Jamie Gruber was living the dream.
The father-of-two had moved his family from chilly Michigan to the sun-soaked coast of Punta Cana, Dominican Republic, and they were overjoyed. The children spent virtually all their time outside by the pool, playing soccer or cycling around town.
But 14 months into the family’s new life, their eldest, eight-year-old Sebastian, suddenly became unwell.
‘We honestly didn’t know what was wrong,’ Gruber told the Daily Mail. ‘We thought he was maybe dehydrated, maybe it was a cold that eight-year-olds tend to get.’
They put him on bed rest, but their son continued to deteriorate.
He had a fever that would spike up and down, often over 100F (37.7C). He looked drained, his skin lost its youthful glow and small circles formed around his eyes.
After two days with no improvement, the parents took him to a local clinic in November 2023 where doctors delivered the diagnosis: He had dengue fever, a mosquito-borne virus and subject of CDC warnings that can trigger brain bleeds.
‘Of course, as a parent, the worst ideas go through your mind,’ Gruber said. ‘Thoughts of the worst outcome always enter your mind, even if it was never going to get to that point.’
Jamie Gruber said that, as a parent, the worst thoughts go through your head when you find out that your child has the disease
Dengue fever is rare in the US, typically only recorded among travelers returning from abroad. But it is endemic to more than 100 countries worldwide, including the Dominican Republic, which registered 174 infections last year.
Last week, the CDC issued a Level 1 global travel advisory after detecting unusual upticks in cases of dengue fever across the world.
In particular, the CDC warned of 16 countries where travelers have an increased risk of contracting the illness, warning them to take precautions to prevent mosquito bites.
The CDC said it ‘has identified a higher-than-expected number of dengue cases among US travelers returning from’ Afghanistan, Bangladesh, Bolivia, Colombia, Cook Islands, Cuba, Guyana, Maldives, Mali, Mauritania, New Caledonia, Pakistan, Samoa, Sudan, Timor-Leste and Vietnam.
Experts say 40 to 80 percent of patients never develop symptoms.
But, for those that do, warning signs can start abruptly as a flu-like illness, before a characteristic red rash emerges, triggered because it attacks blood vessels, causing them to leak fluids.
In serious cases, it can cause life-threatening internal bleeding, respiratory distress and heart failure. It can also lead to shock and organ failure, especially of the liver, brain and heart.
Children under five, adults over 65 and pregnant women are considered to be most at risk of the virus.
If left untreated, the CDC says up to 13 percent of patients die from the infection. With treatment, however, this drops to one percent of patients.
There is no specific treatment for the infection, but doctors may recommend bed rest or IV fluids to help ease symptoms.
Gruber was not sure where or when his son was bitten.
The parents would regularly put insect repellent on their children, but their house did not have any screens for the doors or windows that would prevent mosquitoes from entering. At times before the infection, he added that there were also sudden surges in the mosquito population in his local area.
Sebastian recovered after two days in the hospital on a continuous IV. The day after he was discharged, Gruber said he went back to riding his bicycle
At the clinic, doctors ordered a blood test – which confirmed the dengue infection.
Sebastian was given an IV to replace lost fluids, and the parents were told to bring him back every day for a new IV and to check his blood.
On day five of the infection, doctors found that his levels of platelets (substances in the blood that help it clot to stop bleeding) were dangerously low, prompting them to recommend that he be hospitalized immediately. Doctors say it is ‘very common’ for patients suffering from dengue to have a low platelet count.
The drop in platelet numbers is caused by damage to blood vessels and the fact that the virus may also attack the bone marrow, which helps to produce platelets. In an infection, the immune system may also misfire and destroy platelets.
Low platelet numbers raise the risk of a severe internal bleed that could be life-threatening.
Gruber’s son was in the hospital for two days, where he was hooked up to a continuous IV drip to restore fluid levels, prevent dehydration and shock or organ failure.
The IV also had the potential to trigger increased platelet production.
Nurses came in to check his levels and vitals every hour, Gruber told the Daily Mail.
Gruber said his son appeared better almost immediately after he was placed on the continuous IV drip.
The day after Sebastian was discharged, the boy was back to riding his bike.
Gruber felt they had a lucky escape from the virus.
‘We had a friend whose son, a few years older, went to the hospital for dengue as well,’ he told the Daily Mail.
‘He was there like three or four days and he had like, capillaries burst in his leg, so his legs were all like blotchy – like blood vessels burst in his leg. So he was a little bit worse.
‘At one point, we did get concerned, and we called a friend who is a doctor and asked whether our son was being treated correctly. He said, “Look, they are following a protocol, everything sounds good with his treatment.”‘
Although Sebastian recovered with no lasting complications, the experience has stayed with his parents.
They had screens installed over the windows and doors of their house to keep out mosquitoes, and they are diligent about applying bug spray to prevent bites.
Gruber said he was very impressed with healthcare in the Dominican Republic.
While the country has an increased risk of dengue fever, that means doctors are more familiar with it and can identify and treat it sooner.
‘For the disease, we were in a great place for treatment,’ he said. ‘In the US, many doctors have never seen this virus before.’
