I hate mosquitoes so much that I bring my own bug repellent to parties. But in early March, on a trip with my partner to the idyllic island of Curaçao off the coast of Venezuela, I was caught off guard by insect bites after our bed-and-breakfast hosts said that mosquitoes didn’t usually appear until late summer.
Near the end of the vacation, my legs began to ache. After I couldn’t keep up with my partner on a snorkeling adventure, he pulled me from the water. My ribs felt broken, as if I’d been smashed against large boulders in the sea. Later that day came intense fever, alternating with shaking chills.
Back in Michigan — weak, nauseated and dehydrated from explosive diarrhea — I ended up in the emergency department. Tests showed concerning white blood cell levels and abnormal liver numbers. The physician assistant who saw me was perplexed; she gave me IV fluids, medication for nausea and sent me home.
A few days later I developed itching so severe that I couldn’t sleep. A bright red rash spread over both thighs and up my lower back. My brain was foggy, and my balance was so impaired that I would have failed a sobriety test. My primary care doctor had no answers. But as my head began to clear, it occurred to me to request a dengue fever test.
Two days later, the test was positive.
Despite my training in medicine, I was blindsided. Dengue, a mosquito-borne illness, is surging through Latin America and the Caribbean, including in Puerto Rico, where a public health emergency was declared last week. This year is likely to be the worst on record, in part because of El Niño-driven temperature spikes and extreme weather linked to climate change. As temperatures rise and precipitation patterns grow more erratic, the problem will get only worse.
But neither the traveling public nor our frontline health workers are prepared. Without urgent reforms to how we educate travelers, doctors, nurses and others — as well as reforms to public health surveillance and early warning systems — we will be doomed to miss textbook cases like mine. That means those infected with dengue will miss out on timely treatment, possibly even spreading the virus to areas where it has never been found before.
