Dengue Fever

Many victims of yellow fever and dengue epidemics lie in this New Orleans cemetery.

The title of this blog is not a very catchy title, but I thought I’d drop in here and share a bit of information I learned about dengue fever. This is a fever that has plagued tropical regions of the world for centuries, but thanks to human activity, its reach is expanding. There is a vaccine in the works, but not one recommended for general use by the World Health Organization. People pretty much have to depend on physical prevention.

Dengue Fever is spread by mosquitoes, so prevention means keeping mosquitoes away. The two known carriers are Aedes.aegypti (sometimes called the yellow fever mosquito) and Aedes.albopictus, commonly called the tiger mosquito. It’s the tiger mosquito that is carrying the disease into temperate zones. These are not favored by *Aedes.aegypti*. It seems that the eggs of the tiger mosquito can survive a serious winter. And the eggs themselves can carry the disease.

I wrote a rather long article on this, which describes the most dangerous aspect of dengue: the first bout may be survived by most healthy people without much complication. However a second bout, with another variety of the disease (there are four subtypes) can lead to hemorrhagic dengue. This is a potentially life-threatening condition.

So, if you’ve had dengue and think you might be immune. No. That’s not true. You will be immune only to the type that you caught. The other three subtypes are very dangerous for you. Treatment at a facility with experience in fighting this disease is important.

More information, with links to references, may be found at my Steemit blog: “Is Dengue Fever Coming to a Neighborhood Near You?

Two mosquito species, Aedes.aegypti and Aedes.albopictus, are known to transmit dengue, yellow fever and other viral diseases. It turns out, they can travel pretty far, but mostly take advantage of resources near human habitation. These resources can be any container that holds a small amount of water.

So, empty those gutters. Don’t leave old tires around (this seems to be a favorite egg-laying site), and clear out pools of standing water, no matter where you find them.


A New Short Story to Check Out

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I just published another story on my blog at Steemit.  The story refers to my brother’s brush with death when he was nine years old.  He had severe heart disease. One hospital refused to treat him.  St. Francis Hospital, in Roslyn, New York accepted him as a transfer patient.  The physicians at St. Francis saved his life.

I think my story is a commentary on the fragility of life and on the importance of seeking care at a topnotch medical facility.

I was five when my brother had his crisis.  Everything was clear to me as it unfolded back then.  All of us knew, my siblings and I, that my brother might die.  Although he came out of his acute crisis that first night, he struggled for months to overcome the heart disease that had plagued him for years.

My brother’s struggle became part of my developing psyche.  I don’t think I would be the person I am today without having gone through that early trauma.  While I was just a witness to my brother’s struggle, in a family there is no such thing.  Each person is part of the event.

If you feel like checking out my story on Steemit, please do.  The story doesn’t talk about my brother so much.  It deflects the panic of the moment onto an attending physician, who goes through a life-altering crisis of his own.

Thanks for reading my blog.

 

Bellevue Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital: Book Review


By David Oshinsky

In 2016, a Johns Hopkins safety review panel reported that every year, 250,000 deaths in the United States are attributable to medical error. That’s a whopping 9.5% of all deaths in the country. As eye-opening as this statistic may be, it pales in comparison to deaths attributable to medical misadventure in previous centuries. According to David Oshinsky, author of Bellevue, eighteenth and nineteenth century medical treatment was as likely to be the cause of death as it was to save life. The evolution of medical care from that dark age occurred in fits and starts. Dr. Oshinsky offers a gripping description of the journey from darkness to the relative enlightenment of today.

This author skillfully blends medical and social history. He demonstrates the knack of a skilled teacher as he weaves anecdotes into a narrative of hard facts. Dr. Oshinsky has so much information at hand, that he doesn’t need to resort to conjecture to enliven his story. Truth, he proves, is indeed stronger than fiction.

Examples of Dr. Oshinsky’s dynamic writing are on display throughout the book, most memorably in his descriptions of surgery without anesthesia and treatment without antiseptics. In the first case, a boy’s leg is amputated. The father is present and aids in restraining his son. The sound of a saw fills the surgical theater as the child, without benefit of anesthesia, loses his leg. Shrieks fill the room. The father faints. We, the readers, are left with an indelible impression.

In another instance, President James Garfield suffers the consequences of medical obstinacy. The President is shot. An assassin’s bullet must be removed. The esteemed Dr. Frank Hamilton of Bellevue is called in. He, confident in his skills, declines to follow new guidelines in medicine that prescribe sterilization before contact with a patient. Garfield dies, month later, of massive infection. It is the medical consensus that this death was due not to an assassin’s bullet but to medical misadventure.

Dr. Oshinsky comes to the task of writing his book with excellent credentials. He is a professor of history at New York University and the director of Medical Humanities at NYU Langone Medical Center. In addition, he has won a Pulitzer Prize for an earlier book, Polio: An American Story.

The current book, Bellevue, is about the history of a public institution, and it is more. It traces the history of health care in New York City. It introduces readers to some giants of modern medicine, including Robert Koch, Joseph Lister and Florence Nightingale. The author’s broad perspective offers insight into the immigrant experience and its intersection with New York City politics. Dr. Oshinsky’s wide lens creates a richly textured tableau in which Bellevue Hospital is the focal point.

Bellevue is an easy read. I recommend it to anyone interested in history, and to those readers who would like to gain insight into the culture of the medical profession.

By A. G. Moore 2/10/17

The picture of Bellevue Hospital (above) is used under a Creative Commons
 4.0 International License