Death dances in the Courtyard


Dengue the deadly disease has invaded the historical city of Lahore in Pakistan. The deadly has so far killed more than 350 people in mare three months and more than 14000 Thousands have been infected with the virus. Hospitals are full of dengue patients.  The scare of dengue has started having psychological effects on the people. Open air dinners, parties and outings have been reduced, restaurants and barbeque places seems deserted. The tourists and visitors are more scared than locals. A single mosquito bite scares them of serious consequences. At my construction work site at least 6 workers contracted this disease. The most worrying thing is rapid decrease in blood platelet count. The blood platelet count of one worker was as follows:-

  • 1100 Hours                          -120*(10)9
  • 1400 hours                          -90
  • 2200 Hours                          -60
  • Next Morning                    -25

General Information

Dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue viruses. It occurs in tropical and sub-tropical areas of the world. Symptoms appear 3—14 days after the infective bite. Dengue fever is a febrile illness that affects infants, young children and adults.

Symptoms range from a mild fever, to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash. There are no specific antiviral medicines for dengue. It is important to maintain hydration. Use of acetylsalicylic acid (e.g. aspirin) and non steroidal anti-inflammatory drugs (e.g. Ibuprofen) is not recommended.

Dengue haemorrhagic fever (fever, abdominal pain, vomiting, bleeding) is a potentially lethal complication, affecting mainly children. Early clinical diagnosis and careful clinical management by experienced physicians and nurses increase survival of patients.

  • Wear clothes that cover your arms, legs and feet
  • Close unscreened doors and windows
  • The use of mosquito deterrents in bedrooms is effective to reduce the number of mosquitoes in the room,
  • Correct use of mosquito nets (essential if accommodation is not air- conditioned). For added protection for up to 3 months or longer, mosquito nets can be soaked in 1 % solution of PERMETHRIN (or other repellent / insecticide). If resident in a malaria area, curtains can be treated in a similar manner.
  • Use of mosquito coils and “knockdown spray” (containing pyrethoids) – spray insecticide in cool dark places where mosquitoes lurk.Avoid use of dark colored clothing, perfumes and colognes in the evening and at night, as all these attract mosquitoes.
  • Use of an effective mosquito repellent on exposed skin and clothing. DEET (diethylmethylbenzamide) is an effective safe component of good repellents. The actual concentration of DEET varies widely between different manufacturers, and can be as high as 90% (too high for safety). Choose a repellent with between 30-45% DEET and take the following precautions against adverse reactions:
  1. apply sparingly and only to exposed skin
  2. never apply high concentrations to skin (use those for clothing)
  3. do not inhale / swallow repellent or get in eyes or mucous membranes
  4. do not apply to hands that may touch eyes or mouth
  5. do not apply to wounds, rashes, or abrasions
  6. wash repellent off after coming indoors to stay
  7. if skin starts to burn, wash repellent off and seek medical advice

24 thoughts on “Death dances in the Courtyard

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