DENGUE 187 



human body (from two to five days), explains the rapidity with 

 which dengue epidemics spread. 



The disease begins with starthng suddenness. Within a few 

 hours a normal healthy individual acquires a prostrating fever, 

 a severe headache and terrible aches in the bones and joints 

 which make it necessary to lie still. His face and sometimes 

 his whole body becomes flushed and purple with congested 

 bloodvessels, and the patient is to say the least very miserable. 

 In a day or two the fever moderates, and usually is terminated 

 by a sudden crisis of nose-bleed and diarrhea, relieving the con- 

 gestion which has been felt in all parts of the body. Then follows 

 an interval of apparently normal condition during which the 

 patient feels perfectly well. After a few days there is a return 

 of more or less severe fever and aches accompanied by a measles- 

 like rash. The latter fades in from three to five days and is fol- 

 lowed by a powdery scaling off of the skin. If lucky, the patient 

 now quickly recovers but more often he has lingering and recur- 

 ring aches in various joints, especially the knees and ankles, and 

 he may be thus afflicted for several weeks before final recu- 

 peration, whence the name " breakbone fever." The disease is 

 dangerous to life only if complicated in some way. 



An attack of dengue usually confers immunity on an individ- 

 ual but this sometimes lasts only a year and is sometimes not 

 established at all, since more than one attack during a single 

 epidemic has been known to occur. 



There is no specific remedy known that will cure dengue. 

 Care of the general health, including measures to lessen the fever, 

 headache and bone aches, help in making life worth living during 

 the eight or ten days of suffering. 



Once an epidemic has broken out, it is almost as useless to 

 attempt to stop it as to stop a tidal wave, as far as the mass of 

 the people is concerned. Houses screened against mosquitoes, 

 if available, are havens of refuge, but the tropical villages or 

 cities in which there are enough screened houses to care for even 

 a small per cent of the population are hopelessly lacking, and the 

 rapidity of the spread of the disease makes the isolation of early 

 cases in mosquito-proof wards almost futile. Anti-mosquito 

 campaigns, conducted not merely during an epidemic but at all 

 times, are the only methods now known of preventing epidemics 

 of dengue or of lessening their local prevalence. 



