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Posted: 2017-07-19T09:00:11Z | Updated: 2018-05-10T15:05:42Z How A Single Mosquito Bite Nearly Ended This Artist's Life | HuffPost

How A Single Mosquito Bite Nearly Ended This Artist's Life

I woke up in the middle of the night as if my body was burning from inside," she said.
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This article is part of HuffPost’s Project Zero  campaign, a yearlong series on neglected tropical diseases and efforts to fight them.

British artist Emma Harrison moved to Myanmar at age 25 to start a furniture business in 2014. Inspired by the country’s art and culture, she planned to combine contemporary design with traditional wood carvings.

Instead, a single mosquito bite one that she did not even notice changed the course of her life.

“I woke up in the middle of the night as if my body was burning from inside,” Harrison recalled, describing lying in a London hospital bed a week after she first fell ill.

“I lost all sensations, I could not move my hands and arms. I was terrified,” she said. “Nobody had warned me that this was coming; it was totally unexpected.”

Harrison had contracted the most dangerous form of dengue , known as hemorrhagic fever. Dengue including its milder, flu-like forms is one the fastest-growing infectious diseases in the world, and Southeast Asia has been particularly hard-hit by dengue hemorrhagic fever . Despite the scope of the problem, the disease receives relatively little attention, and patients have no specific treatment options .

Scientists and the global health community are racing to raise awareness and develop effective medicines, but they haven’t kept up with the virus’ expansion, meaning extreme cases like Harrison’s could become more common.

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British artist Emma Harrison at Myanmar's most famous archeological site, Bagan, which inspires her work.
Emma Harrison

Nearly two years after developing dengue in September 2015, Harrison is still suffering the consequences of near-total paralysis. She can barely hold a pen and is only just beginning to write again trembling, slowly after months of rehabilitation. She limps and wears braces on both hands and a knee.

“I don’t even remember scratching a bite,” she said. “I was trying to take precautions like wearing long sleeves and natural repellent.”

“I had a high temperature,” she recalled of her earliest symptom. “I went to the doctor [in Myanmar] only because my flatmates insisted. He looked at me and immediately said, ‘I think it’s dengue.’ The doctor also noticed I had a rash and my mouth was bleeding, all warning signs that a hemorrhagic fever was mounting.”

Harrison was warned that her condition could suddenly degenerate, and if that happened, she would need blood transfusions. Doctors planned to evacuate her to more modern medical facilities in Thailand. But she was concerned about the lower vigilance standards for transfusions in the region  and wanted to be with her family, so she decided to fly back to the United Kingdom the day after seeing the doctor in Yangon, Myanmar.

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Aedes aegypti mosquitoes carry dengue fever.
Paulo Whitaker/Reuters

Dengue is a tropical and subtropical viral infection that, in most cases, is caused by the mosquito Aedes aegypti, the same insect that can spread Zika virus and yellow fever. The disease is endemic in over 100 countries, and the World Health Organization estimates that half the world’s population is at risk. The Aedes aegypti mosquito survives well in cities and likes to bite during the day.

Worldwide, there may be as many as 390 million new infections per year. Most people either don’t have symptoms of dengue and don’t know they are infected, or don’t reach out to medical facilities. Severe dengue, meanwhile, sends half a million people to the hospital and causes 20,000 deaths per year.

In Southeast Asia, dengue is a leading cause of death for children and has reportedly killed nearly 7,000 people between 2011 and 2015 more than malaria did in the same period. The number of cases across the region more than doubled in five years to 490,000 in 2016, while deaths surged by 35 percent last year alone, the WHO told HuffPost.

There are four strains of dengue, two of which are more likely to lead to severe dengue. Falling ill gives you future immunity against the type of dengue you originally contracted, but doesn’t prevent you from getting another form of dengue in the future.

Symptoms of the milder forms of dengue include a high temperature, aching joints, stomach problems and extreme tiredness. These can resolve quickly, but increase the risk of dengue hitting harder a second time.

As the body develops resistance to other types of dengue, the risk of hemorrhagic fever increases. Unlike malaria and despite scientists’ ongoing efforts, a cure is yet to be discovered. The only treatment involves addressing symptoms like fever. There’s a preventive vaccine, but it’s only available in a few countries and isn’t effective or even recommended for everyone.

Early detection of the disease can save patients if they have access to medical care, but many people, especially in poorer countries, do not.

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A patient awaits a routine check-up as he lies under a mosquito net inside a dengue ward of a government hospital in New Delhi, India.
Anindito Mukherjee/Reuters

The severe hemorrhagic fever Harrison contracted can cause dengue shock syndrome  and circulatory failure, and can kill within 24 hours. Harrison’s hemorrhage received timely treatment, and she survived.

But complications, though rare, can also affect the central nervous system.

Harrison started bleeding internally, which caused her spine to swell and led to a secondary infection that developed into transverse myelitis an inflammation of the spinal cord that can cause neurological effects and paralysis.

The past two years have been a painful odyssey for her. Home in England, Harrison sought treatment from specialists at a tropical disease clinic. They struggled to identify her paralysis as a rare complication of dengue, partly because the disease is practically nonexistent in Western Europe and most patients get treatment in the country where they’re infected. Doctors in the U.K. told Harrison the paralysis “would go.” But it didn’t.

“Lifting an arm was as tiring as running up a staircase,” she said. “I suddenly found myself needing help to bring food to my mouth or take a shower. There’ve been moments when I thought I would never go back to my art. And I hadn’t even heard of dengue before moving to Asia.”

With a surge in the number of dengue cases reported in Southeast Asia, the WHO is working with countries there to estimate the real incidence of the often underreported disease.

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A woman from Myawaddy, Myanmar, sits with her son suffering from dengue fever in Mae Sot, Thailand, on Oct. 30, 2007.
Paula Bronstein/Getty Images

Dengue’s spread across the globe is fueled by the advance of its mosquito carrier, abetted by poor water conservation, people moving more frequently and populations exploding in many urban areas.

Research indicates that 60 percent of people with dengue are carrying and potentially spreading the virus but do not show symptoms themselves, said Dr. Mohammad Jamsheed, WHO’s Southeast Asia adviser for neglected tropical diseases.

In Laos, which borders Myanmar, dengue has already reached epidemic levels this year in the capital, Vientiane, according to WHO Laos. In Luang Prabang, a popular destination for tourists in the country’s north, the breathtaking ancient temples set amid lush greenery distract from this country’s growing dengue problem.

Like many others in the city, Keo, who owns a shop on the city’s high street selling elaborately embroidered local textiles, described his personal experience with dengue: “It was unlike anything I had experienced before, I felt exhausted for weeks. My wife and daughter had it too, but it was much lighter.”

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Luang Prabang, a popular tourist destination in Laos, also has a growing dengue problem.
Leisa Tyler/Getty Images

At Luang Prabang Provincial Hospital, busy medical personnel have been readying for a rush of dengue cases, which typically occur during the rainy season of May to September.

“We are equipped for it,” said a doctor on duty. “But the problem is that people often come to the hospital when it’s already too late.”

“Having basic health infrastructure with adequate facilities and trained health professionals is crucial for disease management,” said the WHO’s Jamsheed. “Patients, including children, with severe forms of dengue in rural settings would be at a higher risk of dying if such facilities are not available.”

Unlike leprosy or river blindness, dengue is not only an underreported tropical disease of the poor. Thailand was stunned last year after one of its most popular actors, Tridsadee “Por” Sahawong, died from dengue at the age of 37 after two months in a coma.

“His death increased awareness,” said Dr. On-umar Banpamai, a specialist at Bangkok’s private Samitivej Hospital, one of the few in Thailand that provides the only available and successfully trialed vaccine against dengue, which still offers only partial immunity against the virus.

“I had this vaccination and so did my sons, as this street has one of the highest rate of dengue in the whole of the country,” she said, referring to an elegant street in the wealthy Sukhumvit district in central Bangkok.

“We are going to see how effective it is in coming years,” she added.

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Even people who live in Sukhumvit, an exclusive district in central Bangkok, must contend with dengue.
SeanPavonePhoto/Getty Images

Pharmaceutical company Sanofi Pasteur produced the dengue vaccine , which Mexico authorized for use in 2015. By the following year, 10 countries in Latin America and Asia had approved it. The vaccine has not yet been approved in Myanmar or Laos, however.

While this is an important step forward, the vaccine only prevents an estimated 60 percent of cases and is only recommended for people between 9 and 45 years old. And, for many of the most vulnerable, it comes at a steep price: $260 for three doses.

A study published in the journal Science  suggests that the vaccine could actually cause more harm than good in areas with a low rate of dengue, increasing the incidence of more severe secondary infections. 

The WHO recommends that governments carry out dengue prevalence surveys and consider introducing the vaccine in high-risk areas. The goal is to reduce dengue infections by at least 25 percent and mortality by at least 50 percent by 2020. At least five additional possible vaccines are under development, including one using DNA technology .

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Harrison taking pictures in Bagan as inspiration for her etchings.
Emma Harrison

The Sanofi vaccine is not recommended for touristsbut rather for people living in endemic areas. It is more effective for those who have already had dengue.

This is encouraging news for Harrison, who hopes to move back to Asia someday.

Her condition has improved under a specialized physiotherapist in Florida who has experience treating dengue survivors. Harrison found him by researching neurological rehabilitation and flew to the United States.

“Everything I was struggling with at home fell into place. He knew everything, exactly … I continue exercising at home and I have improved a lot. He has given me hope,” Harrison said.

Before she returns to Asia, she wants to develop a new project to support others suffering from dengue-related paralysis.

“I had to take responsibility myself in order to get better,” Harrison said. “Now I am trying to make a difference and set up a charity to help others in the same situation. People need the right information.”

This series is supported, in part, by funding from the Bill & Melinda Gates Foundation. All content is editorially independent, with no influence or input from the foundation. If you’d like to contribute a post to the series, send an email to ProjectZero@huffingtonpost.com. And follow the conversation on social media by using the hashtag #ProjectZero.

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Before You Go

Neglected Tropical Diseases
Lymphatic Filariasis(01 of18)
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Lymphatic filariasis, more commonly known as elephantiasis, is a leading cause of disability worldwide , according to the U.S. Centers for Disease Control and Prevention. It affects over 120 million people globally and can cause severe swelling of body parts, including the legs and scrotum. While people are usually infected in childhood, the painful, disfiguring symptoms of the disease only show up later in life . (credit:Drugs for Neglected Diseases initiative)
Onchocerciasis(02 of18)
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Onchocerciasis, commonly known as river blindness, is an eye and skin disease that can cause severe itching and visual impairment including blindness. Around 18 million people are infected . Of those, over 6.5 million suffer from severe itching, and 270,000 are blind. The disease is caused by a parasitic worm, transmitted through bites from infected blackflies. The worm can live for up to 14 years in the human body, and each adult female worm can be more than 1.5 feet long. (credit:ISSOUF SANOGO/AFP/Getty Images)
Chagas(03 of18)
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Chagas disease is a potentially life-threatening illness . In the first months after infection, symptoms are mild, including skin lesions and fever. But in its second, chronic phase, up to 1 in 3 patients develop cardiac disorders, which can lead to heart failure and sudden death. The disease is transmitted to humans by kissing bugs, which live in the walls or roof cracks of poorly constructed homes in rural areas, according to the World Health Organization. Of the estimated 6 million to 7 million people affected worldwide, most live in Latin America, but the disease has also spread to the United States. Around 300,000 people in the U.S. have Chagas disease, according to the Dallas Morning News . (credit:Nature Picture Library/Getty Images)
Dengue(04 of18)
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Dengue is a flu-like illness that can sometimes be lethal . In 2015, more than 2 million cases of dengue were reported in the Americas. In some Asian and Latin American countries, severe dengue is a leading cause of serious illness and death among children. Dengue is spread by the Aedes aegypti mosquitoes, the same type of insect that transmits Zika. To reduce the risk of bites, WHO recommends covering water containers, using insecticide, having window screens and wearing long sleeves. (credit:Fachrul Reza/NurPhoto/Getty Images)
Human African Trypanosomiasis(05 of18)
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Human African trypanosomiasis, commonly known as sleeping sickness , is a chronic infection that affects the central nervous system. People can be infected for years without signs, but in the second stage, patients can suffer behavior changes, hallucinations and even slip into a coma and die . Many people affected live in remote, rural areas that dont have easy access to quality health services. This makes diagnosis and treatment more difficult. WHO has identified sleeping sickness as a disease that could be eliminated worldwide by 2020 if the right resources are dedicated to it. (credit:MARIZILDA CRUPPE / DNDi)
Leishmaniasis(06 of18)
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There are several forms of leishmaniasis , including visceral, which can be fatal, with symptoms including fever and weight loss; and cutaneous, the most common form, which causes skin lesions, leaving lifelong scars and disability. The disease, spread by sandflies, affects some of the poorest people on earth, according to WHO, and is associated with malnutrition and poor housing. Around 1 million new cases occur annually, causing 20,000 to 30,000 deaths. Leishmaniasis is climate-sensitive, affected by changes in rainfall, temperature and humidity which means it could be exacerbated by global warming. (credit:Corbis Documentary/Getty Images)
Trachoma(07 of18)
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Trachoma is an eye disease, which if untreated, can cause irreversible blindness . It causes visual impairment or blindness in 1.9 million people, per WHO. The disease is present in poor, rural areas of 42 countries in Africa, Latin America, Asia and the Middle East but Africa is the most affected. (credit:STR via Getty Images)
Rabies(08 of18)
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Rabies is almost always fatal once symptoms show up. Initial symptoms are fever and tingling around the wound. As the virus spreads, people with furious rabies become hyperactive and die by cardiac arrest; people with paralytic rabies become paralyzed, fall into a coma and die. Transmitted by pet dogs, rabies causes tens of thousands of deaths every year. The disease is present on all continents except Antarctica but more than 95 percent of human deaths due to it occur in Asia and Africa. It is a neglected disease primarily affecting poor populations, where vaccines are not readily available. (credit:NOAH SEELAM/AFP/Getty Images)
Leprosy(09 of18)
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Leprosy is a chronic disease, which when untreated can cause permanent damage to the skin , nerves, limbs and eyes. There were 176,176 cases at the end of 2015, according to WHO. While the stigma associated with the disease means people are less likely to seek treatment, leprosy is curable, and treatment early on can avoid disability. Leprosy was eliminated as a public health problem in 2000 meaning there is now less than one case for every 10,000 people worldwide. (credit:Chandan Khanna/AFP/Getty Images)
Schistosomiasis(10 of18)
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Schistosomiasis is a chronic disease that causes gradual damage to internal organs. Symptoms include blood in urine , and in severe cases, kidney or liver failure, and even bladder cancer. Around 20,000 people die from it each year. Transmitted by parasites in infested water, the disease largely affects poor, rural communities in Africa that lack access to safe drinking water and sanitation. [People] get it as kids bathing in water, Sandrine Martin, a staff member for the nonprofit Malaria Consortium in Mozambique, told HuffPost. But the symptoms, like blood in the urine, only develop later and then people tend to hide it because its in the genital area. (credit:Malaria Consortium)
Chikungunya(11 of18)
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Chikungunya is a disease that causes fever and severe joint pain , according to WHO. While it is rarely fatal, it can be debilitating. Since 2004, it has infected more than 2 million people in Asia and Africa. There is no cure for the disease, which is transmitted to humans by infected mosquitoes. The name comes from a word in the Kimakonde language , spoken in some areas of Mozambique and Tanzania, that means to become contorted a nod to the hunched-over position of people who are affected with joint pain. (credit:Universal Images Group/Getty Images)
Echinoccosis(12 of18)
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Echinoccosis is a parasitic disease that leads to cysts in the liver and lungs. While it can be life-threatening if untreated, even people who receive treatment often have a reduced quality of life, according to WHO. Found in every continent except Antarctica, the disease is acquired by consuming food or water contaminated with tapeworm eggs, or through direct contact with animals who carry it, such as domestic dogs or sheep. (credit:Smith Collection/Gado/Getty Images)
Foodborne Trematodiases(13 of18)
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Foodborne trematodiases can cause severe liver and lung disease , and on rare occasions death. Most prevalent in East Asia and South America, the disease is caused by worms that people get by eating raw fish, shellfish or vegetables that have been infected with larvae. While early, light infections can be asymptomatic, chronic infections are severe.More than 56 million people were infected with foodborne trematodes, and over 7,000 people died in 2005, the year of WHOs most recent global estimate. (credit:Alexandre Tremblot de La Croix via Getty Images)
Buruli Ulcer(14 of18)
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Buruli ulcer is a skin infection caused by bacteria that often starts as a painless swelling, but without treatment, it can lead to permanent disfigurement and disability. In 2014, 2,200 new cases were reported, with most patients under age 15. The exact mode of transmission is still unknown. The majority of cases, if detected early enough, can be cured with antibiotics. (credit:ISSOUF SANOGO/AFP/Getty Images)
Yaws(15 of18)
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Yaws is a chronic, disfiguring childhood infectious disease . Affecting skin, bone and cartilage, the symptoms show up weeks to months after infection and include yellow lesions and bone swelling. More than 250,000 cases of yaws were reported from 2010 to 2013, WHO told HuffPost. A lack of clean water and soap for bathing contributes to its spread. Only 13 countries are known to still have cases of yaws, including Ghana, Papua New Guinea and Solomon Islands . (credit:BIOPHOTO ASSOCIATES via Getty Images)
Soil-Transmitted Helminth(16 of18)
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Soil-transmitted helminth infections are among the most common infections worldwide and affect the poorest communities. People are infected by worms transmitted by human feces contaminating soil in areas with poor sanitation. People with light infections usually have no symptoms. Heavier infections can cause diarrhea, abdominal pain, general weakness and impaired cognitive development. Depending on the number of worms, it can lead to death. Up to 2 billion people are infected worldwide, according to WHO. But because infections can be light, not all patients suffer, WHOs Ashok Moo told HuffPost. (credit:Malaria Consortium)
Taeniasis(17 of18)
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Taeniasis is an intestinal infection caused by tapeworms , which mostly causes mild symptoms, such as abdominal pain, nausea, diarrhea or constipation. But if larvae infect the brain, causing neurocysticercosis, the disease can cause epileptic seizures and can be fatal. People get it by eating raw or undercooked infected pork. The ingested tapeworm eggs develop into larvae and migrate through the body. Taeniasis is underreported worldwide because it is hard to diagnose in areas with little access to health services, according to the CDC. (credit:Science Source/Getty Images)
Guinea Worm(18 of18)
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Guinea worm is a crippling disease that it is close to being eradicated. There were only 22 human cases reported in 2015, according to WHO down from around 3.5 million cases in 21 countries in the mid-1980s. The disease is usually transmitted when people with limited access to quality drinking water swallow stagnant water contaminated with parasites. About a year after infection, a painful blister forms most of the time on the lower leg and one or more worms emerge, along with a burning sensation. It is rarely fatal, but can debilitate infected people for weeks. The Carter Center, founded by former President Jimmy Carter and his wife, has been instrumental in efforts to eradicate the disease. (credit:PETER MARTELL/AFP/Getty Images)