Dengue Fever in Sri Lanka: What Travelers Need to Know

Dengue fever is the most common mosquito-borne illness in Sri Lanka and the single biggest health concern for visitors. The good news: most cases are manageable, and dengue is largely preventable if you take mosquito bites seriously. The bad news: cases have been climbing year after year, and Arugam Bay sees its share, especially during the wetter months.

What is dengue?

Dengue is a viral infection spread by Aedes mosquitoes — small, dark mosquitoes with white markings on their legs. Unlike the malaria mosquito, Aedes bites mostly during the day, with peaks around dawn and dusk. A mosquito that bites an infected person can pass the virus to the next person it bites a few days later.

There are four different strains of dengue. Catching one type gives you lifelong immunity to that strain, but you can still catch the other three. Second infections, in particular, can be more severe.

Symptoms

Dengue usually appears four to ten days after the mosquito bite. The classic pattern is sudden onset of:

• High fever, often 39°C or higher
• Severe headache, often behind the eyes
• Intense muscle and joint pain (the old name for dengue is “breakbone fever”)
• Nausea and vomiting
• A rash that appears on day three or four, often on the chest and back
• Extreme fatigue that can last weeks after the fever passes

Most cases resolve on their own within a week to ten days. A small percentage progress to severe dengue, which involves bleeding, plasma leak from blood vessels, and shock. Warning signs of severe dengue include severe abdominal pain, persistent vomiting, bleeding from the gums or nose, blood in vomit or stool, restlessness, and rapid breathing. These signs typically appear as the fever starts to fall — which is when people often relax their vigilance. Don’t.

What to do if you suspect dengue

Come and see us. We can run a quick blood test that confirms or rules out dengue within a few hours, and we’ll arrange platelet monitoring if needed.

In the meantime:

• Drink fluids constantly. Water, oral rehydration salts, coconut water, fruit juice. Dehydration is what turns mild dengue into a hospital admission.
• Use paracetamol for fever and pain. One gram (two 500mg tablets) every six hours, maximum four grams per day for an adult.
• Do not take ibuprofen, aspirin, or any other NSAID. These thin the blood and can cause dangerous bleeding in dengue patients.
• Rest. Your body is fighting hard. Sleep as much as you can.
• Monitor for warning signs. If anything from the severe-dengue list appears, get to a hospital immediately. Call 1990 for a free ambulance, or call us first.

Prevention

There is no vaccine widely available for travelers, so prevention is about not getting bitten. The strategy is the same whether you’re worried about dengue, chikungunya, or Zika, all of which are spread by the same family of mosquitoes.

• DEET repellent, twenty to thirty percent concentration, reapplied throughout the day. Pay attention to ankles, the back of the neck, and behind the ears.
• Loose, light-coloured clothing, ideally covering arms and legs when you’re not at the beach.
• Sleep with a fan or air conditioning on. Mosquitoes hate moving air.
• Use mosquito coils or plug-in repellents in your room in the evening.
• Clear standing water around where you’re staying. Aedes mosquitoes breed in tiny amounts of water — even a discarded coconut shell or a flower-pot saucer is enough.

A note for surfers

You’ll spend the early morning and late afternoon at the beach, which is exactly when these mosquitoes bite. Apply repellent before walking down to the surf, not just before going out for dinner. Keep a small bottle in your beach bag.

If you’re staying for more than a couple of weeks in Arugam Bay during the wetter months, factor dengue prevention into your daily routine the same way you factor in sunscreen.

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This article is general health information and not a substitute for medical advice. If you have a fever in Sri Lanka, come in and see us, or call 1990 for emergency transport.