Dengue is one of the top ten threats to public health worldwide. Dengue incidence has grown by 85% over the last 50 years. It continues to spread rapidly, fuelled by urbanization, population growth and climate change. Today, nearly 4 billion people in 129 countries are at risk of dengue infection.

To hear more about people’s experiences, we visited recovered dengue patients in the historic city of Malacca in Malaysia, living in the highest risk areas for dengue, known as ‘red zones’.

We met 31-year-old Tan Jhii Lian (Jhii), who in 2020 was infected by dengue twice in just three months.

The first time, she went to see a doctor with a fever of 40°C (104 °F), body aches, and weakness. When he found out where she lived, he immediately ordered a dengue test. The result was positive.

’I didn’t know what to expect, but I heard it could be quite serious. Because I have worked in hospitals, I have seen cases where dengue patients had to be admitted into the intensive care unit,’ Jhii said. She was sent home with medicines and instructions to rest, but as her fever got worse, Jhii found herself in and out of different hospitals.

Leaving her young baby was the most difficult aspect of the new mother’s ordeal. ‘The first time my daughter was just around six months old, and the worst thing is that she’s never been away from me before since her birth. We were so worried about who would take care of her and how long I would have to be in the ward.‘

‘I was stuck there with a high fever. I was shivering even with a jacket and four layers of blankets covering me. There’s no treatment, there’s only symptomatic treatment available right now. I couldn’t fight back, so I just endured the whole experience.’

Following her recovery, Jhii and her family took stringent preventative precautions. They covered all doors and windows with mosquito netting and avoided going out at peak mosquito biting times. But just three months later, she got infected again.

While the first infection had caused symptoms of high fever, lethargy, and muscle aches, this time she had severe abdominal cramps and diarrhoea. ’The second time, I couldn’t even take in any food or even water. Just one sip made the cramp so bad. It was really painful.’

Because there is no specific treatment for dengue, once again the hospital could only give her supportive care. ‘They gave me anti-diarrhoea medication, paracetamol, and a drip, that’s all.‘

Because of the infections, Jhii told us ‘my milk supply halved after each infection and as a result, I only managed to breastfeed my daughter until she was ten months old.’

Living in a dengue red zone puts Jhii at high risk. ’I’m still living in fear that I might contract the virus a third and fourth time. Every time they do the fogging, we know that there is a case, and it’s actually quite frequent in my neighbourhood.’

’I know that the more times you get dengue, the more serious it can get. So, of course I’m scared. The first time I just had a fever, but the second time my blood result was worrying. So, I’m scared of what will happen if I get it a third time.’ Jhi also particularly worries about her daughter. ’She’s so young. For me having been infected twice, there’s a very high risk of her getting it. I just can’t imagine a baby contracting dengue.’ 

’It’s everywhere and there’s nothing we can do about it. If we had a vaccine or medication to treat it, at least we would know there’s a solution.’

Across the world dengue causes immense individual suffering and puts enormous pressure on over-burdened health systems. In South-East Asia the incidence of dengue increased by 46% between 2015 and 2019, mostly affecting children under the age of 15. Severe dengue is a leading cause of hospitalization and death in many countries. In Malaysia, the last major outbreak in 2019, as an epidemic swept South-East Asia, saw a new record of 131,000 cases.

DNDi is partnering with dengue-endemic countries on a project that aims to find a safe, affordable, and effective treatment for dengue.

Photo credit: Abang Amirrul Hadi – DNDi