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Dengue fever is a viral infection carried by the female Aedes Aegypti mosquito and generally occurs only during and after the rainy season. this mosquito generally lives in warm climates, so in Panama is most likely to be found in coastal areas, and much less in the mountains

Dengue fever is also known as “breakbone fever” due to the very painful joints in the body. Anybody that has had dengue fever will tell you in no uncertain terms, that they have never felt so miserable, so weak or so totally “out of it”.  I have seen strong men reduced to an utter state of weakness, others desperately trying to fight the symptoms not believing that they could possibly have dengue fever!

There are four distinct, but closely related viruses that cause dengue - DEN1, DEN2, DEN3 and DEN4. Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) are complications arising from these.  Recovery from infection by one strain provides lifelong immunity against that virus but confers only partial and transient protection against subsequent infection by the other three viruses.  There is good evidence that sequential infection increases the risk of developing DHF.


    A Mild to severe headache
    Pain behind the eyes
    Joint and muscle pain
    Fever and chills
    Back Ache
    Nausea (with or withour vomiting)
    Extreme tiredness
    Possibly a rash on arms legs and torso
Quite often the first time you catch Dengue, the symptoms are so mild you don't think anything of it - like a mild flu, however if you get it again, it is likely to be much worse. In fact, if you suddenly get strong symptoms there is a good chance that this is your second infection, not the first. The main indicator of Dengue, as opposed to flu, is the pain behind the eyes.
In some people the symptoms are quite sudden and in others it could take a few days, starting off with very mild symptoms. Dengue is very often misdiagnosed as having the ‘flu’ and antibiotics are given, which from experience worsen the effects and slows down the recovery period. The long term effect of not being sure that you have actually had Dengue is that when you are infected a second or third time, symptoms are much worse and you could develop Dengue Hemorrhagic Fever.

The initial symptoms of DHF is a high fever (40-41 C and a severe headache.  Small purplish spots can be seen on the skin (blood is leaking out of the vessels).

These symptoms are then followed by

    Abdominal pain
    Nausea and vomiting
    Bleeding of nose and gums
    Sore throat and a cough
    Blood in the stool
    Large bruised areas appear on the skin due to severe bleeding.

If you develop DHF, you need to be in hospital - quickly

The severe hemorrhage results in a decrease of blood in the body, which results in Dengue Shock Syndrome  (DSS).

Patients must have their fever reduced as soon as possible and be closely monitored for the first few days until condition is stabilized.  A patients condition may suddenly worsen after a few days if the fever has not been brought down. The patient's temperature will suddenly drop and the patient will show signs of circulatory failure. The patient may go rapidly into a critical state of shock (DSS) which could (and in almost all cases does) result in death within 12 - 24 hours.

Infected humans are the main carriers and multipliers of the virus, serving as a source of the virus for uninfected mosquitoes.  The virus circulates in the blood of infected humans for 2 – 7 days, during which subtle symptoms like tiredness, mild headache, and that “hot” feeling at times can be observed.  It is so subtle that most people suspect they are just overworked or “depressed” because of all the rain.

When a person finally succumbs to the illness the fever generally last from 3 – 7 days with the headache, aches and pains lasting much longer (up to 14 days). The after effects of the virus, tiredness, loss of appetite, unable to concentrate could last up to 6 weeks.  I have seen cases lasting as long as 3 months!

According to WHO dengue has become a world-wide health risk, with the numbers of infections, and subsequent deaths of dengue hemorrhagic fever on the increase each year.


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