Dengue re­cur­rence rarely se­ri­ous

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

Dr Cal­abresi is a GP and ed­i­tor of Med­i­cal Ob­server. Send your queries to­ I con­tracted dengue fever about 10 years ago when I was visit­ing Malaysia. Al­though quite sick at the time, I fully re­cov­ered and have been well since. I am­plan­ning a trip to Asia early next year and was told I had to be ex­tra care­ful about be­ing bit­ten by mos­qui­toes be­cause a sec­ond dose of dengue could be very dan­ger­ous — is this right? I thought my im­mu­nity would be strength­ened by the pre­vi­ous in­fec­tion? IT IS true that a sec­ond dengue in­fec­tion can be very se­ri­ous. How­ever, this more se­vere form of dengue— dengue haem­or­rhagic fever — is very rare. Dengue fever is a vi­ral in­fec­tion spread via mos­qui­toes that clas­si­cally in­volves high tem­per­a­tures and mus­cle pains, among other symp­toms. There are four serotypes, or strains, of the dengue virus, all of which can cause the dis­ease. Once you de­velop the in­fec­tion from one serotype, you are gen­er­ally im­mune from get­ting the in­fec­tion again from that serotype but you are not pro­tected against the other three serotypes. Should you get in­fected with one of th­ese other serotypes it is thought there is a risk that the an­ti­bod­ies you al­ready have in your body from the pre­vi­ous in­fec­tion could cause a se­vere re­ac­tion, which is the haem­or­rhagic fever. As the name im­plies this more se­ri­ous dis­ease is char­ac­terised by fever and bleed­ing, and can lead to shock and even death in its sever­est form. For­tu­nately it is not com­mon and chil­dren are more at risk than adults, but none­the­less it would be wise to be ex­tra vig­i­lant in avoid­ing be­ing bit­ten by mos­qui­toes in ar­eas at high risk of dengue fever. I reg­u­larly get those spray-on tans to avoid look­ing lily white, which is my nat­u­ral skin colour. Are there any long-term side ef­fects? GEN­ER­ALLY speak­ing, the tan­ning prod­ucts that you ap­ply to the sur­face of your skin are safe, pro­vided you are not al­ler­gic to them. They con­tain syn­thetic or veg­etable dyes that sim­ply stain the skin, with lit­tle if any be­ing ab­sorbed into the blood­stream where it could af­fect other ar­eas of the body. The rapid turnover of skin cells en­sures that the sur­face skin cells stained by the fake tan will be shed within a cou­ple of weeks. I have a ptery­gium grow­ing on my right eye. It is not caus­ing me any real trou­ble, al­though it is get­ting big­ger. I would like to get it sur­gi­cally re­moved but I have heard there is a good chance it could come back. I am42. Does it make any dif­fer­ence to the chance it will re­cur if I have it op­er­ated on now, or should I leave surgery un­til the ptery­gium causes prob­lems? UN­FOR­TU­NATELY, whether you have the op­er­a­tion sooner rather than later, the risk that the ptery­gium — a fi­brous growth on the eye­ball — will re­cur is still rel­a­tively high — about 20 to 35 per cent. This is more likely in younger peo­ple. Th­ese days the re­moval of larger ptery­gia is of­ten ac­com­pa­nied by a con­junc­ti­val graft which is be­lieved to lower the risk of re­cur­rence. Also, ra­di­a­tion and cer­tain med­i­ca­tions are some­times used af­ter the op­er­a­tion to pre­vent re­cur­rence — though th­ese can have side ef­fects. There are things you can do to re­duce your chances of the ptery­gium grow­ing back, in par­tic­u­lar avoid­ing the ma­jor ir­ri­tant — UV light. Wear­ing wrap-around sun­glasses, and hav­ing the op­er­a­tion in the win­ter months will help. There are also some is­sues other than re­cur­rence to con­sider. You don’t want to leave the op­er­a­tion too late as the larger the ptery­gium, the more likely scar­ring will oc­cur, and if it has en­croached on the cornea this might af­fect your vi­sion.

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