing the more severe forms of the disease, potentially fatal dengue haemorrhagic fever.
“Any traveller with a history of prior infection should seriously reconsider any holiday or business travel plans to areas reporting outbreaks,” said Travelvax’s medical director, Dr Ed Bajrovic.
For Julian Lee that news is ‘like a sentence hanging over us’.
A typical family holiday in Thailand
For the couple and their girls, Emerald (aged 8) and Cosima (5), the two-week holiday in late June was identical to those of the tens of thousands international visitors who flock to Thailand each year.
The Lees chose a hotel on the southern island of Ko Phi Phi, complete with a shady balcony over a leafy garden. As the couple enjoyed a cool beer in the afternoon sunshine, they barely registered the bites from mosquitoes buzzing around their legs.
Their plan had been for Nicole and Cosima to stay on for a few extra days while Julian and Emerald flew from Thailand to his native England to stay with his family. Soon after he left Nicole’s flu-like symptoms became much worse – debilitating fever, acute diarrhoea, vomiting, and nausea.
“As she became more ill, Nicole got worried about what would happen to Cosima if she (Nicole) had to go to hospital in Thailand,” Mr Lee said.
“Who could she have turned to? Cosima could have been quite vulnerable.”
Urgent flight back to Australia
Despite her now obvious illness, Nicole dashed to the airport and managed to secure seats on the next flight home for herself and her daughter. Thankfully, Cosima’s infection was mild and only manifested itself back in Australia.
“Nicole was incredibly lucky to get on the flight – airlines are usually reluctant to allow ill passengers to fly,” said Mr Lee. “Thank God she did...”
Back in Sydney, Mrs Lee’s doctor initially diagnosed an E.coli infection. However, two days later, when her symptoms worsened and the tell-tale red rash appeared on her torso, she was admitted to hospital.
Mr Lee collapsed soon after his arrival in London.
“I did not get so much of the diarrhoea and nausea that Nicole had, but I had the aching joints and a very high temperature – to the point that I was quite delirious at times in hospital, my family told me,” he recalled.
(Fortunately, such is the hit-and-miss nature of mosquito-borne diseases like dengue, Emerald escaped infection. Although she too received multiple mosquito bites, the insects had not bitten an infected person before biting her, so the virus was not passed on.)
Initial symptoms misdiagnosis
His symptoms, too, were initially misdiagnosed; he was prescribed flu medication.
“I just don’t think dengue is something many GPs have come across, so they don’t consider it,” Mr Lee said.
“They need to be more aware to check for it in travellers who return from infected countries with a fever or other signs of illness.
“But, I must admit that it just wasn’t on my radar either. One thinks about the diseases that have a bit of a profile, like hepatitis and malaria, but I did not think about dengue - not for a moment.”
Neither was there a warning from the hotel on Ko Phi Phi about the risk of dengue.
“Perhaps they didn't know or didn't care, as the trough of stagnant water we had under our air-conditioning unit probably suggests,” he said.
“It was only when I returned to Australia that I found a general warning buried on the Smartraveller website. But, when I started reading up on the disease I found it’s clearly very prevalent.”
Growing number of Aussies infected
Prevalent, indeed. More than 2.5 billion people in Asia, South and Central America, the Caribbean, and the Pacific (including Australia’s tropical north) are now at risk from dengue – 40% of the world's population. The WHO estimates 50–100 million dengue infections worldwide annually.
Already this year in Australia there have been 1128 dengue cases – most of them ‘imported’ from Asia. With six weeks of the peak dengue wet season still to run in Asia, observers are predicting Australia’s total will top 2009’s record of 1406 cases.
There is yet another headache from the illness: Mr Lee’s insurance company has now challenged him to produce documentation to prove his brush with dengue was not a subsequent infection, which may void his claim. He fears he may have to take his claim for the reimbursement of hospital expenses to the insurance Ombudsman.
“We were unlucky,” Julian Lee said.
“We are now among the statistics of Australian cases.”
Research risk, take precautions
“With hindsight, I would have covered up, slapped on the strong insect repellent on us, and educated myself about dengue. I didn’t even know that the (Aedes egypti) mosquitoes that spread dengue bite during the day.
“And, I would certainly have made a point of finding out if it was a risk in the place I was visiting.”
And, that is precisely Travelvax Australia’s advice to travellers: Find out about the nature of the disease, take measures to avoid bites, and you will greatly reduce the risk of getting dengue.
To find out if dengue will be a risk at your destination, call Travelvax Australia’s free travel health advisory service on 1300 360 164.
At that time, you can also make an appointment for vaccinations and a pre-travel health assessment with travel health medical professionals at one of our 32 clinics around Australia. You will learn much more about dengue, where and when it is a risk, and how to avoid it, as well as receiving expert advice for a healthy, trouble-free journey.
Read Julian Lee’s account of his family’s brush with dengue.
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