THE GLOBE AND MAIL | In a small mosquito infested Malaysian port the dengue is angry, and one man who thinks he is impervious, isn't
Within a lining of emerald grasses, fists of sewage clot the stream that lies along my path. It's a fetid path, wrought with litter, but in my nine months of living in Port Klang, Malaysia, it has never produced the surprises that travellers fear -- such as snakes, predators, or worse, a tropical virus.
Barrels of salt-dried squid sit on the porch of Mrs. Lee's grocery. A woman enlightened by the words of Confucius and Bon Jovi, she sells the hard-found Chinese tobacco I'm after. It's smoke, thick and black, slides down my throat like hot pudding. She holds the tobacco pouch above my hand. "My son has the dengue fever -- many others too. Be careful, we might have an outbreak."
The Swahili called it ka denga pepo, sudden seizure, or evil spirit, and they revered it from afar. The Spanish mocked it, calling it dengue, prudery or fastidiousness, and it hit them ruthlessly. Recently, outbreaks of sudden seizures have hit the world in epidemic proportions, as evil today as ever before.
The dengue fever (pronounced DEN-gay) is a non-fatal, tropical virus transmitted by the day-biting Aedes mosquito. There are four dengue types in over 200 countries. The virus incubates in the bloodstream for up to 25 days then attacks suddenly as searing orbital pain, fever, rash and severe joint and muscle pain lash the body. After a quick remission, a fever climbs up to 40 C, the spleen inflates like a water balloon and the original orchestra of pains returns.
I follow Mrs. Lee's advice to avoid the mosquito-infested path, to cover my skin and smear a toxic soup of insect repellent over my body. But after six days, it starts with a headache and a chill. Then even delicate cottons claw my skin. Within 30 minutes my body boils with the dengue.
The virus' attack on Port Klang moves methodically. It strikes Oscar, the lime-juice vender then bears down on thirsty pedestrians as they pass under buzzing Pepsi signs. It's now daytime, but what day I don't know. The bedroom curtain laps like a loose sail as a breeze pushes in and mops up the sourness of bad breath and sickness. A long-tailed macaque cries somewhere in the pagoda trees. I strain to look over the sill and see the monkey, but instead catch a crested serpent eagle sweeping the canopy for snakes. Outside, it's a perfect day.
Days later my chills have eased and my stomach roars for food. I prepare to stand when the sheets cling to my skin. I sit up, soggy with what can only be urine. Ashamed, I shuffle to the window and look for the noisy monkey.
My dizziness returns with vertigo. I sway right, wobble and tip, aiming my fall for the bed but crash into the fan. Here I sit and review the days: I can't eat; it all comes back. I can't walk; I fall down. Chills. A rash. Depression, confusion and anxiety run relays in my mind with vicious transition -- but the true horror arises when I look to my bed. I crawl to the mattress and sniff: the odor is pungent, yet delicate and warm, like tears. Like sweat. Thank god, I think, it's only sweat.
Like any creature fighting for survival, the dengue virus is evolving within our changing environment. In the 1960s hemorrhagic dengue (DHF) surfaced, hitting victims hard, often with internal bleeding and heart failure. DHF is not a new strain of dengue fever, but rather the body's inability to combat a re-infection. Dr. Anne McCarthy of the Laboratory Centre for Disease Control in Ottawa explains that "in the past, dengue type-two was the one commonly associated with DHF...but now we're seeing DHF with the other three types (of dengue) as well." Though few Canadian tourists have contracted DHF, frequent travellers should take extra precautions, McCarthy adds. "People can have a non-apparent infection the first time, and when thy have a second infection they suddenly have DHF."
"...you don't want to take any chances. The dengue is angry."
The doctors in Port Klang feel that my neighbor's brother, Nazaruden, may have DHF. On a quiet and blistering afternoon, Zuraya, my neighbor, storms into my flat, "They're monitoring Naza for bleeding! Get up. You're going to the hospital."
Tropical nations fearing DHF outbreaks have launched programs to thin the Aedes population--by capping wells, stocking ponds with larvae-feeding fish and spraying insecticides. But officials in poorer countries are often forced to channel their resources into more immediate priorities.
Today DHF is a leading cause of death and hospitalization among children in Southeast Asia. Zuraya's concern for my safety, she explains in a dart of traffic, is perpetuated by these tragedies around her. "You be been here for many months...you don't want to take any chances. The dengue is angry."
Patients teem in the public hospital. The smell of soap and latex is thick. A fatigued doctor sits in a tube of light and points to my chair. She pulls a tray of syringes from a shelf and draws my blood before plunging a booster shot in my arm. I mention the raspberry polka-dots that rose over night.
"More mosquito bites," she says. "It's all part of the cycle."
Within one day the blood test return favorably. Dengue Type 2 and no hemorrhage. From here, the headaches shrink, the fever calms and eight days later I'm walking again to Mrs. Lee's grocery.
She is swaying gently to a racy Bon Jovi number -- "feeling like a Monday" -- thrilled they'll be playing soon at the Shaw Alam Stadium -- "but someday I'll be Saturday night!" Confucius would be proud.
Her son has recovered without any hemorrhaging and will go back to school within the week. I ask for a pouch of the nameless Chinese tobacco -- the weed I've smoked for nine months despite my heaving chest.
"Why don't you try something milder," Mrs. Lee suggests. "Why do you smoke this pipe tobacco anyway?"
I stare long at Mrs. Lee. "I've been smoking pipe tobacco?"
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