Dengue Fever in the Cook Islands, Facts and 5 Helpful Steps if You Get Sick

IslandAwe – Dengue Fever in the Cook Islands

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Dengue fever is one of the most significant global pandemics since decades, and meanwhile, it is present on all continents. Since a couple of years, Dengue fever in the Cook Islands is an increasing threat.

There are several hundred cases of Dengue fever in the Cook Islands each year. The Tiger mosquito, which transmits the virus, is present all year round. Since there is no vaccine and no specific treatment, it is important to know about precautions, symptoms, and steps to take if one gets sick.


After Pietro and I had lived in the Cook Islands for a few years, we fell ill with Dengue fever ourselves. Thus, we also provide first-hand information in this article.

Get your free Dengue Fever in the Cook Islands infographic at the end of this article.



Key Facts About Dengue Fever in the Cook Islands

About Dengue Fever in general:

  • Dengue fever is the most common tropical viral disease. It exists permanently in 120 countries.
  • An estimated 400 million people are infected with dengue fever each year worldwide. And around 100 million develop the disease. Half of the world’s population is at risk of getting it.
  • Dengue is a mosquito-borne viral infection. Only the female Aedes mosquito transmits it, known as the tiger mosquito, because of its tiger-like stripes on the back legs.
  • There are four different types of dengue virus (DENV 1-4), which is why you can fall ill four times.
  • An infection will provide you with lifelong immunity against this particular serotype. 
  • Dengue can be fatal if it turns into a hemorrhagic fever. It causes internal bleeding or dengue shock syndrome with circulatory failure.
  • There is no effective vaccination against Dengue. In the case of illness, only the symptoms can be treated. 


For more key facts, see the Dengue-Website of the WHO.


About Dengue Fever in the Cook Islands in particular:

  • Every year there are several hundred cases of Dengue Fever in the Cook Islands. With the country’s population of about 17.000 inhabitants, that is a recognizable amount.
  • The majority of Dengue cases appear in Rarotonga, the capital island. The virus rarely spreads to the outer islands. Only a few cases have been recorded in Aitutaki, Mauke, and Pukapuka. Besides, in case of a Dengue fever outbreak on Rarotonga, the government usually closes the outer islands to keep them safe.
  • So far, all cases of Dengue fever in the Cook Islands are virus types 1 and 2 (DENV1, DENV2).
  • The Tiger mosquito is a massive threat and the reason for persistent Dengue fever in the Cook Islands. Tons of mosquitos are breeding in standing water, the swamps, and humid forest areas of Rarotonga. To eradicate mosquito larvae, the Cook Islands Ministry of Health regularly sprays insecticides.


Newspapers regularly provide information when there is an outbreak / rise in Dengue fever in the Cook Islands, such as Cook Islands News.



How to Avoid Dengue Fever

IslandAwe Tiger mosquito spraying
Dengue Fever in the Cook Islands – Spraying Against Tiger Mosquitoes



Dengue Fever in the Cook islands increases because of a massive amount of infectious Tiger mosquitoes everywhere all-day-round.

Thus, the simple answer is: avoid Tiger mosquito bites at any time.

Do the following:

  • Use mosquito nets and wear long light pants and shirts when possible. Don’t wear dark colors because they attract mosquitos. 
  • Use a strong insect repellent containing DEET. The insect repellent “OFF! Family care” is quite helpful and available on the Cook Islands as the Australian “Bushman” is. 
  • The mosquitos tend to breed in humid and stale water areas. Hence, avoid risk areas, such as swamps and rainforests. Ensure that around your accommodation are not standing water bodies, like in pots, containers, and tanks.
  • Of course, kill the mosquitoes if you see them. It is worth hunting them down, and they do not move quickly.


Symptoms of Dengue Fever

The illness occurs 4-10 days after an infectious bite, and these symptoms usually last 2-7 days:

  • High fever. Around 40 C/ 104 F, over several days
  • Pain behind your eyes
  • Muscle and joint pain
  • Severe and itchy rash
  • Stomach and bowel problems, Nausea & vomiting
  • Loss of Appetite
  • Fatigue


Unfortunately, Dengue fever also comes with some long-term side effects. For example, recurring fatigue, joint and muscle pain, and hair loss.



5 Steps to Take If You Get Sick With Dengue Fever

  1. First of all, get a blood test to confirm an infection if you recognize the symptoms. You should know for sure whether you suffer from Dengue fever and which virus type (DENV1 – 4) it is.

  2. Blood tests. Your platelet count should be confirmed every few days. It is an indicator of the severity of the disease. The lower the number of platelets, the more weak your body is.

  3. To improve the blood count, take the pawpaw leave extract*, you find the recipe in the next paragraph.

  4. Take only an appropriate pain reliever, not one which can aggravate the disease. Avoid Aspirin or Ibuprofen, which increases the risk of internal bleeding.

  5. Stay hydrated. Because the fever dehydrates the body, and you don’t feel like drinking or eating at all. Get an infusion / intravenous drip at the hospital or doctor’s office if you cannot handle it yourself. Rest and help your body to recover. 

There is no further medical treatment available for Dengue fever in the Cook islands. Unless you suffer from severe Dengue Fever and you need intensive care.


IslandAwe Pawpaw tree

* Support from Mother Nature –
The Pawpaw leaf extract

Even if you are not into it – try natural medicine. The Cook Islanders swear on this bitter pawpaw leaf extract.
We tried it too, and it helped us to recover.  

Here is the recipe:

  • Wash 5 medium-sized pawpaw leaves well and cut them into small pieces.
  • Bring to the boil in 2 liters of water and let simmer until the liquid is reduced by half (almost to one liter). Sieve the leaves and store the broth in a glass container. 
  • Do not keep the extract in the refrigerator for more than 24 hours. Make a fresh batch.
  • The patient receives two tablespoons (or 30 ml) of the extract four times a day. Ideally before each meal and at an interval of approx. 6 hours.



To Protect Others:

  • Stay at home. You should not leave your house for a couple of days after you felt sick, because you can infect others. A mosquito can transmit your virus.
  • Make your home safe. Protect your family members or other housemates from infection. Keep your home mosquito-free and avoid mosquitoes biting them under any circumstances.





You Might Also Be Interested In …


this related topic:
The Tiger mosquito is one of the hazardous animals in the country. If you want to learn more about those, have a look at our post about 10 Dangerous Animals in the Cook Islands.

… our first-hand experience of Dengue fever in the Cook Islands:
If you want to learn more about the course of the disease, read the following two chapters. There we both recorded our experiences with Dengue fever in the Cook Islands in a diary. It shows how the disease develops and how you feel with it.


Dengue Fever in the Cook Islands – Eltje’s Dengue Diary

  • Day 1: Migraine day? I take one of my migraine pills. But somehow, that does not work today. I am tired and sleep a lot. I cannot eat, and I drink only.

  • Day 2: I still have a migraine?? I am impatient, and I double the dose. Still, this doesn’t help. I spend the day in bed and do not eat.

  • Day 3: Migraine??? I do not get it. Now I am taking the German tablets instead of the Australian ones. Haha – why should this make a difference? I also recognize that my headache is actually eye pain; it sits behind the eyes. I still have no appetite. Eating is a big problem, even though Pietro cooked his famous Spaghetti Bolognese. Pietro points out that I might have elevated temperature and recommends taking a flu tablet. This is what I do.

  • Day 4: The eye pain is gone, the elevated temperature too. But I am still not hungry. Pietro picks up Fish & Chips for dinner. “Are you just looking at the food only, or do you eat something today?” he asks. I do not eat.

IslandAwe Dengue fever rash
  • Day 5: I get a rash on my legs and feet. And why do I have to eat again?

At Night: My palms itch like hell. I cannot sleep at all.

I scratch myself so much that I think my skin peels off any minute.

My legs and feet, including the soles, are dark red now – creepy


  • Day 6: It is Saturday. After the sleepless itchy night and severe stomach issues, I decided to go to the doctor. Guesswork in the hospital. Too many non-specific symptoms. The doctor guesses on gastritis and an allergic defense reaction. He recommends stomach tablets and an antihistamine.

  • Day 7: I start eating again. My rash looks wild, but it is not itchy anymore.

  • Day 8: The stomach problems are gone. I also switch back from tea to coffee. But the rash takes weeks to heal completely. Scary is the fact that the skin on my feet’ soles peels off completely. It takes me weeks before I can walk properly again because it is so sore.

  • Day 10: Pietro gets a fever…


When Pietro became sick with Dengue, I got doubts about my sickness. Thus, I had myself tested a day later – with a positive result. The surprise: I was double positive. My blood showed antibodies from 2 different dengue infections, type 1 and 2. 


My long-term side-effects: 2 months later, I start massively losing hair for over six months, which caused a trauma. I lost more than 60% (!) of my hair during this period.



Dengue Fever in the Cook Islands – Pietro’s Dengue Diary

  • Day 1: Pietro tells me he is developing a fever. He doesn’t feel well and takes a flu pill. At night: chills set in, and Pietro sleeps with three layers of clothing or blankets.

  • Day 2: Pietro has a high fever, 39.5 Celsius. He keeps having chills, so his body continues to heat up. He is tired, has a headache, and spends the day in bed. He doesn’t eat, and I keep urging him to drink. He takes Paracetamol and Ibuprofen alternately.

  • Day 3: Up and down in terms of body temperature. At some point, we have the impression that the situation is normalizing. But it doesn’t. The fever exceeds the 40-Celcius mark. Pietro doesn’t like anything anymore. Eating and drinking become a problem. The many tablets do the rest. His stomach is not feeling well. In the meantime, he can no longer sit or lie down. His back hurts, and I try to help with a gentle massage.

  • Day 4 (Easter Weekend): It’s Saturday, the situation is unchanged. I urge him to see a doctor, mostly because I see dehydration coming. He is so weak he can’t even sit in the car, and we prepare a bed in the back area.


Deja vu – my doctor from last week, and it’s Saturday again. Pietro gets an infusion. All symptoms state Dengue, and he is tested for it. Because it is also a public holiday, the result will not be available until Monday afternoon.

  • Day 5: No changes: high fever, headache, and muscle pain. Pietro can only take Paracetamol. Ibuprofen and Aspirin can increase possible internal bleeding and are therefore taboo.

  • Day 6: Around noontime, the test result arrives: Dengue positive. Pietro has to give blood again because his platelet values ​​are pretty down and need to be monitored. 


I am terrified now and willing to try everything that might help.

This is the moment when I go for natural medicine, which local friends recommend to me. I drive around the island and collect pawpaw leaves. The pawpaw leaf extract helps lower fever and improve blood values​ ​as a preventive measure against internal bleeding, which can be lethal.

And – I am going for a dengue test…

  • Day 7: A light at the end of the tunnel appears. The fever has dropped under 40 C, Pietro is having breakfast. But he is exhausted, the muscles ache, the stomach remains torn. And he gets diarrhea. At night he starts to sweat, again and again, so he wanders between the warm bedroom and the colder living room.

  • Day 8: The fever is gone, but sleep deprivation is now a problem. Pietro gets a whole-body rash, everything itches. The following night is another disaster.


And my test result is there: Dengue positive. Yet, I am in the recovery phase, and my blood values ​​are average.

  • Day 9: A nurse comes to visit us at home. Pietro is fever-free and feels a bit better. She promises to do something about itching, which she, unfortunately, does not do.

  • Day 10: The rash no longer itches, but the nurse brings the medicine for it – a day too late.

  • Day 11 – 20: Pietro in the recovery phase.

Pietro’s long-term side effects: Even a year later, he still suffers from sudden fatigue and muscle and joint pains. He also lost a recognizable amount of hair.


Click the image below for your FREE Dengue Fever PDF Infographic.

Dengue-Cook-Islands-Infographics
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