dengue mosquito

When Hydration Becomes a Hindrance

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According to a recent report published by The World Health Organization, Singapore has been identified to be one of the best countries when it comes to dengue control. This has caused an increase in the average age at which people are first infected with the disease, causing more elderly to fall ill. Infectious disease specialist Dr. Leong Hoe Nam says that Singapore has become “A victim of its own success”.

A 2007 seroepidemiologic study conducted during a dengue epidemic in Singapore has found that older people are more likely to encounter health problems when infected with dengue, especially if they have never been infected before.

Once infected, making sure that you drink enough water and that you are hydrated is the most effective way to fight the virus and lower the chances of death. This is due to the main complication in severe dengue called vascular leakage, a condition where fluid leaks out of blood capillaries.

Although, elderly patients, who have weaker immune systems or pre-existing health conditions such as heart or kidney problems, may not be able to cope with the additional amount of water needed to keep hydrated.  Fluctuations in fluid balance caused by dengue and by attempts at hydration may cause heart or kidney failure as the organs in the elderly are too weak to handle the change. Dr Leong says “The very hydration that helps fight dengue will kill these people because of system overload.”

Numerous factors have been identified in the odds of dying from dengue such as: ethnicity, education, health and age. In Singapore’s case however, age is the major factor because of dengue control, said Dr. Leong. There has been five deaths in Singapore this year alone directly relating to dengue which highlights the vulnerability of senior citizens. Furthermore, there has been 21 deaths due to dengue since 2013; thirteen of the victims were aged 60 or above and only two were younger than 45.

Professor Leo Yee Sin, director of the Institute of Infectious Diseases and Epidemiology at Tan Tock Seng Hospital, said that seniors with pre-existing medical conditions, suspected to have dengue, should seek medical attention as soon as possible. Hospitals are better able to care for seniors, closely monitoring their condition and managing their fluid balance. Professor Leo Yee Sin says that “Singapore is entering a different dengue era where were are seeing much older adults infected.”

A version of this article appeared in the print edition of The Straits Times on June 02, 2016, with the headline ‘Deaths of more seniors ‘may be linked’ to effective dengue control’.

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