The Dengue Thingie

Dengue Fever is a mosquito borne virus that is quite common in tropical regions. The same regions where we are currently watching for Avian flu. The symptoms of Dengue fever are remarkably similar, at least in the beginning of the illness, to a severe influenza.

Over the past few months we’ve seen outbreaks of mysterious viral fevers, along with pneumonia, that have at first glance appeared to be avian flu. Places like India, Indonesia, Thailand, and Vietnam. After a few days, we’ve been reassured that the outbreaks were Dengue fever. A terrible disease for those in an affected area, but not one that can turn into a pandemic.

Yesterday, after two months of cover-ups, Thailand announced the return of bird flu to their region. Since May, they’ve maintained that the poultry deaths reported where due to weather, or chicken cholera, or the phase of the moon. And reports of human illnesses in remote areas of the country have been attributed to Dengue fever and other exotic (to us, anyway) diseases.

The death of a 17-year-old boy in Phichit, Thailand brings in an interesting twist. They boy was diagnosed with Dengue fever, and apparently tested negative for Bird Flu. He was placed in a ward with other Dengue patients. After he died, someone thought to take another test, and this time, he tested positive for H5N1 avian flu.

Thawat Suntrajarn, chief of the Phichit province disease control department, said the victim suffered from a deadly combination of dengue fever and bird flu, which he said was common in people who die from the H5N1 strain of the virus.

This is a pretty amazing statement.

First, it’s the first time I’ve heard anyone say this. As far as I know, no other health official has intimated any co-infections of H5 and Dengue in the 230+ human cases.

Dengue is, however, endemic in many parts of the world. It stands to reason that at some point, co-infections would be found. The question is: how many of the tens of thousands of Dengue victims out there, also have avian flu? How many cases of H5N1 infection are we missing?

The fact that the Thai patient was retested post-mortem, after initially testing negative for bird flu (very common), was probably a fluke. Most countries would much rather admit to Dengue Fever than Avian Flu. His intimate contact with fighting cocks, which died mysteriously prior to his hospitalization, apparently spurred interest.

Obviously, sometimes a cigar is just a cigar. And most Dengue patients are, in fact, just Dengue patients. But thousands of cases of Dengue fever are being reported right now in S.E. Asia, and this is not the wet season, when you’d expect mosquito borne illnesses to flourish. We are hearing reports of hospitals in Thailand, and Vietnam, being overrun by Dengue patients. Most are not being tested for Bird Flu. And the early tests, in any event, have proven repeatedly to be unreliable.

Finding the true extent of bf infections, with the confusing background noise of Dengue Fever, is going to be nearly impossible. But I wouldn’t be surprised to find that at least some of these `Dengue’ patients are in fact, infected with H5N1.

Not surprised at all.

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