There were no complications of dengue fever or worse outcomes of MS in these patients, and only four of them needed short-term treatment withdrawal due to lymphopenia.
Hi Gavin, fascinating article. So in conclusion people on S1P modulators (fingolimod, siponimod, ozanimod, ponesimod) and natalizumab are no more at risk than the general population to exotic neurotrophic viruses?
No. They seem to be able to fight the infections, in this case dengue, once they get infected. The numbers are too small to generalise to the wider population. I suspect based on the COVID-19 data that people with MS on anti-CD20 therapies will be at higher risk of severe and potentially fatal infections.
The title caught my attention. I had Dengue Fever in 1979. Many years later when I was diagnosed with MS my neurologist at the time ( Dr William Sheremata) thought that the origin could have been dengue. I am currently on Tysabri and have had 258 infusions to date.
Prior to diagnosis, i spent a large portion of my 20s working in the interior of the Amazon rainforest, sustaining surely hundreds of mosquito bites a week. On one occasion, I became seriously unwell with flu-like symptoms, vomiting, diarrhea, fatigue, the works. It was pretty bad and I did wonder if I'd finally caught malaria or similar. The doctors out there concluded I just had a stomach infection and it went away soon enough.
The other point to note is that to travel there I followed all the NHS Fit For Travel vaccine recommendations and had a phenomenal amount of injections, including for yellow fever, which I understand can cause demylenination in the short term. I often wonder nowadays whether the amount of vaccines I took in such short space of time somehow shirt circuited my immune system and led to me developing MS.
In early September, 2023 we had a week's holiday in Aix-en-Provence in the south of France.
The daily temperature (above 30°C) was brutally oppressive at times.
The mosquitos were out in force and I ended up with several bites over the course of the week.
We returned to the UK on a Friday and on the Saturday evening I developed a runny nose and started sneezing during evening. I had felt fine earlier in the day and put it down to a mild cold due to the climate change.
Sunday was a different ballgame entirely. My temperature hit 38.5°C accompanied by headaches, tiredness and lethergy. I tested for Covid but was negative. My temperature remained high for several days. I felt dreadful and it took me a week to recover.
My wife is a nurse and we did research on the NHS website and concluded that I had picked up a mild form of Dengue Fever from one of my mosquito bites. My GP agreed with this conclusion but said that she could not be 100% certain unless I had a blood test carried out.
Once recovered, I read article on a website (BBC or Guardian newspaper) which said that Dengue Fever had reached the south of France.
Moral of the story; you don't have to travel far from the UK to contract Dengue Fever. Be prepared by taking something to deal with mosquitos!!
I live in Australia where we have a number of nasty tropical diseases and although my medical team do encourage being careful they have never made me feel more at risk than the general population and Tysabri appears to one of the main drugs of choice here (alongside mavenclad and Ocrevus)
Never had dengue fever but I'm heading to Bali next month... I also don't do very well with insect repellent. I remember going on one family walk in the Marlborough Sounds. There are really no sand flies there but it was dusk and my mum made me spray insect repellent on. I couldn't breathe well on the walk and we had to go home. But back at the house I still felt like I couldn't breathe. Finally I took a shower and felt a lot better. I put it down to the insect repellent. Since then though I've reacted to a lot of things especially aerosol sprays, men's cologne and household cleaning products. I find natural essential oil-based insect repellents work well and don't affect my breathing.
Hi Gavin, fascinating article. So in conclusion people on S1P modulators (fingolimod, siponimod, ozanimod, ponesimod) and natalizumab are no more at risk than the general population to exotic neurotrophic viruses?
No. They seem to be able to fight the infections, in this case dengue, once they get infected. The numbers are too small to generalise to the wider population. I suspect based on the COVID-19 data that people with MS on anti-CD20 therapies will be at higher risk of severe and potentially fatal infections.
The title caught my attention. I had Dengue Fever in 1979. Many years later when I was diagnosed with MS my neurologist at the time ( Dr William Sheremata) thought that the origin could have been dengue. I am currently on Tysabri and have had 258 infusions to date.
Prior to diagnosis, i spent a large portion of my 20s working in the interior of the Amazon rainforest, sustaining surely hundreds of mosquito bites a week. On one occasion, I became seriously unwell with flu-like symptoms, vomiting, diarrhea, fatigue, the works. It was pretty bad and I did wonder if I'd finally caught malaria or similar. The doctors out there concluded I just had a stomach infection and it went away soon enough.
The other point to note is that to travel there I followed all the NHS Fit For Travel vaccine recommendations and had a phenomenal amount of injections, including for yellow fever, which I understand can cause demylenination in the short term. I often wonder nowadays whether the amount of vaccines I took in such short space of time somehow shirt circuited my immune system and led to me developing MS.
I was diagnosed with PPMS in 2006.
In early September, 2023 we had a week's holiday in Aix-en-Provence in the south of France.
The daily temperature (above 30°C) was brutally oppressive at times.
The mosquitos were out in force and I ended up with several bites over the course of the week.
We returned to the UK on a Friday and on the Saturday evening I developed a runny nose and started sneezing during evening. I had felt fine earlier in the day and put it down to a mild cold due to the climate change.
Sunday was a different ballgame entirely. My temperature hit 38.5°C accompanied by headaches, tiredness and lethergy. I tested for Covid but was negative. My temperature remained high for several days. I felt dreadful and it took me a week to recover.
My wife is a nurse and we did research on the NHS website and concluded that I had picked up a mild form of Dengue Fever from one of my mosquito bites. My GP agreed with this conclusion but said that she could not be 100% certain unless I had a blood test carried out.
Once recovered, I read article on a website (BBC or Guardian newspaper) which said that Dengue Fever had reached the south of France.
Moral of the story; you don't have to travel far from the UK to contract Dengue Fever. Be prepared by taking something to deal with mosquitos!!
I live in Australia where we have a number of nasty tropical diseases and although my medical team do encourage being careful they have never made me feel more at risk than the general population and Tysabri appears to one of the main drugs of choice here (alongside mavenclad and Ocrevus)
This article is very reassuring. Thank you!
Never had dengue fever but I'm heading to Bali next month... I also don't do very well with insect repellent. I remember going on one family walk in the Marlborough Sounds. There are really no sand flies there but it was dusk and my mum made me spray insect repellent on. I couldn't breathe well on the walk and we had to go home. But back at the house I still felt like I couldn't breathe. Finally I took a shower and felt a lot better. I put it down to the insect repellent. Since then though I've reacted to a lot of things especially aerosol sprays, men's cologne and household cleaning products. I find natural essential oil-based insect repellents work well and don't affect my breathing.