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Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - I've been travelling around the globe on a very delayed gap year (I'm now 36!) At least this means I'm not on the traditional shoestring student budget, so I can afford to do things like diving. I'm Advanced Open Water qualified and have racked up over 100 dives. Anyway, I ended up in Fiji, and after a 40 minute dive to a max. depth of 26m came up with a headache, sore joints and a blotchy rash on my stomach. Naturally I freaked out but was taken to the chamber and recompressed with oxygen. To cut a long story short, the treatment didn't help and in fact I came out feeling worse, with fevers, shivers, shakes and nausea. I was eventually evacuated back to the UK, where after a lot of head scratching and pints of blood samples being taken I've been diagnosed with Dengue fever. I'm feeling a lot better since starting treatment, but I'm still unsure as to whether I was bent and this was a coincidence, and whether I can dive again?

A - I can totally see why recompression treatment was given to you here, but this just goes to show that even the most apparently obvious case of “the bends” can turn out to be something else. Dengue fever is a potentially life-threatening illness caused by a group of closely-related viruses, transmitted to humans by our good friend the mosquito (seriously, what are they good for?!) Sudden onset of muscle and bone pains with fever and headache is classic and gives rise to Dengue’s charming nicknames, “breakbone fever” and “bonecrusher disease”. It can cause serious bleeding problems, and lower the white blood cell and platelet counts. Outbreaks are common in Queensland, Australia and a recent epidemic in Bolivia infected 31000 people. Treatment is basically supportive whilst your body does the hard work to eradicate the virus – fluids in large quantities, and sometimes blood or platelet transfusions are necessary. The key differentiating factor between Dengue and a bend is the high fever – this would be much more indicative of infection than bubble-related disease. Once you’re fully recovered, you should be able to get back to diving. And remember all the usual preventative advice – insect repellent galore, long, loose and light-coloured clothing, mosquito coils and nets etc.

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