Maarten Vasbinder lives in Isaan for 1½ years, where he met a wonderful woman with whom he shares joys and sorrows. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers and writes about medical facts.
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Hello Maarten,
I contracted a Denquefever in early 2015 and am still not the old one until now. Tired very quickly after little effort, first to act in the event of a flu or virus infection.
A chronic chest cough. I had two blood tests and these were OK by Dutch standards.
My question, could it be that something is still not okay, something that they may not be able to investigate here in the Netherlands because it is not an issue here and/or is known?
We also used the water that is offered at the water service outlets. Read later that this may not be okay?
I don't really know how to proceed.
With regards
Egbert
˜˜˜˜˜˜˜
Dear Egbert,
It says something like Post Dengue Syndrome, which is believed to be caused by an autoimmune reaction.
In autoimmune reactions, immune cells attack their own body. Something we see in rheumatism, among other things.
Many researchers believe that a viral infection is at the root of such reactions. A plausible explanation, although never proven.
I myself also think of prions, infectious proteins, which cause, among other things, mad cow disease. I researched this 35 years ago.
There are also indications that such a reaction can occur with Dengue, although there is actually no evidence other than a few elevated laboratory values such as: CD4 / CD8 ratio, cytokines and C3a and C5a. However, it is not all very clear and not simple either.
The duration of symptoms generally does not exceed two years. That is longer than we are used to with, for example, mononucleosis. Maybe you do and that's easy to investigate.
The greatest experts on Dengue are at the University of Singapore. The Havenziekenhuis in Rotterdam was also well informed in the past.
As for the water you drink, I can't help you any further. You should have that tested.
I myself drink Tesco water, which has the advantage that it tastes good and is not halal.
For the rest, make sure you eat healthy and tasty.
Yours faithfully,
Maarten
Dear Maarten, a question about your answer to this one,
What is the verdict if water is not Halal? Does Halal water exist?
Kind regards, Arjen (I am not Muslim)
Hi Arjen,
I suspect Maarten means that Tesco water is cheap. Halal certified water (yes it really exists) is currently the most expensive water there is. Even more expensive than 'holy water' (yes that also really exists)..
Even many Muslims see the nonsense of halal water. See for example: https://faabdul.wordpress.com/2015/12/01/8-reasons-why-i-will-not-consume-the-halal-certified-water/
Michel,
Indeed, Tesco water is cheap, but also one of the few types that is not halal. Take a good look at the bottles you have at home.
Arjen,
The difference between halal and haram (non halal) water is that halal water is approved by an imam. That approval costs money and that money is used to subsidize all kinds of fighters, among other things. That it contains camel pee, as some claim, is a monkey story.
Many products are halal, because otherwise they are threatened to ban them for Muslims. Coca Cola for example. This method is called extortion.
We will not talk about the extremely cruel halal slaughter methods. Kosher slaughter, which I am not in favor of, also cuts the spinal cord so that the animals only suffer for a few seconds.
I realize I'm going way off topic now.
Unfortunately I can't add a halal sign, but you can find that on google.
Hello Maarten,
Speaking of dengue, I have heard (read) somewhere that there are 4 variants of dengue, and if you have had it once, you become immune to it, what is true about this?
Lunghan
Lunghan,
Indeed, there are four varieties of Dengue. If you've had all four, you're fairly immune.
You can have that tested if you want.
A vaccine against three of the four variants will probably be on the market this year.
As far as I know there are now 5 variants. Having had 1 leads to immunity for that variant. On the other hand, the risk of the so-called bleeding version is greater if you become infected by 1 of the other variants. This hemorrhagic version leads to a sharp decrease in blood clotting capacity and is much more serious than the common dengue. hospitalization within the first 3 days is then necessary.
Speaking of dengue: there are many mosquitoes in Thailand and you do not know which one can infect you.
Could it also be that you contract dengue but do not get the symptoms or in a very mild degree so that you do not even realize it?
Conversely, it seems to be the case that some die from it, while most are cured again after a short time.
ger,
The mosquito that transmits Dengue is the tiger mosquito. That is a small mosquito with transverse stripes. The malaria mosquito is much larger, just like the common mosquito. They are all bitches, at least the females.
Many people don't even know they've had dengue. For most, it progresses like a mild flu.
Symptoms: Sudden onset of high fever, headache (usually behind the eyes), pain in muscles and joints, and skin rash such as measles. When the fever is gone, slight bleeding from mucous membranes in the mouth and nose may occur. Better consult a doctor before then.
In severe cases, significant vascular leakage can occur, which can lead to fluid in the lungs and kidney failure. Bleeding also occurs.
It is useful to know the blood group, but it is always checked before a possible transfusion, to prevent disasters. The test takes less than a minute.
Hi Maarten,
I don't know much about diseases, about mosquitoes all the more. Dengue is mainly transmitted by the tiger mosquito (Aedes albopictus), but not exclusively by this mosquito. And this mosquito brings (can) transmit many more diseases.
“The Dengue mosquito” therefore does not exist, Dengue can be transmitted by many more species. The behavior of the Tiger Mosquito ensures that the spread is much faster than Malaria. The mosquito is aggressive and mainly active during the day. She also stings when you walk or work. The sting is painful (you “feel” it) The mosquito knows this and therefore only stays with one host for a short time. Because of this, she needs 3-4 hosts to collect enough blood.
Thank you for the useful information you provide!
Arjen.
Arjen,
Thank you also for your information. Perhaps you could ask the editors to post some pictures of the various mosquitoes of the Aedes and other families, which transmit Yellow Fever (Aedes Aegypti), ZIKA, Chikungunya fever, Dirofilariasis, Japanese Encephalitis and the Usutu Virus, among others. An article about all those mosquito species seems even better to me, something in the style of the column by the biologist Fop I. Brouwer. “What lives and grows and always fascinates us”.
Sincerely,
Maarten
Peter,
Indeed, there is thought to be a fifth serotype from a patient in Singapore. That's still up for debate, but I think you're right. In microbiology there is a strong attachment to dogmas and people do not like to admit that someone else has discovered something. However, it has remained with that one patient as far as I know.
It is true that a second infection with a different serotype entails more risks.
The new vaccine no longer has that risk, it is said.
How long can it take from being stung to getting sick. Can you still get symptoms of Dengue after 2 weeks at home in the fresh Netherlands?
Dear Martin,
About 2 years ago I contracted dengue. Which variant is unknown to me.
I was hospitalized for 5 days for this. I could barely walk, my fingers were crooked and I could hardly open my mouth to eat (only yogurt with the small white spoon provided)
Also a lot of muscles and my joints hurt.
My question to you is how long can the pain in the joints last? This is because I sometimes suffer a lot from my joints.
Yours faithfully,
Hendrik S.
Jack,
The incubation period is between 4-14 days, but is usually shorter at 4-7 days.
Getting sick after 14 days is rare.
Dengue is now also found in Europe since the tiger mosquito started traveling.
Henry,
Average duration of complications after dengue is about 2 years. Because the chronic pain after dengue is not common, little is actually known about it. Chronic joint pain seems to occur mainly with a deficiency of vitamins E, D and B12.
Vit B12 is best administered by injection. You can buy E and D in pills
So I would start with that.
If that doesn't work, I think it would be best for you to visit a Dengue specialist.
Sincerely,
Maarten