Malaria and dengue second time?

[Tim francis]

I’ve had dengue and malaria once. I was in Central America almost four weeks before making it to Texas. At the er, they thought I had cancer. So the oncologist said I had malaria. After a week of fevers a doc in Panama said I had dengue. Three weeks later, a doc in Mexico said I had dengue. I’m assuming I had both maybe at the same time. If I remember right, the oncologist said if I get dengue or malaria again it could be fatal. If I was to cruise in malaria dengue areas again, will the preventative shot do anything and anyone know how serious it can be if I contract either again. I know I should ask a doctor but don’t really have one. Thanks.

[Dsanduril]

Dengue can be much more serious the second time around. There are four types of dengue, you may get immunity from the type you had, but conversely the other types can be much more serious if contracted. Science is still developing, but it appears that the new types use the antibodies of the first type to attack you more effectively. This can lead to internal bleeding and liver failure (and possibly death as a result), symptoms that are not generally present the first time around. So, bottom line, not from a doctor of any kind, is that yes, if you did indeed have dengue it can be much more serious the second time around if you get one of the other strains.

Don't know about the efficacy of the shot under those conditions, but if you have a place to get a shot you should be able to talk with them about it.

[Jerry Woodward]

Just because a doc in Mexico said you had Dengue doesn't mean you actually had it unless he did a specific serological test. That is important to know: are you seropositive for Dengue? Dsanduril is right, there is a theory called antibody dependent enhancement (ADE) in which antibody to one dengue strain can exacerbate infection to another dengue strain. However, not everyone gets the the more severe hemorrhagic fever the second time around. Even if you do get a more severe infection and get medical care, the risk of fatality is low. The vaccine is reasonably effective but is only recommended for those who are already seropositive (to avoid the chance that the vaccine itself could induce ADE). That is why it is important to know whether you are actually seropositive for dengue.

Malaria is actually a bigger worry. It is a very different beast, a parasite with blood forms and liver forms. It can go dormant in the liver and re-appear at a later time. Again, did the doctor just suspect you had malaria or was it actually confirmed by tests? If it was confirmed malaria, you should have undergone intensive treatment to make sure you got rid of all the liver stage disease.

If you didn't go through treatment and no testing was done, I suggest you find a doc familiar with tropical medicine and get tested. He/she will then recommend treatment if you indeed had/have malaria and possibly a dengue vaccine if you are seropositive for dengue. The only approved malaria vaccine isn't very effective and requires 4 doses. I don't think I would bother.
Once you are sure you are malaria free, I would not let the fear of another dengue infection stop me from cruising in the tropics. The best prevention is to use mosquito repellent, anchor out, and if you are in an area where there are lots of mosquitoes (like the jungle) use netting.

[Tim francis]

I don’t think the doc in colon panama and the town in Mexico doc did anything but bloodwork and saw that my levels were really low. They said take vitamins and iron and water. That’s all they said with a little language barrier. If I remember right, the oncologist said for sure it was malaria. All I remember is taking a few prescriptions for it. I know the morning before I went to the er, I had a bad fever and couldn’t breathe for about 45 minutes. I was getting the bare minimum oxygen just to not pass out. I was posturing. I think that’s what it’s called where my hands and all were clamping and I couldn’t get out of the prone position to crawl outside for help. The more I tried to move, the less I could breathe. It wasn’t anxiety. I was super calm and collected.
Thanks so much for the information.