NATURAL HOLISTIC MEDICINE BLOG - Florida is currently experiencing an unusual surge in locally acquired dengue fever cases, prompting concern among public health officials and residents. This mosquito-borne illness, often referred to as "breakbone fever" due to its severe body aches, has seen a significant uptick, with the state reporting 324 cases this year alone. While many associate dengue with tropical travel, the current outbreak highlights the growing threat of local transmission within the United States, particularly in regions with thriving mosquito populations.
Maurice Kurtz, a 73-year-old resident of St.
Petersburg, Florida, recently experienced the debilitating effects of dengue firsthand.
His ordeal began on September 19, when he awoke with a fever of 101ºF and overwhelming fatigue.
"I went around the block and, oh, I ached so much," Kurtz recounted to CIDRAP News.
He described the pain as far exceeding the discomfort of his most strenuous workouts, noting it was "way beyond the tightness and aching I get from the most strenuous workouts I’ve ever done." Initially, he suspected the flu, despite lacking typical respiratory symptoms like a cough or sore throat.
Over the weekend, Kurtz slept for 16 hours, a stark contrast to his usual active lifestyle which includes swimming, biking, and running.
Seeking Diagnosis Amidst a Growing Outbreak
By Monday, Kurtz’s fever had subsided, but exhaustion persisted.
Negative results from flu and COVID-19 tests did little to clarify his condition.
A friend, aware of the ongoing dengue outbreak in central Florida, advised Kurtz to seek medical attention and specifically request testing for the mosquito-borne disease.
Upon visiting an urgent care clinic, Kurtz found that staff were initially resistant to his dengue test request.
"I said, ‘Well, I did the COVID, flu thing, and it was negative.’ They said, ‘We just test for them,’" Kurtz recalled.
The physician, after ruling out common infections, initially dismissed the possibility of dengue, stating, "Well you don’t have any of those." Kurtz pressed his case, explaining his symptoms and his reason for seeking a dengue test.
Geographic Misconceptions and Persistent Symptoms
The physician's response revealed a common misconception regarding the outbreak's location.
"He says, ‘Well, it’s really up in north county, in Hillsborough [County].
We don’t have it down here,’" Kurtz stated.
This geographical assumption proved incorrect when Kurtz revealed he had visited Tampa, Florida, the acknowledged epicenter of the dengue outbreak, just days prior.
Despite his doubts about feeling sick so soon after his visit, a blood sample was eventually taken for dengue testing.
The ensuing days were marked by continued fatigue and an unusual amount of sleep.
It wasn't until late Saturday that the Pinellas County Health Department contacted Kurtz with his diagnosis.
Understanding Dengue Fever: An Unusual Florida Epidemic
Dengue fever, also known as breakbone fever, is typically contracted through the bite of infected mosquitoes, most commonly Aedes aegypti and Aedes albopictus. While these mosquito species thrive in Florida, local transmission in such numbers is considered unusual. Dawn Wesson, PhD, director of Tulane University’s Vector-Borne Infectious Diseases Initiative, told CIDRAP News, "Florida is approaching or has already surpassed 300 cases, and it’s a lot. The epicenter is somewhat unusual in that we tend to see most of the cases that are local transmission … further south." She explained that Aedes aegypti is particularly efficient at transmitting dengue because it preferentially feeds on humans. The virus is transmitted when an infected mosquito bites a person, a process often unnoticed due to the mosquito's small size and relatively painless bite. Local transmission occurs when a mosquito bites an infected person and then subsequently bites an uninfected person, creating a chain of transmission.
The Role of Climate and Vector Control
Experts suggest that rising global temperatures due to climate change may contribute to an increase in dengue outbreaks.
"We need to be more prepared for these sorts of things and to understand what’s driving it," Wesson commented, questioning whether increased human movement to areas with ongoing transmission or the return of asymptomatic or mildly ill travelers to regions with competent mosquito vectors are the primary drivers.
Effective mosquito control, including insecticide spraying and eliminating standing water sources that serve as breeding grounds, is crucial.
Both Hillsborough and Pinellas Counties have intensified these mitigation efforts and declared states of emergency.
Symptoms and Complications of Dengue
Maria Alcaide, MD, a professor of medicine at the University of Miami Health System, described dengue as a "febrile illness" characterized by fever, severe body aches, extreme fatigue, nausea, vomiting, and diarrhea.
Distinctive symptoms can include a rash and intense pain behind the eyes.
While most individuals recover fully, repeated infections or severe cases can lead to serious complications such as capillary leakage, where plasma seeps from blood vessels, causing a dangerous drop in blood volume, and hemorrhagic fevers.
"It’s a little different than plain loss of fluid from having a fever or sweating, and it is more complex and is very characteristic of dengue," Alcaide explained.
Unlike the flu, dengue typically does not present with respiratory symptoms.
The nickname "breakbone fever" stems from the excruciating pain associated with the illness.
"What really differentiates it is the intensity of the pain," Alcaide noted, "People with dengue can say, ‘I can hardly move out of the bed to think about going to the hospital because it hurts so much.’"
Treatment and Prevention Strategies
There is no specific antiviral treatment for dengue.
Management focuses on alleviating symptoms through rest, adequate fluid intake, and over-the-counter pain relievers like acetaminophen (Tylenol).
Crucially, individuals with dengue fever must avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), as these can exacerbate bleeding and volume depletion complications.
Severe illness is more common in older individuals, those with pre-existing health conditions such as kidney disease, diabetes, or heart failure, and individuals who have contracted dengue multiple times.
Prevention remains the most effective strategy, emphasizing the avoidance of mosquito bites.
This includes using insect repellent containing DEET, eliminating standing water around homes, wearing protective clothing, and staying indoors during peak mosquito activity hours.
Kurtz, now recovering, shared his experience to raise awareness.
"I just got a mosquito bite and I’m recovering from this disease, which has a reputation of being this rare tropical thing," he said.
"The likelihood of you getting it is very, very slim.
But it could happen to you—and in [my] case, it did." His return to lighter activities, such as a relaxed bike ride in early October, signifies his recovery, though the memory of the severe illness serves as a stark reminder of the persistent threat posed by mosquito-borne diseases in Florida.
Note: This information is intended for general awareness. Dengue fever is a serious illness, and individuals experiencing symptoms should consult a healthcare professional for accurate diagnosis and treatment. Public health recommendations and guidelines should always be followed.
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