Dengue: Uninvited and Unwanted, Came to our House

Well I finally got dengue, I knew the chances were good, the numbers for Manabi were high but we hoped that we had taken all the precautions necessary to avoid these mosquito borne diseases.  We were wrong and I am now part of the growing statistic for the disease here in Ecuador.

My symptoms: first for about three days prior to the first big symptoms I had this awful feeling that I had bad breath, had not changed toothpastes, or eaten anything different but my mouth taste/odor was not right.  On Tuesday I had this headache pain right about my left eye…a sharp pain that lasted only a few seconds, it happened a few times and it was gone so I basically forgot about it. Early morning Wednesday after 1am I got up with the chills and a fever, had a terrible headache and pain in my eyes. I got up added another blanket and attempted to sleep.  Early the next morning I felt even worse, could hardly get out of bed, but assumed it was some sort of flu and was going to ride it out.  After sleeping on and off during the day on Wednesday, Joe was taking my temperature which stayed around 100-101 all day, he gave me Tylenol and as much water as I would drink.  I finally gave in and called my friend Eva around 6:30 pm to call Dra. Christina for me.  Dra. Christina arrived within 30 minutes, along with mi amiga Eva as my translator, and assessed my symptoms and diagnosed dengue…She gave me three shots, two in the backside and one in my arm, left a prescription for three items to get and to start taking 2 Tylenol every 6 hours starting the next morning…Drink plenty of water and get lots of rest.  Within 10 seconds after the first shot I could feel the difference and the headache started to dissipate.  No chills or measurable fever during the night.

Woke Thursday morning feeling beat up but with only a slight headache, tired and a slight fever.  Several things can happen over the next week or so – I can get a rash over my body, get the chills and fever back, and watch it doesn’t progress to something worse.

I guess the reason for writing this is to let folks know that it is not easily going to go away by itself.  As soon as you feel any of these symptoms go to your local clinic, call your general practitioner and please DO NOT TAKE any ibuprofen type products……..

We are pretty proactive people and when it comes to dengue, hemorrhagic fever from dengue, zika and chikungunya we take what I consider good precautions. Our yard is kept neat and all low hanging branches, bushes and flowers are kept cut back. We use Detan repellent every day, Joe fumigates the yard and house for mosquitoes every week and we walk around with cans of spray when we are outside.  We rake up leaves each morning and have no standing water around.  I do attempt to water early mornings so that the topsoil is not wet during the night hours. But none of those precautions help with this one mosquito. I could have been bitten while taking my morning walk but again I put on Detan before I leave the house, I could have been bitten at a local restaurant on Saturday night while out for dinner but again I wore Detan or I could have been bitten in my own home or yard where I always use Detan.

Everyday seemed to have a different symptom, first the headaches and eye sensitivity, next the fever and chills, next just sweats, total exhaustion, sick to stomach with diarrhea, after 12 days I finally feel back to my normal self.

Joe did get fresh papaya leaves from a producing tree and put them through the juicer added lemon juice and sugar and I drank that three times a day towards the end.  this was advice from a friend in Panama. I do think it helped.  World, look out. I’m back!!

Hemorrhagic Fever Dengue: Additional Information

I received the comment below from our friend Keith Daniels regarding my post yesterday on Hemorrhagic Fever.  Keith currently lives in Dolega, Panama.  I thought his comment interesting enough to do as a separate post.

Keith Daniels The prevention method, is either drinking papaya tea daily (mixed in with whatever you like to cover the taste) or eating, and chewing up, a tablespoon of papaya seeds per day. In about a week the number of daily bites will go way down. This is not effective for “all” species of mosquitoes, but works quite well on the majority of disease carrying species. My experience has shown that it also works well on black flies, sand flies and other biting gnats. After using it for a week, my bites while working outside dropped from 50 to 100 down to 2 to 5. The discovery that papaya could do the above was by a Peace Core couple in Borneo. I met them right after they came out of the jungle and walked up to our oil field base camp, around 1975 or 1976. I invited them in for some coffee and real food. While they were gorging, they told me the story of how they discovered the connection. They said they were South Africans and were going back to report on what they had found. Since then there has been a lot of medical research done on Papaya extracts and they have found that the Papaya plant is a chemical factory and contains lots of medical compounds. The fruit, except for the seeds, does not have any medical uses, at least that they have found so far. There is a cure for the deadly hemorrhagic part of Dengue. It is currently used in most of South East Asia and in South Africa. Note that it does not relieve any of the painful symptoms of regular Dengue–it just keeps you alive so you can enjoy them. There is also a easy way to lower number of mosquito and other insect bites that you get… to almost zero. The fatal part of the hemorrhagic version, is from the virus preventing the production of blood platelets that prevent you from bleeding out externally from cuts… and internally as well if the platelet count gets too low. The cure is a tablespoon of crushed or ground papaya leaves, not the little ones nor the big old leaves, but the ones that are still semi tender, taken 1 to 3 times in a day. Results are that the bleeding is over in less than 12 hours. The platelet count will go at least back to normal, if not higher. Last time I checked, they did not know exactly how this worked–nor why one dose sometimes cured the problem for good. You can Google “dengue papaya South Africa” (less the quotes) and find out more. Keith made this further comment in a separate email to me earlier today: I am not up to date on what is being done or researched, about Papaya.  That is why I gave a Google search pattern to search for.  But if you have any specific questions, that might trigger some new memory recovery of info I have forgotten… Theoretically this should work on any disease that causes a drop in platelet count, and should definitely be tried on them. Note that allergy reactions are possible with papaya.  I would try a skin reaction test by rubbing the crushed leaf or seeds on an area of tender skin and see if there is a reaction. Thanks Keith for your comment.

Dengue Hemorrhagic Fever

This morning two military officers came to the gate wanting to add something to our cistern. This has happened in the past as a preventative of mosquitoes living and breeding in our house water system.

Within 20 minutes three people from the local municipality came by to fumigate the entire house.

They told us that this was due to two people in our neighborhood having contracted Dengue Hemorrhagic Fever. Not to be taken lightly – when we lived in Panama there was a dengue outbreak and a number of deaths from its evil twin, Dengue Hemorrhagic Fever. It comes on the same way, similar symptoms. People think they have a cold or the flu and start self medicating.  NSAIDs (nonsteroidal anti-inflammatory drugs) can turn dengue into hemorrhagic which can be fatal.  Folks who regularly take aspirin for their heart, ibuprofen for pain and soreness and the like are at risk as well.

Chikungunya and Dengue and You

 

Chikungunya: As of today May 22, 2015 there are reported to be 11,897 incidents of Chikungunya and two deaths in Ecuador. Most of these reported cases are in the provinces of Guayas, Esmeraldas and Manabi.  The two deaths are reported to be in the province of Esmeraldas.

http://www.eldiario.ec/noticias-manabi-ecuador/356356-dos-personas-mueren-a-causa-del-chikungunya-en-ecuador/

I am posting a few bulletins with regards to Chikungunya, how to avoid it and how to have it treated.

World Health Organiation: http://www.searo.who.int/entity/emerging_diseases/topics/Chikungunya_FactSheet_Chikungunyafever.pdf

CDC: http://www.cdc.gov/chikungunya/pdfs/CHIKV_DengueEndemic.pdf

 

Dengue: In the same article referenced above in El Diario there are 17,824 incidents of dengue and two deaths.  Concentration of these incidents has been reported in Guayas, Manabi and Esmeraldas provinces.   According to the local paper there is a third death, a 16 year old boy in Rocafuerte. This would bring the death toll to three.

CDC: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/dengue

Very interesting and important side note on both Dengue and Chikungunya: If you take daily aspirin or a blood thinner or similar you are at increased risk if you contact one of these two diseases.  With dengue it can elevate to hemorrhagic fever which can be fatal. In Chikungunya there is a danger in increased bleeding as some of the symptoms may include bleeding from the nose, bleeding internally, and the like.

The reason this fact is interesting is that a lot of us Expats probably take aspirin daily and some perhaps other medications like blood thinners for heart issues. And have never thought of or have not been advised of the increased risk they may have should they encounter one of these two not uncommon illnesses.  I know that during dengue outbreaks they take ibuprofen and similar items off the shelves.

Be sure to check for standing water, remove trash and leaves from your property and above all use insect repellent (Detan) reapplying a few times each day and if you see mosquitoes in your home sleep under a mosquito net.

So let’s be careful out there!

When the Lights Go Out

This part of the coast has frequent power outages, yesterday while we were in San Jacinto the power went out around noon and never came back on until after 6:30 last evening. Sometimes it can be as little as 15 minutes or go on for the entire day or night. Joe and I have discussed purchasing a generator to power our refrigerator and the water pump when this occurs – which is pretty often – but we are not up to that on our wish list for the house yet. A few days ago we did check off one smaller item – a little kerosene lamp. We were in Portoviejo shopping for our monthly supplies and saw this little lamp. Well they actually are not using kerosene any longer this is fueled by paraffin oil and the label states that it is sootless, smokeless and odorless. We could have purchased citronella oil but I can’t stand the smell and don’t think it makes one bit of difference in chasing mosquitoes away.

I did find my Palo Santo bowl as well. While returning from Portoviejo I had our driver stop at a road side stand and I got this beauty for $2.50. I like the smell of Palo Santo and I do think it is a good mosquito repellent. Note after the posting of this article: Palo Santo is a dried wood that is used by the locals to repel mosquitoes, our first exposure to it was an artisan store in Puerto Lopez, each evening as we would walk back from dinner we would smell this lovely almost sweet aroma in the air, this is Palo Santo. In my one post on “Building a Finca” Dec. 1, 2012 there is a photo of a Palo Santo tree from our friends Ivan and Max’s finca here in San Clemente. I understand that the wood needs to be dried for two years prior to being used as a mosquito repellent.

What more could we ask for – light when the power is out and a sweet-smelling mosquito repellent – we are ready for a quiet evening on our porch.

Lights out!

Being Cautious and Aware of Your Surroundings Here

 

Be cautious and aware of your surroundings while traveling around Ecuador. Before you say well I have half a brain, or I’m from Chicago do you think it’s safe there, or repeat the realtorspeak about how they don’t feel uncomfortable day or night walking anywhere and that you just have to use common sense etc. This is a very important message and a lesson in risk/reward. This is our take!

Please do yourself a favor and leave all your good jewelry, fancy expensive clothing, watches, fancy purses, backpacks, laptops and camera equipment at home. Bring items of lesser value; a small inexpensive computer, a camera you picked up at Wal-Mart, a well-worn backpack and other items that if taken would not necessarily ruin your trip. If wearing a backpack, have it hanging across your chest or under your armpit not on your back and do not put anything under your seat or above your head while riding on a bus. Keep all your belonging in your lap so that you can control them. Make copies of your passport and other important documents and lock the originals in the hotel safe. Do not bring a wallet full of debit or credit cards, only big stores and upscale hotels accept credit cards anyway. In Panama, we remember trying to use a US Visa card at a place that said Visa accepted only to learn they meant only National cards (cards issued within the country) not international. Be sure that your bank in your home country knows that you will be traveling in Ecuador and that your ATM cards work in Ecuador. Have the list of contact numbers in a separate place for these cards so if they are taken you can cancel them immediately. Do not carry large sums of money on your person, only take what money you will be needing for the time you will be out that day. Keep money in different pockets, a few dollars here, a $10 bill there, DO NOT pull a wad of cash out in public and wave it around. You are just looking for someone to follow you and knock you over the head. If you have an old wallet put a few expired credit cards and a small amount of cash in it and use it as a throw away wallet. If confronted, throw the wallet down and run in the opposite direction.

Recently a traveler we met had a bad experience when taking an unmarked taxi in Guayaquil and lost her luggage. In my personal opinion it was the bus services unprofessional handling of a situation that led to this women being left off the bus at the bus companies office instead of the bus terminal. The only taxis available to her were unmarked instead of the yellow licensed taxi. This kind of theft happens regularly. Never walk away from your luggage, do not use unmarked cars or taxis that do not have the drivers identification located either on the headrest or displayed on the dashboard. I have a friend who sits in the front seat and writes down the driver’s name and ID number on a pad right in front of the taxi driver or pretend to use you cell phone to call and give a friend this information. Not that all theft can be avoided but you should make an attempt to show that you are a smart traveler. Some folks just don’t have anything and see foreigners with things that they could sell and feed their families for weeks.  Busy areas like bus stations, airports and now even shopping malls seem to be prime places for theft. One scenario that I have heard about is a fine-looking gentleman approaches and while he is distracting you his accomplice is taking your packages. This has been done with beautiful young women, old ladies asking for directions to a bank and guys dressed in suits distracting you for a split second.  These folks do this for a living and are very good at it. I am not telling you to be rude to people but be extremely cautious. Do not place your handbag or packages on a separate seat or hang you purse on the back of the chair while in the food court, instead place these items on your lap or between your feet so that you are always in control of your belongings.

Keep things like laptops in a small store bag, do not carry it in its little pouch for all to see. It costs nothing to find a Super Maxi bag. Not many folks are going to try to take a shopping bag from your hand. Keep your camera in a pocket or a small handicraft bag worn across your chest DO NOT hang your bag on one shoulder or dangle your camera from your wrist. If walking with another person put your bag between the two of you not on the exposed side..

For safety reasons don’t bring your fancy high heeled strappy sandals. Between the pot holes, missing chunks of sidewalk, missing water covers, uneven or non-existent sidewalks and roads a turned ankle will ruin your day. Instead bring a good pair of flat sandals with straps, a nice pair of worn sneakers or comfortable walking shoes. And don’t leave your shoes, sandals or anything of value on the sand away from you because again they will be gone when you turn around to find them.  We had friends in Salinas who took their footwear off and left two pair of nice sneakers on a rock in Chipipe while they took a swim in the ocean. You guessed it – they walked back to their Salinas condo barefoot.  Bring a ball cap or buy a hat when you get here as the sun is harsh. Even when it is hidden behind clouds you can get a nasty burn. Wear sunblock, we wear 50 or higher block when sitting on the beach, you can burn in just a matter of minutes so be kind to your skin and maybe save a ruined vacation by using a good block.

You cannot drink the tap water on the coast but bottled water can be cheap. We get a 5 gal container of water delivered to our home for $1 and he brings it right into my kitchen. Small bottles of water are available for as little as .30 cents in most stores a bit more in restaurants and you have a choice non carbonated (sin gas)  or carbonated (con gas). Place a bottle of water in your bathroom for brushing your teeth as well.  Toilet paper should not be flushed anywhere in Ecuador. There will be a small trash can in each cubical for this purpose, please be respectful of the customs here and do not leave some hotel or restaurant stuck repairing a toilet issue that you caused!  That awful sewage overflow you see on a nearby sidewalk may be yours! BE AWARE all places do not provide toilet paper, please carry a small flattened roll and be sure to have it with you when using a restroom. Some places like malls have one paper dispenser outside of the stalls for toilet paper.

Dogs are allowed to run free as far as I have seen on the coast, I have never been afraid or approached in a threatening manner by a dog in all these years but folks I know have had some problems so just be aware. Most are not family dogs, what I mean by that is they do not know about being petted and will only approach if you are offering food. I would not give food to them unless you want them to follow you home. These dogs may look homeless and uncared for but I assure you their owners lock them on their property at night and allow them to roam free during the day.  A dog’s life in South American is harsh but it is the way it is.

Jellyfish in the water can be a very painful experience. If the winds are high or it is several days after a full moon the chances are good that jellyfish will be floating around in the water. If stung do not wash with salt water, do not rub because you can be pushing the little stingers into your skin. Instead use vinegar or lemon juice to wash the area.

Fly season on the coast can be unbelievable. We found that Salinas had some issues with flies but Playas was terrible for several months with a great deal of flies all around town. We found a strange and unusual remedy of filling clear plastic bags with water and dropping a penny into each and hanging them around our porch in Playas. We even would take a bag to our favorite restaurants and put it in the middle of our table while we were eating. It was a very big problem and the thought of them landing on my food really turned me off. I’m talking 20 or 30 on your table, arms, food……We put on repellent on our arms and hats (which we leave on the tables).

Mosquitoes are another issue at certain times of the year on the coast. We have made it a habit to use Detan liquid each morning after our showers and Joe uses it again before retiring. Palo Santo is a wood that is sold for chasing away mosquitoes, along with these electrified plastic rackets and the small cones and coils that you light. Using a mosquito net to cover your bed is also practical.

Mosquitoes here or anywhere in South America are not playing around. If you are bit by one you may well get dengue. The locals call it Breakbone Fever http://en.wikipedia.org/wiki/Dengue_fever, it is extremely painful and there is nothing that you can take to ease the pain only for fever. DO NOT take ibuprofen or any anti-inflammatory as it can cause an escalation to hemorrhagic fever (now called severe dengue). Also, if you have gotten dengue the chances on getting Hemorrhagic Fever with the next infected mosquito bite are greatly increased. And hemorrhagic fever can be fatal. http://www.nlm.nih.gov/medlineplus/ency/article/001373.htm  Buy repellent and use it often. This is one of those risk/reward things you don’t have to think about.

Weather related issues. Rough weather happens on the coast, with unusual high tides and rip tides you need to be aware of the warnings that are posted in the newspapers. The Portoviejo paper is http://www.eldiario.com.ec , the Guayaquil paper is http://www.eluniverso.com these are the two main papers for coast news.  Each coastal area has its own ocean idiosyncracies ask the locals about the swimming conditions and if you don’t see anyone in the water there is probably a good reason.

When traveling around Ecuador you can find yourself at elevations over 9,000 feet. If you have health issues that can be exasperated by high elevations you should be cautious and consult your doctor before traveling to these high elevation cities. Here are a few articles that my help before you decide on your itinerary: http://www.eso.org/public/outreach/pressmedia/high_alt_fact.pdf as well as http://voices.yahoo.com/the-health-benefits-risks-high-altitude-living-4171887.html?cat=5

Malaria, yellow fever and the like. If you are going into very rural areas or the jungle you should read the precautions that the CDC has listed on their website http://wwwnc.cdc.gov/travel/destinations/ecuador.htm and this other article http://www.travmed.com/guide/country.php?c=Ecuador  We have not heard of any issues related to these illnesses in the cities on the coast. If you are not going into rural or jungle areas we feel that the use of these medication could be more harmful that beneficial.  We know folks who suffered for months taking unneeded precautions. The only caveat would be Esmeraldas has had some reports of malaria.

Please do your research before making a trip to Ecuador. It is so much better to be prepared. There will be enough surprises and hopefully many of them will be good ones. And, as they say, this ain’t Kansas.