Aedes aegypti mosquito, vector for dengue fever
During 1941-1943 a little known epidemic of Dengue Fever swept Queensland down to Brisbane with up to 85% infection rates in some towns. In Townsville alone, 5000 cases were reported with 25,000 probable infections. Judging from past performance and taking other areas into account, it is guesstimated that this figure could at least be doubled.[1]
In 1943, a young woman of 19 would take a twilight river cruise on a Brisbane river and be bitten by a mosquito. Born and bred in the southern state of Victoria, the young woman was in Queensland, having been offered an opportunity to work as a clerk with the Australian Tax Office. In war-time Australia such positions were hard to come by and highly desirable with good prospects for the future. It was a contract position for six months and when expired, the young woman returned to Melbourne.
Succinct entries in her diary of 1943, 1944 and 1945 leave a trail of frequent visits to general practitioners, first in Brisbane, and then in Melbourne. With an economy of words, the young woman tells her story:
Fever. Terrible headache. Very listless. Haemorrhage. Aching all over.
Those are the clues the daimon of that young woman left me ~ a shaman with forensic skills ~ trusting that I would, with an integrated knowledge of Western health sciences, skills in energy medicine, become an Adept at tracking the path of seemingly unconnected crumbs of evidence, and to arrive at a destination in order to close a door.
Thirteen years later in 1957 this woman, now 33, would experience a psychosis so severe as to warrant hospitalization within the Experimental Ward of a renowned Melbourne psychiatric hospital. Eventually a diagnosis of Manic Depression would be affixed to her symptomology. That initial diagnosis would not really be reviewed or questioned, and the drugs prescribed did little to resolve the underlying disturbance which truly was organic in its nature.
Extract Mendhekar DN, Aggarwal P, Aggarwal A. Classical mania associated with dengue infection
Dengue fever is considered to be one of the major health problems in South East Asia. [Australia is just down the globe, Australasia] Initially, neurological manifestations associated with dengue received little attention but now there have been several reports of encephalitis and encephalopathy. However nowhere in literature has dengue fever been mentioned as a cause of or associated with acute psychosis or mania.
Here we report a 21-year-old male, a resident of Delhi who after an acute dengue infection, developed an episode of classical mania. He was admitted to psychiatry department with history of overactivity, excessive talking, argumentativeness, extreme irritability, grandiosity, abusiveness and decreased need for sleep of 4 days duration. Six days prior to onset of psychiatric illness he developed fever (40.3oC) associated with severe headache, confused behavior, generalized body ache, anorexia and occasional vomiting.
Patient was diagnosed as a case of mood disorder, with manic feature according to DSM-IV-TR (293.83). Emergence of manic symptoms in the absence of risk factors such as personal and family history of bipolar illness, cyclothymia suggests organic condition responsible for the mania. A systematic study is needed to find out the prevalence of associated psychiatry disorders.[2]
Aggarwal's article was cited by researchers Blum Pfeifer & Hartz in their 2010 correspondence, Psychiatric manifestations as the leading symptom in an expatriate with Dengue Fever, in which a 52-year old Swiss female patient in Haiti presented with physical symptoms of a blood-borne disorder, and following her admission to hospital developed a psychiatric syndrome characterized by the following symptoms: ideas of reference and delusions with vivid acoustic and visual hallucination, accompanied by agitation and psychotic fears. She heard voices denouncing her from people close to a (non-existent) swimming pool. [3]
It is a well-known fact that the vector for Dengue Fever, the mosquito Ae. aegypti is clearly well able to utilize any available breeding site: large water holding sites are their preferred nurseries.
The number of positive large water holding sites like drums and water storage jars averaged 39%, mid-sized containers like rock holes, buckets and tires averaged 44%, and all other small containers averaged 48%. A reduction in large water storage containers due to the introduction of piped water could be expected to reduce the overall mosquito population and increase the number of positive mid to small sized containers. Seasonality is unlikely to influence breeding sites that are maintained by human activities, however, small rain-filled breeding sites could be severely affected since they require frequent refilling to maintain larvae. [4]
The ability to interpret images contained within hallucinatory states is not the forte of practitioners of Western medicine whose vision has been narrowed and impaired by too many hours spent peering through a microscope, and inhaling the fumes of formalin. Western health sciences do not teach their students the language of the soul, does not teach their acolytes the subtle nuances of the visual language the intelligence of the body employs in order guide the shamanic practitioner into making a more focused assessment of the bug-a-boo which has breached the immune-defences of the patient.
Unfortunately, in 1957 Melbourne, this thirtysomething female patient's physical symptoms and psychotic presentation was not identified as being manifestations of an acute recurrence of dengue. They would have assumed dengue to have been a factor and perhaps were not aware of her previous medical history, and most likely they did not even think to contact this woman's general practitioner to discuss her history.
Such failure to pay attention to details is the thin wedge of medical malpractice...and much more to boot.
The physicians and psychiatrists would not have expected to see this female patient's psychiatriac manifestations as the leading symptoms in a recurring cycle of Dengue Fever: and so they did not see
beyond their bubble.
Four years later, in 1961, this woman would give birth to a female child unaware that dengue had predisposed her to certain pregnancy complications. The child was delivered via emergency C-section after the cord prolapsed placing both mother and child at extreme risk. It was opportune that a highly skilled and competent doctor was in attendance who acted swiftly to release the child from a hostile womb. The medical facility was not a well-equipped inner city hospital, but a small bush-nursing centre on the far outskirts of Melbourne.
It all could have gone the other way. My life could have ended there and then.
Today is the birth day of a remarkable woman and extraordinary healer whose life and times has been my inspiration and touchstone for the research that I do: Elisabeth Kubler-Ross.
Watch that first step: it's a doozy!
Notilia
[1] A Review of the Dengue Mosquito, Aedes aegypti (Diptera: Culicidae), in Australia. Dean Canyon (PhD). Tropical Infectious and Parasitic Diseases Unit, School of Public Health and Tropical Medicine, James Cook University, Townsville Qld 4811, Australia
[2] Mendhekar DN, Aggarwal P, Aggarwal A. Classical mania associated with dengue infection. Indian J Med Sci [serial online] 2006 [cited 2012 Jul 7];60:115-6. Available from: http://www.indianjmedsci.org/text.asp?2006/60/3/115/22764
[3] Abstract Infection Volume 38, Number 4 (2010), 341-343, DOI: 10.1007/s15010-010-0029-9
[4] Dean Canyon, PhD.
Image of penguin found at The Peta Files
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