By Sara Mulholland, ND, Bach Human Movement Studies, Level 1 Yoga Teacher Cert., Level 1 Reiki Cert., Cert. Angel Intuitive, Cert. Crystal Healer.
Bali is the sort of place that conjures up images of beautiful beaches, restful resorts, and super cheap shopping. Never in a million years would I have expected my well planned, much anticipated family holiday in this exotic place to have such a devastating effect on my health. When you travel to a third world country, you are warned about the water, the food, the undesirable element of the population, even terrorism, but no mention was made of the horrendous result of a single mosquito bite.
My husband, two sons and I had decided to spend Christmas/ New Year celebrations at Legian in Bali and spent an enjoyable ten days taking day tours to many parts of country. None of us wore mosquito repellent, it hadn’t even occurred to us, and not one person had mentioned it to us during our stay. I woke up on the 2nd of January feeling as though I had been hit by a truck. That was the end of my holiday, and the beginning of my nightmare. Every bone, muscle and organ in my body hurt, especially my eyes, and during the next 48 hours my temperature continued to climb. Fevers and headaches added to the symptom list, so I rang a friend who was staying in Bali, a nurse, and she supplied some painkillers which eased the aches and brought down the fever. By the third day, however, I was worse, so my husband took me to the BIMC, the special hospital for foreigners, and from my symptoms they suggested I might have Dengue Fever. A blood test on the seventh day with the virus confirmed it.
Dengue Fever is contracted from a small female black and white mosquito, Aedes Aegypti, that only bites during the day, but can wreak havoc on the circulatory and immune system. Incubation is from 5-10 days, and the virus has an abrupt onset with a fever that can reach 41 degrees. During this fever, if an infected person is bitten by a mosquito, that mosquito will become contagious for the term of its life and infect every person it bites. Symptoms last from 2 – 10 days, and can have ongoing effects on the immune system. Dengue is now endemic in 100 countries, especially South East Asia, Africa, the Americas, East Mediterranean, Western Pacific, and even Queensland in Australia. The World Health Organisation estimates that there are now about 50 million cases per year, and these are only the reported ones.
A complication of the virus is the decreased blood count (platelets) and if this should fall below 100 (normal is 150-400) hospitalisation is required, and a drip inserted. There is no cure and no prevention, and as such I suffered through 8 days of pure hell. I had to come off the painkillers, as they contained ibuprofen, which thins the blood, and may result in internal bleeding, a dangerous side effect called Dengue Haemorrhagic Fever (DHF). Only Panadol is allowed, and after 8 days on an almost empty stomach, caused extreme nausea.
As a Naturopath and yoga teacher, my health was extremely good before Dengue hit me, and bad as I felt, I didn’t end up in hospital. Most other victims I met hadn’t been so lucky and were admitted to the foreigners’ hospital and placed on drips. One Australian lady from the same resort was in hospital for nearly 10 days with a blood count so low doctors wouldn’t let her fly home. Apparently the onslaught of bad weather had caused an increase in the mosquito population, resulting in a larger than usual outbreak of Dengue Fever, which did not discriminate between visitors and locals. The 11 year old son of our driver ended up in intensive care while we were there, a very scary scenario for my own 11 year old son. I prayed that my children would be safe.
I lay in bed in my 4 star hotel room for ten days, thankful for my clean sheets and comfort, knowing things could be worse, but feeling extremely sorry for myself, nonetheless. It was the nastiest virus I have ever had in my life, and I wouldn’t wish it on my worst enemy, I truly felt like I was dying. Even though I had no appetite, I had to force myself to drink copious amounts of pure water, guava juice, and eat small meals. Thank God for room service, and a caring hotel staff member named Ary. Every morning he made me a strong guava juice, (locals say it’s supposed to help with Dengue) and ordered a couple of soft boiled eggs to provide protein and iron, which I managed to hold down. In other parts of Bali, I knew there were people suffering with dengue who couldn’t even afford the hospital, let alone the Panadol. I tried to feel grateful.
Mornings were the worst, waking up with an intense headache and fever, and aching all over. Panadol took the edge off the pain, and during the longest week of my life I suffered through each minute, hour and day, until late on the 7th day I began to feel slightly better. Another strange symptom then began, itching all over my hands and feet. Apparently this can also occur over the limbs and torso, with redness and rashes, due to the leaking of blood through the capillaries. The itching stopped after the 10th day, but even after flying home to Australia, I still experience headaches, swollen glands, extreme tiredness and a slight aching behind the eyes if I do too much. Incredibly, after being home for two weeks, I began to shed all the skin on my arms and legs. I can only surmise that this was due to the dehydration that the top layer of skin must have experienced during the fever stage, as I never got the chance to sunbake during the latter part of the holiday! Others I have since contacted through a website for Bali are also having ongoing symptoms.
Even more upsetting though, is the knowledge that I am not immune to all strains of Dengue after going through all of this. In fact the opposite is true. I am more at risk of the life threatening DHF should I be exposed to the other three of the four known viral strains. A 5% mortality rate is less than comforting, and a second contraction, especially within a year of the first, can be very serious.
After returning home, I read a small but devastating article in the Sydney Morning Herald online about the death of Natalie Feist, a 15 year old Australian girl. She died on Jan. 2nd this year after contracting Dengue fever in the Phillipines while on holiday with her family. As my heart went out to her parents, I couldn’t help wonder if this tragedy could have been avoided with better public awareness of the virus. In 2004, the Seattle Times reported the death of Californian girl Anna Manzanarez after she visited Mexico. She thought she had a nasty flu, and collapsed in her shower a week later. Reuters News Service on the internet gives statistics of deaths in 2003 in Jakarta, Indonesia as 743, with this doubling in 2004. Stop Global Warming. Org quotes 2005 deaths as 1,298, and at least 748 in 2007, with more expected at the time of the article. Another article by Brian Handwerk in National Geographic News in Oct, 2006, quotes Duane Gubler, director of the Asia Pacific Institute for Tropical Medicine and Infectious Diseases at the University of Hawaii, and an expert on dengue fever, “As a public health problem, Dengue ranks right up there…it is number two after malaria… if you compare dengue’s overall impact to that of Ebola and Marburg- these highly fatal hemorrhagic fever diseases that get a lot of press- they aren’t even in the same league. I consider them relatively unimportant compared to dengue.”
Why is it then, that most people I speak to in Australia, have never heard of Dengue fever? Even my wonderful travel agent didn’t know to warn us before we went. From what I have read, the growing increase in Dengue fever is being attributed to many things. Time Magazine, in an article by Krista Mahr in Dec, 2007, says that Global Warming is partly to blame. With the increasing temperatures, the rainy seasons are becoming longer, producing more mosquitoes, and more victims. With air travel so readily available and the long incubation time of 5-10 days, dengue has spread to many countries and is no longer considered just a tropical disease. Where is the information, the news alerts, the horror at the incredible amount of deaths it is causing? Perhaps, now that it is no longer “just” a third world country disease, but a global threat, it will be taken much more seriously.
PREVENTION
I contribute the fact that I wasn’t hospitalised to the daily ingestion of Olive Leaf Extract for one month before we left. Its antioxidant, anti viral, anti parasitic, and anti bacterial properties, although unable to prevent my reaction, in my opinion, may have minimised the effects of the virus, and are still helping my immune system recover. I’ll never again leave home without it.
Other preventive methods, while not foolproof, can help to reduce the likelihood of being bitten by mosquitoes. I suggest taking high doses of Vitamin B complex before and during travelling, as mosquitoes apparently hate the taste. Vitamin B1 is the repeller but the whole complex should be taken to prevent imbalance in the system. One I like to use is Tresos B, a naturopathic formula, but check with your own naturopath or chemist before purchase. Drink guava juice, and keep mosquito repellent handy at all times. The one that is recommended contains a chemical called DEET (diethylmethylbenzamide) but check the concentrations as it can be toxic, especially on children. Anything with a concentration 40% and under can be physically worn, do a skin check first, but over this percentage it should be sprayed on clothes only. Apparently natural sprays are less effective, but definitely better than nothing. Citronella, tea tree and lavender oils are the best essential oils to travel with and have been known to deter mozzies. I used a lot of lavender oil for the headaches, and to help me sleep.
As these mozzies bite during the day, especially mornings, try to cover up with loose light clothes from feet to neck and wrists, and don’t forget the head. Avoid wearing anything containing perfumes, even shampoo, soaps and laundry detergent, as the smell attracts them. Use mosquito nets for children to sleep under, and check with your hotel to ensure they are spraying for mozzies daily, especially in wet season, November to May. As the highly toxic DDT is said to still be used in some areas to kill mosquitoes, it might pay to ask questions.
RECOVERY
When I returned from Bali I saw a medical doctor to again confirm that I indeed had Dengue Fever. While sympathetic, he didn’t seem to know a lot about the virus, and stressed that it would take me at least a year to recover. He apologised that there was nothing that the medical profession could do, and I would have to wait it out. To combat the ongoing symptoms of this virus, I have been forced to take supplements as well as Olive leaf extract and my usual organic food diet. A course of acidophilus was the first line of defence, to increase the friendly bacteria in the bowel.
I also use Co enzyme Q10, 150 mg, every morning before I eat. The brand of my choice is Excel, a naturopathic recommendation, as many brands are easily oxidised, so research before you buy. CoQ10 increases the oxygen within the cell, giving more energy.
After a decent breakfast I take pancreatic enzymes, both to help with digestion and assimilation, but also to aid with inflammation. Other wonderful supplements which have given me back my health are Eagle brand Tresos B comlex, and Astraforte, which is a mixture of astragalus, and Reishi mushroom, for immune support. I also take these at night after dinner, and ensure that I don’t miss meals or eat too much sugar, as the result of this is immediate tiredness. I found that I don’t tolerate alcohol well either and will avoid it until my liver has completely recovered.
Scheussler’s 12 cell salts have also been extremely beneficial to the recovery of all my cells, and the product, First Stage of Illness, containing Ferrum Phos and Kali Mur, has been invaluable when I have been coming down with the many, many viruses my immune system has been unable to protect me against in the last nine months.
Before leaving Bali, I met an expat at the airport, who recommended Evening Primrose Oil as a healing agent. He said that all the expats living in Bali used it. As I believe there are no accidents, I took the advice of this stranger on board, and am also taking EPO. As the effects of the omega-6 fatty acid, gamma linoleic acid, in EPO on the hormonal and immune system have been well documented, I felt it was definitely worth a try. It is well known as a powerful anti inflammatory, good news for the pain suffered by Dengue victims. However, it is important to mention that omega 6 oils need to be balanced with omega 3 oils, readily available from fish oils and walnuts.
The benefits of yoga cannot be excluded, as the asanas are extremely valuable in balancing the energy throughout the meridians of the body. The breathing methods help to increase the release of toxins, and meditations undertaken during class or self practice will promote positive thoughts and increase serotonin levels. Depression and low energy during a long term illness can be a debilitating side effect, and the gentle nature of yoga can be experienced by anyone. During the worst of my illness, I was still able to do breathing exercises and meditate to calm myself. As soon as I was able to get out of bed, I began to do simple yoga postures, sitting or lying. Any postures with an upside down motion hurt my head, and it took about three weeks before I was able to tackle those. My yoga students were very patient as classes were postponed for the New Year until February, and many had to be cancelled over next few months due to the many viruses I easily contracted.
Any type of energy healing is also worthwhile investigating. I use crystals, Reiki, and flower remedies, and have especially found homeopathy and acupuncture very valuable.Tai chi and Qi Gong are also good options. Crystals that I have found beneficial include smoky quartz, clear quartz, ametrine, fluorite, and malachite. Wear on the body or keep close to the energy field. Ensure the quality of healing by placing the crystals in the sun for a few hours every second day to recharge them. Crystal elixirs and essences should only be made by experienced healers, as some crystals are toxic when taken internally.
If anything good has come out of this experience, I would have to say that it has given me a new level of understanding of the disabling nature of illness. I will never again take my health for granted, nor will I dismiss the suffering of others. Empathy and compassion are no longer just words that I use to describe emotions; they are alive within me in every beat of my heart. I feel glad to be here and so grateful to the Universe with every cell in my body. Good luck to other travellers, and I hope that my illness and advice has armed many of you with knowledge for your protection.
SYMPTOMS
Abrupt onset
Flu like
High fever
Severe headache
Pain behind eyes
Muscle and joint pain
Rash
Redness of skin
Severe itching
Peeling skin
Extreme fatigue
Vomiting
Diaorrhea
Abdominal pain
Hair loss
Anorexia
Dehydration
Decreased blood count
Minor bleeding- Nose and gums
COMPLICATIONS – SEEK MEDICAL ATTENTION
DHF
Internal bleeding
Bleeding gums
Bleeding from other bodily orifices
Bruising
Death can occur
TREATMENT
Hospitalisation – helps increase blood count with intravenous bodily fluids
No vaccination available
Blood tests- positive identification after day 3, but results may be elusive.
Panadol only
Drugs such as aspirin and ibuprofen are contraindicated- thin the blood.
Lavender oil-used topically- may help with headaches, fever and sleep.
PREVENTION
Natural- Vitamin B complex
– Olive leaf extract
– Guava juice
Essential oils- Citronella
-Tea tree
-lavender
Other- Cover up with loose clothing
– Use DEET based mozzie repellents, or at least use citronella
– Stay at hotels that spray repellents regularly, but not DDT
– Eliminate all water collectors in vicinity to prevent breeding
HELPFUL HINTS AND SUPPLEMENTS
Acidophilus
Astraforte
Cell Salts
Coenzyme Q10
Enzymes
Evening Primrose Oil
Olive Leaf Extract
Vitamin B complex
Yoga
Meditation
Crystal Healing
Reiki
Homeopathy
Acupuncture
BIBLIOGRAPHY
Alonso-Zaldivar, Ricardo, “Dengue Fever Conquered? Apparently not”, 25 Jan, 2008. seattletimes.nwsource.com/html/nationworld/2004144327_dengue25.html
Arga, Adhityani and Davies, Ed, “Southeast Asia Battles Dengue Surge, Climate Fears.” 10 June, 2007, Stopglobalwarming.com (1 Feb, 2008)
Carty, Lisa, “Bitten, then she died”, Sydney Morning Herald, 13 Jan, 2008, www.smh.com.au/news/national/dengue-fever-claims-sydney-schoolgirl/2008/01/12/119998865038
Handwerk, Brian, “Dengue Fever. Growing Threat Rivals Malaria, Ebola, Experts Say”, 18 Oct., 2006,
news.nationalgeographic.com/news/2006/10/061018-dengue-fever.html
Hall, Judy, The Crystal Bible, Godsfield Press Ltd, Great Britain, 2003
Mahr, Krista, “Why Dengue Fever is Spreading”, 6 Dec, 2007, www.time.com/timemagazine/article/0,9171,1691616,00.html
Moore, Matthew, “Hundreds die as dengue fever sweeps Jakarta” 2 March, 2004, www.theage.com.au/articles/2004/03/01/1078117361822.html?from=storyrhs
Price, Daniel, D., MD, “Dengue Fever”, 31 Jan, 2008, www.dhpe.org/infect/dengue.html
Reavley, Nicola, Vitamins etc., Bookman Press Pty Ltd., Melbourne, 1999.
Reuters News Service, 26 Feb, 2004, www.planetark.com/dailynewsstory-cfm/newsid/24004/story.htm
Ritchason, Jack, ND, Olive Leaf Extract, Spectrum Marketing, Australia, 2000.
World Health Organisation, “Dengue and dengue haemorrhagic fever”, April, 2002, www.who.int/mediacentre/factsheets/fs117/en