My impetus to treat Dengue fever came from the fact that in 1998 I had submitted my final year project on ‘The Therapeutic Use of Homeopathy in Cholera’. On graduating, my intention was to return to Sri Lanka and use this information to treat such epidemics. In developing nations such as Sri Lanka, resources are not always available to combat epidemics and homeopathy can provide cost effective treatment. Homeopathy also had an exemplary record in treating the Cholera epidemic in London in 1854, where a fatality rate of 16 percent was compared to the fatality rate of 54 percent under allopathic treatment. Homeopathic medicines were used in reducing the incidence of Dengue fever by 93 percent in Brazil in 2008. Homeopathic prophylaxis was administered to over two million people in Cuba in 2007 against Leptospirosis which reduced the incidence of disease by 90 percent.
“Dengue was first reported in Sri Lanka in 1965 but has become a regular epidemic since 1989. The peak incidence of the disease generally comes after the monsoon season, in June – July and October – December, when the density of the two mosquito carrier species – Aedes aegypti and Aedes albopictu – is especially high”.
(National Plan of Action for Prevention and Control of Dengue Fever 2005 – 2009 Epidemiology Unit, Ministry of Health, Sri Lanka)
This trend has changed as reported by the Epidemiology Unit in April 2009; 1,249 cases were reported in January alone and a total of 3308 cases reported in the last nine weeks and 40 deaths have occurred. This is in comparison to the 6,560 cases reported in 2008 and 27 deaths in that year.
A virus carried by mosquitoes, mainly the Aedes aegypti, infects humans with Dengue fever. A patient is deemed contagious until the fever abates. Isolating patients is crucial during this phase, although this is not the reality. There are four types of the virus that cause Dengue and infection from one type confers immunity against that type only, meaning that individuals may contract Dengue again in their lifetime from the other three types. The incubation period is about five to six days, usually preceded by two days of headaches and malaise. It may take a patient about three months to fully recover.
Characteristic Symptoms of Dengue Include:
Fever lasting more than three days. It tends to go down for a day or two, only to reappear. (Bi-phasic pattern)
Petechial rash starting in the limbs and spreading to the body and face.
Nausea and vomiting.
Excruciating body pains and headache.
Bleeding from the nose, mouth or rectum may indicate Haemorrhagic Dengue Fever.
Clinical findings will include thrombocytopenia and plasma leakage shown in the Haematocrit count (HCT) or Packed Cell Volume (PCV).
Female 31 years old
Symptoms started on 21/05/2004.
Platelets 264,000 K/ul Normal Range 150,000 – 300,000 K/ul
WBC 6,018 K/ul Normal Range 7,000 – 9,000 K/ul
Platelets 204,000 K/ul
WBC 2,066 K/ul
HCT 40.1 % Normal Range 38 % – 42 % (female)
Platelets 173,000 K/ul
WBC 2,048 K/ul
HCT 41.2 %
24/05/2004 Admitted to hospital and Dengue antibody IgM tests positive
Platelets 130,000 K/u
WBC 2,270 K/ul
As she was pregnant we decided being in hospital was the safer option. The patient only received intra-venous fluid. I started the patient on therapeutics employed to match the symptom picture and to support the red flag symptoms. Therapeutic prescribing involves looking at group of remedies that have an affinity with a certain disease picture. They are differentiated on the totality of the patient’s characteristic symptoms in the acute context. In the case of Dengue, the red flag situations are: when the platelet count drops below a critical level and the patient may need hospitalization for intra-venous fluids or transfusion of plasma/blood; WBC may fall leaving the patient’s immune system vulnerable to any infection; high fevers of 102 degrees Fahrenheit or 39 degrees Celsius and over; severe nausea/vomiting where the patient is unable to keep hydrated.
Rx China officinalis 30c one pill thrice daily (to prevent the platelets from going below 150,000 and it regulates the HCT by preventing plasma leakage)
Echinacea angustifolia 30c one pill thrice daily (to regulate WBC count/fever)
Apis mellifica 30c one pill thrice daily (therapeutic – dusky appearance of skin/oedema/headache and no thirst)
I instructed her to take these three remedies 15 minutes apart, morning, noon and evening. (Approximately 6 hourly)
Patient was discharged on the 27th of May and I have a blood report dated 06/06/2004
Platelets 349,000 K/ul
WBC 8,047 K/ul
At this point the remedies were discontinued. Constitutional remedies like Sepia and Phosphorus were prescribed to complete the recovery.
The complications of Dengue are that it is a debilitating disease taking about three months, in some cases, to fully recover. There can be hair loss, low energy, lack of appetite, liver complications and depression. These can be addressed with organ support remedies like China officinalis, Avena sativum and Nux vomica and constitutional remedies for the depression.
According to the health protection agency in U.K. 37,000 cases were reported in 11 districts in Sri Lanka during 2006 – 2007. 1058 cases were tested and of them 682 tested positive for Chikungunya. Serology tests are the only way to distinguish between the Dengue and the Chikungunya virus, as they share similar symptoms. It is spread by the same mosquito as the one that carries Dengue and an interesting fact is that Chikungunya epidemics appear and disappear at intervals of 7- 8 years. The last time Chikungunya was reported in Sri Lanka was in 1969. This is a case during the start of this epidemic but tested positive for Dengue.
Female 68 years old
Presenting symptoms: lack of appetite, fever and immobility due to oedema and joint pain especially of the ankles and wrists. Absence of rash.
Admitted to hospital on 04/10/2006 because she could not sit up or feed herself.
Platelets 177,000 K/ul
WBC 2,024 K/ul
HCT 39.6 %
05/10/2006 Time 6:30 pm
Platelets 165,000 K/ul
WBC 2,019 K/ul
HCT 36.6 %
She was given intra-venous fluids, Paracetamol and her prescription drugs for Diabetes.
Rx Echinacea angustifolia 30c. and I instructed her to take one pill every hour of being awake until the next blood report.
06/10/2006 Time 5:57 p.m.
Platelets 172,000 K/ul
WBC 2,076 K/ul
She was discharged on 7th October and continued Echinacea one pill thrice daily
Platelets 251,000 per cu mm
WBC 4,700 per cu mm
HCT 37.3 %
My reason for giving Echinacea angustifolia only was an intuitive and practical decision. WBC was critically low and the Platelets were dropping and the Echinacea comprehensively dealt with the whole symptom picture! I later prescribed Rhus toxicodendron for the arthritic symptoms that persisted for nearly six months. Adjunctive treatment included physiotherapy.
Male 36 years old
04/11/2006 presented with exhaustion, cough and fever. The patient did not wish to take the Dengue antibody test.
WBC on 01/11/2006 12,890/mm3
Rx Hepar Sulphuris 30c one pill thrice daily
China officinalis 30c one pill thrice daily (prescribed only for the exhaustion because the platelet count 216,000/mm3 and HCT count 43.20% were normal)
08/11/2006 WBC 12,250/mm3
HCT 45.40% Normal Range 42 % – 54 % (male)
14/11/2006 WBC 11,780/mm3
28/12/2006 fever relapsed. It was at this point that I realized that I may be treating Chikungunya. It was also the first case where I observed the virus increasing the WBC/Platelet count.
Rx Echinacea angustifolia 30c one pill thrice daily for two weeks
04/01/2007 WBC 6,590/mm3
HCT 46.20 %