IST MEDICAL SCHEME CLINIC
Belia Klaassen, MD
Ype Smit, MD
PO Box 2651
Dar es Salaam
Tanzania
Tel : +255-22-2601307/8
Fax : +255-222-2600127
Mobile : 0754-783393
E-mail : istclinic@istclinic.com
Date
1/04/2014
Dengue Fever Alert , third update since first of 27/1/14
To our customers,
Since late December 2013, at IST clinic, an increasing amount of patients ( at least 72 confirmed)
have been diagnosed /suspected with dengue fever, a febrile disease caused by virus that can be
transmitted by the “tiger” mosquito’s (Aedes Aegypti) that bite also during the day, in Dar es
Salaam. The diagnosis is made by the clinical picture and the results of full blood picture after ruling
out malaria, as well as by a rapid dengue test. For the first cases, we could only perform a rapid test
specifically for dengue fever, which becomes positive around day 7 of the disease, but we can now
perform a rapid dengue test within 1-2 days of the symptoms. The results of this test are ready
within an hour, confirmation of the test is done by the ministry of health. Malaria will always be
checked as well, as the 2 diseases have similar symptoms and are sometimes seen together.
All cases are being reported to the ministry of health and a small outbreak in Dar es Salaam has
been confirmed now. Further studies are performed to detect which type of dengue virus is involved,
but from the first results dengue serotype 2 has been found. (In 2010, during a smaller outbreak,
serotype 3 was found).
In order to protect yourself we advise to use mosquito repellent with DEET and use mosquitonets
treated with insecticide. There is no specific treatment.
Information about dengue fever signs and symptoms follows below:
The disease manifests as a sudden onset of severe headache (typically behind the eyes), running fevers,
muscle and joint pains and sometimes a rash. Other possible symptoms are nausea, abdominal pain and
vomiting. The symptoms resemble malaria a lot (except for the rash).Some cases develop much milder
symptoms which can be misdiagnosed as influenza or other viral infection when no rash is present. Thus
travelers from tropical areas may pass on dengue inadvertently, having not been properly diagnosed at the
height of their illness. Patients with dengue can pass on the infection only through mosquitoes or blood
products and only while they are still having fever. The classic dengue fever lasts about two to seven days,
with a smaller peak of fever at the trailing end of the disease (the so-called "biphasic pattern"). Clinically,
the platelet count will drop until the patient's temperature is normal. Complications like Dengue
Haemorhagic Fever (DHF, with higher fever and bleeding in the skin) and dengue shock syndrome (DSS)
are possible, however no serious cases like this were seen during the outbreak of dengue in Dar es Salaam
and Zanzibar in 2010 and this episode only a few more serious cases. Patients who have been diagnosed
with dengue in the past and are infected again are however more at risk for the more complicated types of
the disease.
So far all cases seen at IST clinic were mild/moderate , some patients needed iv fluids.
If you develop these symptoms please come to check your blood. Don’t take aspirin,
ibuprofen or diclofenac as this medicin can cause internal bleeding. Paracetamol can be
used . Take plenty of fluids!
Dr Belia Klaassen, IST clinic, Dar es Salaam, 1/4/2014