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Comment by macintux | Hacker News Reader

For anyone unfamiliar with dengue, among its more notorious aspects is that repeated infections over a victim’s lifetime can make its impact worse.

https://en.wikipedia.org/wiki/Dengue_fever

Very happy to hear this news. Selfishly, with a warming climate the impact of the virus is likely to spread, and generally the more tropical diseases we can wipe out the better.

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> For anyone unfamiliar with dengue, among its more notorious aspects is that repeated infections over a victim’s lifetime can make its impact worse.

One really minor nitpick, but I think it's different strains of dengue that get you: get infected by one, and you get resistance for that strain, but also become more susceptible to develop complications or die from a separate strain.

I was lucky enough to get the non-hemorrhaging type. But now if I get the hemorrhaging type it will be extra bad. So that's lame.

I thought that the hemorrhaging wasn't necessarily related to a strain, but _is_ a possible heavier outcome regardless of the order you get them in?

i had it pretty heavy, all the symptoms as by the book, but two independent labs showed that i didn't have dengue. so now i do not know if i had it or something different with very similar symptoms

afaik, Chikungunya and Zika can be very similar to Dengue.

False negatives are common when testing on the first week of symptoms. But after 1-2 weeks serology testing is accurate. My 1st exam was negative and the 2nd (after 2 weeks) was positive. There are other viruses with symptoms similar to Dengue like Zika and Chikungunya.

Very relevant nitpicking! Also makes vaccination more tricky as it should ideally cover all strains to prevent the same effect.

My understanding is that the current vaccine helps against all strains, but also makes the infection worse if you do still happen to catch Dengue (similar to a previous infection.) As a result this risk is managed by only giving the current vaccine to people who have already had Dengue atleast once

To clarify a bit, if you've already had dengue once, the vaccine is recommended since it makes you less likely to catch the other strains of dengue and it reduces the odds of severe complications.

However, if you've never had dengue, the vaccine is not recommended since it increases the odds of complications.

This rather odd effect is known as antibody-dependent enhancement: https://en.wikipedia.org/wiki/Antibody-dependent_enhancement

I had dengue once and got vaccinated afterward, since I live in a dengue hotspot. However, not many do, the cost and complexity (~$300 for 3 shots over 18 months, generally not covered by insurance) also dissuades many.

Hiya - I don't live in a dengue hotspot country but have had it (grandparent lives in a tropical country) and would like to get Dengvaxia to make it a bit less risky to go back... do you know if your country would allow flying in to get the vaccine? May I ask which country it is?

Thanks!!

I'm pretty sure you can just go up to a pharmacy here in Costa Rica and get it for about 140$ - if you want I can confirm for you

https://www.nacion.com/ciencia/salud/vacuna-contra-el-dengue...

Hi yes please that would be amazing! Some of my family is in the US so it wouldn't be too hard to drop by on the way there :)

You want to try Farmacias Sucre out here for vaccines (I think they were the only ones I could find who did the yellow fever one), although maybe the best way to take it would be seeing a doctor to get a prescription after checking your antibody levels. Most pharmacies here have a general practitioner in there who maybe even owns the place for consultation... just look for the person in the white jacket. Chances are their English is fine. Also looks like Clinica Biblica has it for only about 88$, they're alright:

https://alivioexpress.com/inicio/esp/detalle-producto.php?pr...

Fantastic, thank you!

What happens if one gets Dengue for the first time after only one dose of Dengvaxia.. not the complete scheme? Will it be as bad (complications-wise) as having the complete vaccination scheme?

You should absolutely *avoid* using this vaccine _unless_ you have been previously (and provably) infected by one of the strains of dengue. Unless you want to actually *increase* your risk of doing a hemorrhagic form. Seriously don't do it, people have died over it.

What happens in the scenario in which someone hypothetically got the first dose but didn't finish the vaccination scheme?

This fact makes the stat from the article all the more alarming.

> In 1970, only nine countries had faced severe dengue outbreaks, now there are up to 400 million infections a year.

It amazes me to think of how relatively small the team that worked on this was in relation to the outsized benefit to humanity.

That's public heath in a nutshell.

as opposed to?

Far more people working on male pattern baldness cures

I live in the tropics, I've gotten dengue before. Can confirm that it feels like getting run over by a bus. I actually have more fear about getting it again than I do around coronavirus.

The funny thing is that me and my roommate at the time just thought we had really bad achy flus. I think we probably should have gone to the hospital in retrospect.

I stayed the whole day in bed without eating anything in the 1st day. I ate in the whole week what I used to eat in a day. In retrospective, I learned to eat less and, in the long term, I got healthier due to it.

Yes probably the best news I've read today. A friend got sick of it sometime back and it was one of the most harrowing experience of his life. The amount of pain is just indescribable. He had blood coming out of his gums and whatnot. Anything to eradicate this and malaria is just amazing news.

This is extremely good news. I watched my brother spend a week and a half in a hospital in a small Ecuadorian village due to a dengue infection. His fever was dangerously high for days and then his platet counts dropped so low that he was at significant risk of internal bleeding.

The vaccine causes Antibody-Dependent Enhancement (ADE) as well as natural infection [0], so the situation as a whole is not very good.

[0]: https://en.wikipedia.org/wiki/Dengue_vaccine#CYD-TDV_(Dengva...

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