Everything you (n)ever wanted to know about Dengue Fever

Greetings from Nevada, where our family is freezing! After so many months sweating in tropical heat, weather in the 40’s and 50’s feels downright frigid. But we are glad to be at my mom’s house while we re-group and figure out our next steps. I, personally, am feeling better each day about our new reality (hot showers are helping), though I’m still sad about our mission coming to an early conclusion.

I realized from a few comments I received regarding my last blog post that I ought to clarify just why, exactly, we felt the need to leave Honduras early. It was not because Adelina was too sick to stay. She had relatively mild symptoms of both Typhoid and Dengue, and –had they been more severe—I honestly would have trusted the Honduran doctors to treat her more than I would doctors here in the States (Honduran doctors, after all, see these illnesses all the time). By the time Adelina received her Dengue diagnosis, she was already passing through the critical phase of the illness without complications.

The reason a Dengue Fever diagnosis was a “line in the sand” for Eric and me was because of the danger of Adelina getting Dengue a second time. A second Dengue infection carries a significantly higher risk of developing into Dengue Hemorrhagic Fever, a potentially fatal complication of the disease (more below).


Dengue is a mosquito-borne illness

I’ve done a lot of research about Dengue in the last week (researching is one of the ways I cope with stress), and I thought you all might be interested in some of the things I’ve learned about Dengue Fever.

The Disease

Dengue Fever is an illness endemic to many tropical countries, especially in Latin America and Asia. It is a virus, transmitted via mosquito bite. Symptoms typically appear 4-7 days after a bite from a mosquito that has previously bitten someone infected with the disease. A Dengue virus infection involves three phases: febrile, critical, and recovery.

During the febrile phase, temperatures spike and head/joint aches are common. Dengue has been nicknamed “breakbone fever,” which gives you a good idea of how painful it can be; in Adelina’s case, fortunately, her discomfort wasn’t extreme. Additionally, Adelina did not develop the Dengue rash that occurs in 50-80% of infections. Toward the end of the febrile period, it is common to see a sharp drop in blood platelets; before more specific diagnostic testing was available, platelet counts were the primary way of diagnosing Dengue fever.

After the febrile period, Dengue progresses into the critical phase. This is the most dangerous time for an infected person. In the 3-4 days after fever subsides, there is a risk that the disease will progress into Dengue Hemorrhagic Fever (DHF). DHF is a potentially fatal complication involving internal bleeding (usually in the gastrointestinal track), bleeding under the skin, and excessive vomiting. Patients can develop a specific form of shock, called Dengue Shock Syndrome. DHF is considered a life-threatening condition, and it is especially dangerous in children.

Most people with Dengue, including Adelina, do not develop Dengue Hemorrhagic Fever. They progress right through the critical phase without complications and enter into the recovery phase. During recovery, platelet counts normalize and other symptoms improve. It is typical for people with Dengue to experience fatigue for several weeks after infection; we have definitely seen this in Adelina.

Heightened risk of second infection

We ended our mission at the Finca early due to the heightened risk of a second Dengue infection for Adelina. There are four strands of Dengue fever, any of which can –but usually don’t—progress to Dengue Hemorrhagic Fever.

Once infected with a strand, people are typically immune to that specific strand for the rest of their lives. However, if they are infected with any of the other three strands, the body’s immune response is confused and they have a much higher risk of developing Dengue Hemorrhagic Fever than they did with the first infection. The body’s immune system recognizes the Dengue, but for some reason the antibodies it produces actually bind to and spread the virus, rather than attacking it. An article I read compared it to a Trojan Horse effect: the antibodies actually help the virus enter the body’s cells, so a person is much more susceptible to a critical infection. One study put the risk of developing DHF in a secondary infection as eight times greater than in a primary infection.

That’s why we left Honduras. We just couldn’t take the risk of Adelina getting infected again and developing Dengue Hemorrhagic Fever.

Dengue Vaccine

A few years ago, a Dengue vaccine was developed and rolled out in a few countries in Latin America and Asia. However, researchers found that vaccinating children who had never previously had Dengue made them more susceptible to developing DHF. Basically, the vaccine was acting like a primary infection and increasing the risk of DHF in a “secondary” infection.

The good news is, if somebody has already had a Dengue infection, the vaccine does appear to work to immunize against the other three strands. In other words, since Adelina has already had Dengue once, we can get her the Dengue vaccination and she should be protected from the other three strands . . . and that elevated risk of DHF.

For me, this is a great relief, as it means Adelina won’t be restricted from traveling to Dengue-endemic regions for the rest of her life. Currently, the Dengue vaccination is only available for people ages 9-45 who have had a confirmed Dengue infection, so we will have to wait four years before we can get the Dengue vaccination for Adelina. All things considered, this just isn’t so bad.


When she’s 9, Adelina can get the Dengue vaccination

If you, like me, enjoy reading medical articles, you can check out the ones that I’ve posted below, which are among those I’ve read in the last week. Also, just FYI, please stay tuned to this blog: I do plan to finish out my ABC’s of Life on the Finca blog posts. Although we have left Honduras, the Finca mission is still very much alive in my heart!

Links to articles about Dengue and DHF:








Oh, my friends. It has been a rough couple of weeks.

Right around the time that my last blog was posting, our sweet Adelina came down with a fever. After six days of spiking temperatures, she was diagnosed with Typhoid Fever. We spent Mother’s Day traveling 7 hours roundtrip to a hospital in La Ceiba, where Adelina received IV antibiotics and was discharged to the care of our wonderful Finca nurses.

When Addy’s fever didn’t subside as expected, she received further testing… and was diagnosed with acute Dengue Fever, in addition to the Typhoid. The two diseases are completely unrelated (Typhoid is food/water-borne, Dengue is mosquito-borne). It was just plain rotten luck that Adelina got them both at the same time. Thanks be to God, she has now been fever-free for three days, and she is returning to her spunky, sassy self.

But we are coming home.

Fever smiles

I took this picture when Adelina was at the height of both Typhoid and Dengue (though we didn’t know it at the time). Still our smiley girl, despite crazy tropical illnesses.


Kiara or Adelina contracting Dengue has always been a “line in the sand,” health-wise, for our family’s mission. Before leaving the U.S., I had read enough articles about the risks of a secondary Dengue infection (like this one and this one and this one) that I knew a primary Dengue infection would send us packing.

Honestly, though, I am reeling. While life in Honduras does involve a greater level of general risk than life in the U.S., up until this recent outbreak, Dengue was not a major one. There are literally no missionaries in recent history who have gotten Dengue; it simply hasn’t been an issue at the Finca. And contracting both Typhoid and Dengue at the same time… well, that’s just unprecedented.

Eric and I have always said that the health and wellbeing of our kids had to be our number one priority throughout this mission. As the Finca’s founder, Zulena Pescatore, put it during our retreat, “Family is our ‘first church.’” Eric and I thoroughly discussed the need to prioritize Kiara’s and Adelina’s wellbeing over our call to mission (should it come to that), and –as I said—we had even talked about this specific contingency before departing the U.S. So, in one sense, the decision to end our mission early and come home is an easy one. But, in every other sense, it is incredibly difficult.

Friends, I am so very heartbroken.

At the risk of sounding melodramatic, it feels like someone has died. Our mission at the Finca, which we had dreamed of and discerned long before it began, and which has brought us such deep joy and so many incredible memories, is like a beloved friend… And I am not ready to say goodbye. Every time I remember another event that I will be missing (the arrival of summer missionaries, Honduran Independence Day, one of my favorite Finca kids’ graduation), I experience another wave of grief. I’m pretty sure I have cried more in the last two days than in all of my previous time at the Finca.

Pero, ánimo. (But, take heart.) Even in these moments of sadness, anxiety, and uncertainty, we have experienced moments of profound peace. Last night, as we said our evening prayers together, Adelina (seemingly out of nowhere) piped up, “Guys, I think God is just calling us to come back home.”

And this morning’s Gospel reading begins, “Jesus said to his disciples, ‘Do not let your hearts be troubled. Believe in God, believe also in me.’”

That is, of course, what being a missionary is all about: believing in The One who called us to the Finca in the first place… and recognizing that He is also The One who, ultimately, calls the shots.

At the moment, I don’t like the shots that have been called. But I do believe in The One who calls them. And so I am typing this blog post in a fancy, air-conditioned hotel room down the street from the best hospital in La Ceiba. Adelina (who, just for fun, has also developed bronchitis, almost certainly due to her weakened immune system) is cuddling with her sister in the bed next to me. Earlier today, one of the best pediatricians in the city cleared her for travel back to the States, pending the results of a parasite-screening. Our suitcases, hurriedly packed amid tearful goodbyes yesterday, are stacked in the corner.

Dengue Test

Adelina’s positive Dengue test. “It’s amazing how much one mosquito can change your life!” quipped one of the Franciscan sisters at the Finca.

We are hoping to travel to my mom’s house in the next few days. Our primary concern is getting Adelina back to full health. (A couple of hours ago, I had to plead with her to stop jumping on the bed naked, so I think we’re well on our way.) After that…. well, this is an excellent opportunity for us to take Jesus at His word and not let our hearts be troubled.

Today’s Gospel continues:

“And if I go and prepare a place for you, I will come again and will take you to myself, so that where I am, there you may be also.”

Amen, we do believe.

The ABC’s of Life on the Finca: E-G

Hello again, friends! My apologies for the delay in publishing this next section of my Finca ABC’s. I planned to write and post this blog last week; unfortunately, I spent most of last week in bed with what turned out to be a severe, systemic infection. Our Finca clinic doctor said he had rarely seen bacterial counts as high as mine in his career, so today I am thanking God for doctors, for laboratory workers (especially those, like mine, who are able to do their job without the aid of a computer), and for strong antibiotics. Sadly, my illness encompassed my 34th birthday, so I’ve now spent both Christmas and my birthday at the Finca sick in bed. Whomp whomp.

This illness really shook me up, not just because I was so sick (fever approaching 104 and almost-unbearable head/joint aches), but because my symptoms caused me to fear I had contracted Dengue fever. Dengue is a nasty, mosquito-borne tropical illness with a certain peculiarity: it is almost always worse – and indeed can be fatal – the second time around (miserable as it is the first). There is currently a terrible Dengue outbreak here in northern Honduras, and the Finca hasn’t escaped: one of our Honduran employees recently came down with it and was out of work for nearly two weeks.

Before Eric and I left for Central America, we discussed circumstances which would prompt us to leave the Finca. One of them was if either Kiara or Adelina contracted Dengue, due to the risks –especially for children—of a poor outcome upon contracting the illness a second time. We simply aren’t willing to risk that second time. So, here’s my prayer request to everyone out there: Please join us in prayer that nobody else at the Finca comes down with Dengue, and that this outbreak is contained and those affected by it healed quickly! Thank you.

ANYWAY. Continuing along with Letters E-G…

E is for Escuela

Escuela means school, and it’s a huge part of our lives here. Each morning, the girls get dressed in their uniforms (the same uniforms that children across all of Honduras and, in fact, most of Central America wear). At 6:55am, Eric or I walk with the girls across the Finca to school. Eric teaches from 7:15-10:30am at the colegio (middle school). The girls attend school for two-thirds of the day, from 7:15-11:15am. As they’re leaving with Eric, I’m usually arriving to teach my Computación class.

Honduran uniform

Adelina and Kiara in their Honduran school uniforms

I have generally been very impressed by the school here at the Finca. “Our” Finca kids comprise less than a quarter of the student population; most of the students at our school walk here from neighboring communities every day. The director/principal has been part of the school for 20 years; as a matter of fact, she used to live in the same house we live in, back when Finca teachers all lived on-site. The school conforms to Honduran national curriculum standards, which are surprisingly thorough. In a parent survey last November, our students’ families expressed extreme gratitude for the education their children are receiving.

Morning Assembly

Morning assembly at the school

Of course, this being Honduras, the challenges of operating a school in a developing country are real and pervasive. Many of our students’ parents have limited education/literacy, so our kids can’t get help with their homework. When it rains, the children who walk several miles to the school are delayed or prevented from coming altogether. Even the parents’ enthusiasm for the school can be somewhat heartbreaking: “I can’t imagine a better school than this one. There are classrooms and desks, and the teachers all show up! It’s a great education.”

Nonetheless, I can say with confidence that our students have the opportunity to receive a good education here, which is not the case with most rural schools in Honduras. I am proud to be contributing, even in a small way, to these kids’ learning.

Students running for school

Neighborhood students running into the Finca at the start of a school day

F is for Fogón / Facebook

Fogón – A fogón is an outdoor wood-burning stove, and it’s an essential part of life on the Finca. All the houses on the Finca have traditional indoor stoves; however, our chimbo (propane) is rationed due to its high cost, so things that take a long time to cook (like beans or a frozen whole chicken) are always cooked on the fogón. When we first arrived, starting the fire for the fogón was a frustrating and time-consuming venture, especially when it had recently rained and our wood was damp. Now, though, we’ve gone through the process enough times and learned enough tricks of the trade that it’s no longer the intimidating struggle it once was. FYI: Egg cartons burn better than cereal boxes, and cotton – like, say, an item of clothing that no longer fits because it’s too stretched-out from hand-washing – is good to hold onto for a rainy day (literally).


Cooking beans on the fogón

Facebook – If you haven’t already “liked” the Farm of the Child Facebook page, you should do so now! As part of my Donor/Benefactor communication responsibilities, I take photos here “on the ground” and caption them for our Facebook page. My goal (which, I must admit, I rarely reach) is to have 5 photos per week to share with the Facebook world. I take the photos, caption them, and send them off to our U.S.-based Program Administrator for posting.

One added challenge to photographing the Finca is that we cannot show any of our kids’ faces. Our children are vulnerable; they come from traumatic and sometimes violent backgrounds, so protecting their privacy is imperative. You may have noticed that I never post pictures of our smiling Finca kids (though I have many) on this blog; our privacy policy is the reason. Although it can be difficult to get the right shot (“No, don’t look at the camera!”), it is also especially rewarding when everything comes together to “tell the story” without showing any faces.

Facebook screenshot

Screenshot of our page; you should “like” it to receive our updates!

G is for Garifuna

The Finca is nestled among several Garifuna communities in Honduras, which is such a great blessing. The Garifuna people are a fascinating and inspirational part of Honduran/Caribbean culture. Their story truly gives truth to the term “history is better than fiction.”

Día de Garifuna

School poster honoring the Day of the Garifuna

Around 1675, a ship carrying enslaved people from what is now Nigeria shipwrecked in the Caribbean. The survivors made their way to the island of St. Vincent, where they intermarried with the Carib people and then successfully revolted against French attempts to force them into slavery on the sugar and cocoa plantations. When Great Britain took control of St. Vincent in the early 1800s and attempted to colonize them, the Garifuna proved to be so nettlesome to British plans that they were exiled to the island of Roatán (anti-colonialism for the win… sort of). From there, they dispersed to the mainland of Honduras, Guatemala, and Belize.

The Garifuna have their own language (a mix of Carib, French, English, and Spanish), food (lots of cassava and seafood – we watched a group of Garifuna fishermen catch a barracuda off our shore), music (lots of drums and shakers), and general lifestyle/culture. Early in our time at the Finca, we attended a Garifuna Mass at the Cathedral, and the vibrancy of the clothes, music, and dancing reminded me of my beloved Uganda. What a treat!


A Garifuna fisherman showing off the Barracuda he caught off the shoreline of the Finca

One particularly inspiring thing about living in a Garifuna-populated area is witnessing a sort of alternative history to the crushing legacy of slavery we know in the U.S. The Garifuna people are not an oppressed minority burdened with centuries of subjugation and institutionalized sin. Racism does, of course, exist here. But the upper-echelons of society are filled with Garifuna; they are the lawyers, doctors, accountants, etc. of the region. If anything, the Garifuna seem to have more, not fewer, opportunities than the average Honduran citizen. Nationally, the country of Honduras honors Garifuna culture with the Day of the Garifuna, in which the Garifuna people are celebrated, and anyone of Garifuna heritage has a government holiday.

It’s enough to make one sigh wistfully and think, “What if…”

Classroom (1)

Kiara’s Math/Science teacher, Profe Martín, is Garifuna

Okay, folks, I’m going to cut it off there, as this blog post is already longer than I intended. To be continued soon!