Peru Suffering Worst Dengue Outbreak In Its History, Over 146K Cases

Peru is suffering a very bad outbreak of something that’s been nicknamed “break-bone fever”—dengue. In fact, it’s been a historically bad outbreak, as in the worst dengue outbreak that the country has ever had. The outbreak has already left over 146,000 people infected and at least 248 dead. It’s also resulted in the resignation of Rosa Gutiérrez, MD, from her post as Peru’s Minister of Health amidst questions about her handling of the outbreak. And don’t expect Peru to get a break from this outbreak any time soon.

That’s because El Niño and Cyclone Yaku brought lots of rain to the northern portions of Peru during the months of April and May. And such conditions have led to a situation that really bites and sucks: surge in the mosquito population. That’s included a surge of Aedes aegypti, the mosquito that can carry any of the four different types of dengue viruses out there and infect you by biting you.

Dengue is not a fun illness to have—very few things nicknamed “break-bone” are. Only about one in four infected with the dengue virus will develop symptoms. That may sound good but in the words of Run-DMC, it’s tricky. When you have asymptomatic dengue, you may not even realize that you have dengue unless you’ve gotten a blood test to establish the diagnosis. While getting infected with one type of dengue virus may help your develop immunity against that specific type, it won’t do so for the other three types. In fact, it can raise your risk of having worse dengue when infected by other types of the dengue virus. Not realizing that you’ve had dengue before may leave you unaware that you’re at greater risk for developing severe dengue. Dengue can be a bit like hearing the song, “Who Let The Dogs Out?” It can be a lot worse the second time around.

It is more common to have mild dengue. Mild dengue typically consists of two to seven days of fever along with nausea, vomiting, a rash, muscle pain, joint pain, bone pain, or eye pain. Don’t let the “mild” moniker mislead you, though. Dengue fever ain’t like Bieber Fever. It earned the nickname “break-bone fever” because the pain can feel like someone is breaking your bones.

While there’s no specific treatment for dengue, getting lots of rest, drinking plenty of fluids, and taking acetaminophen for the fever and pain can help. Be on the lookout, though. To put it mildly, mild dengue can turn into severe dengue within just a few hours. And severe dengue is a medical emergency.

So, when you may have mild dengue, look for the following warning signs that severe dengue is just around the corner: suffering belly tenderness or pain, vomiting at least three times over a 24-hour period, vomiting up blood, bleeding from your nose or gums, or having blood in your stool. You may also notice tiredness, restlessness, or irritability. Of course, vomiting up blood in of itself can make you restless. You don’t typically say, “I’m vomiting up blood right now but let’s just continue with the date” or post on Instagram, “Vomiting up blood, #Zen.” If you notice any of these symptoms, see a doctor as soon as possible. And don’t just see a doctor and wave. Seek emergent care from that doctor.

That’s because severe dengue can lead to shock, bad internal bleeding (as opposed to good internal bleeding), and potentially death. Severe dengue ends up affecting around one in every 20 people who are sick with dengue. You are more likely to get severe dengue when you’ve already had dengue in the past. That’s why having had no symptoms during a previous dengue episode can be a bit misleading. The first dengue infection can prime your immune system to react more aggressively the second time you get infected. The resulting “antibody-dependent enhancement” can help make dengue worse the second time around. You are also more likely to develop severe dengue if you are an infant or pregnant.

Dengue has been on the rise globally. From 2000 to 2019, the number of reported cases around the world in a given year went up from 505,430 to 5.2 million, according to the World Health Organization (WHO). Dengue has been more common in the hot humid climates where the Aedes mosquitoes tend to live. But these regions have been expanding over the past few decades as global temperatures have continued to rise. That’s because, you know, climate change is real, despite what some politicians and personalities may insist.

There is a vaccine against dengue, called Dengvaxia. But wait for it, wait for it, wait until you have had dengue at least once to get the vaccine. It’s use is restricted to children from 9 to 16 years of age, who live in areas that are endemic for dengue and have already had a previous laboratory-confirmed dengue virus infection. That’s because you don’t want the resulting antibody response from the vaccine to make you more likely to get severe dengue.

Unless the current rate of climate change can be slowed, expect more and more such dengue outbreaks to occur. And the hot take is that with temperatures on the rise throughout the globe Aedes aegypti mosquitoes have been spreading their wings to locations that typically haven’t had such mosquitoes, including many part of the U.S. So, in the coming years, expect to hear of dengue outbreaks where you haven’t heard of them before. This is yet another reason why governments and businesses may want to work at a much more feverish pace to reduce the pollution that’s still being pumped into the air and stop treating the Earth like a gigantic toilet bowl.