It’s 10am in Chiang Mai, northwest Thailand, and I return to the guesthouse from breakfast feeling a little sluggish. There was no prior warning that anything was amiss when I leapt out of bed a few hours ago, but now I’m suddenly feeling weak with a very mild headache. It’s a strange sensation, one that I can’t remember ever having felt before. I’m due to catch a bus with a fellow traveller at midday to a nearby village and assume that I’ll shake off the ill feeling. I get to work packing but as time passes I begin feeling worse and worse. At 11am something tells me I best rest up for the day, so 10 minutes after checking out, I check in again, assuming that a day’s rest will see me right.
What followed were to be three days of pretty intense fever, where things simply went from bad to worse. Incredible weakness, a racing mind that involved itself in all sorts of random ridiculous thoughts, little sleep, if any, at night, no energy and the most intense pain right behind my eyes every time I moved my eyeballs.
Up the rickety old stairs in the rundown guesthouse was my room. It had a mosquito net that had seen better days, one now dotted with holes draping down over a crumby bed in a room with some homemade wooden shutters for windows. It was late August, the tail end of monsoon season, which only means one thing in South-East Asia, an abundance of mosquitos, the prime suspects for my ordeal.
It was on day four, with a much improved fever that I went to the hospital. The day started out with me getting out of bed, walking downstairs to take a shower, but then returning to bed directly afterwards for a three-hour sleep due to the exhaustion of having taken a shower! In hospital, after a glance at my blood values and the depleted platelet count, dengue fever was promptly diagnosed. With next to no appetite and in danger of dehydration, they kept me in for a further four days on a drip.
I had heard so much about this disease, and indeed had even met an Irish girl while in Korea who had had it. Tales of her experience were at the time enough to scare me. She suffered tremendously. In truth I had never suspected dengue from the get-go. From all I had read online, I had expected the fever to be much worse. While my fever was bad, it certainly was not what I had anticipated, and is what delayed me in going to the hospital. It does seem however that it affects everyone in different ways. Many people suffer greatly while others get it and barely know they’ve had it. It seems I fell somewhere in between.
Being on the road for extended periods you open yourself up to these sort of setbacks now and again. Marcus Aurelius, the Roman emperor once said “The impediment to action, advances action. What stands in the way becomes the way”. With illnesses of this nature, you have the choice to wallow in self-pity or accept it, learn about it and focus on recovery and the opportunities it will open up.
Within reason, I’d venture to say that many types of ill-health don’t necessarily have to be a negative thing. On my two years on the road, the bouts of illness I have experienced have allowed me to acquire abundant knowledge about my body. I was rarely in tune with my it, rarely had a true understanding of the food I ate, what worked for me and what didn’t, had zero presence, and ignorantly fueled it up with what I considered healthy, having zero regard for the feedback it gave. Treating it like a car which you fill up and expect to start-up and run effortlessly all day is one way which is sure to lead to problems. Having the occasional setback can be the ideal catalyst to begin educating yourself.
By day seven the effects of dengue fever had vanished, leaving me just as suddenly as they come on a week earlier. A blood test confirmed a rising platelet count and I was on my way.
The recovery period for dengue can be quite drawn out for some. Ranging from a number of weeks to many months, most people seem to say it takes around 2-3 months for energy levels to return to normal. For me it took about 3-4 weeks. Within that time I was frequently tired after only minor exertions. It was a couple of months later that I started to notice that I was having days with a severe lack of energy. Initially I attributed it to the dengue fever, but have since realised that it was the effects of some dietary experiments I was carrying out on myself. Once I got the diet rectified my energy levels quickly returned.
Now, here comes the part many of you may be wondering. Yes, dengue does often cause hair loss, although not always. It doesn’t happen until some time after you have contracted the fever, maybe 2 or 3 months, but it can be quite distressing if you don’t know, or expect it, beforehand.
My hair started falling out in Vietnam about two months after recovering. Initially a little puzzled, I assumed it was a change in shampoo. Day after day however, more and more hair would be spread on my pillow each morning. I could pull out tufts of it by running my fingers through it. I started taking vitamin supplements thinking it was some sort of deficiency. It continued until one evening when showering in Saigon, I saw my wet hair in a mirror and realised how light I was.
At this point I began to take it a little more seriously, did some googling and was reassured to see that dengue was the probable culprit. A visit to a doctor and some blood tests confirmed that everything was in order and that dengue was the cause of the hair loss. In all, I suffered hair loss for almost 2 months and lost quite a bit all over. It has now thankfully grown back!
Tips for dealing with Dengue
Here are a few tips I can offer from my experience of having dengue for anyone who comes across this via google in their hour of need!
- If you find yourself in certain parts of Asia during monsoon season, as I did, then there’s a good chance of getting it. Remember there is no vaccination against dengue. Bite prevention is key – as it is for any other mosquito bourne disease – so take the necessary precautions to avoid getting bitten. Cover up, sleep under a good net in the danger areas, and remember that the mosquitos that spread dengue bite in the morning and during the day, not at night. Wearing DEET is also an option. I used it occasionally and although doctors say the toxic effects of it are not harmful to your skin, I’m still to be convinced. On one particular occasion while wandering around rural Laos doing some photography, I had a tripod slung over my shoulder and realised that the DEET on my arm had corroded the paint on the carbon fibre leg of the tripod. My forearm was black!
- If you do happen to get an otherwise unexplainable fever, then best get it checked out without delay. A simple blood test at a hospital will allow a doctor to diagnose you. This is especially important if the fever turns out to be malaria rather than dengue, where it crucial to treat it without delay. There is no treatment for dengue, so hospitalisation isn’t always necessary. Incidentally, if you contract dengue for a second time, they say it can be quite serious, so best get yourself to a hospital without delay if you suspect that second infection. There are 4 strains of dengue and you are only immune to the strain that you got infected with.
- This one may be different for different people, but I never tell my family when I get sick. Even though it can be quite tough to be so sick so far from home, I don’t believe that calling home to tell your family you have dengue fever is a good idea. Maybe it’s just me, but they won’t be able to do anything from 1000’s of miles away. It only leads to worry and unnecessary stress for them. I have had a few bouts of illness on the road and never told them until I was fully recovered. I once had a skype with my mother while I was in Sri Lanka and after mentioning that I had a minor bout of diarrhea from some dodgy food, I received a call every day until I had recovered. Diarrhea, a strangely often welcome occurrence at times to a traveller, is pretty minor by comparison so I quickly learned to keep quiet after that reaction!
- Finally, don’t listen to me when it comes to medical advice! I write this article knowing it’s well possible that someone hungry for info could be stuck in a remote mountain village in north Vietnam with a raging fever, hours away from a doctor, and has resorted to google while tethering off a painfully slow 2G connection looking for help! If that is you, then I hope this article helps you out. For others, there is plenty of information available online written by certified practitioners who are in a much better position to advise. Here is one such website with abundant information on dengue fever. One final thing I would recommend before travelling to a given location, is to have a basic understanding of the diseases that are on offer in that particular area. It’s always better to go prepared, and don’t leave without insurance!
I’m no doctor after all, just a fool who wandered around Chiang Mai in shorts in monsoon, slept in a room with no windows under a net full of holes!! Don’t let it be you!
– Safe travels
PS – If you have had dengue fever, please do let me know about your experience below.