Hi, it's Alexa Yabel from New York Times cooking. We've got tons of easy weeknight recipes, and today I'm making my five-ingredient Creamy Miso pasta. You just take your starchy pasta water, whisk it together with a little bit of miso and butter until it's creamy. Add your noodles and a little bit of cheese. It's like a grown-up box of mac and cheese. That feels like a restaurant-quality dish. New York Times cooking has you covered with easy dishes for busy weeknights. You can find more at nytcooking. Com.

This is The Opinions, a show that brings you a mix of voices from New York Times Opinion. You've heard the news. Here's what to make of it.

My name is Deborah Haynie, and I am an occupational and environmental medicine physician. I work in Ann Arbor at the Ann Arbor VA. I travel to Latin America, and and was in Curaçao. One day, I noticed some itching in my ankles and in my elbows, but it was tiny little bumps. It wasn't really very concerning. We talked to the host of the Airbnb, and she said, There are no mosquitoes this time of year. It's not mosquitoes. I assumed it was some small bug called a nosium. The next day, I started to have muscle aches. We were on our way to snorkeling, and I was sitting in the car and just rubbing my legs because they hurt so badly. And then I started getting hot. I'm glad I didn't have a thermometer because I probably would have been frightened. I was taking Tylenol regularly, and I had to get up because we were flying out that morning. And by the time I got home, it was midnight. I slept through much of the next day. I was scheduled to work in the afternoon, but I simply couldn't do it. That night, I developed this severe diarrhea that lasted for over 24 hours.

It was like a colonoscopy prep on steroids. And then I developed total body itching. And that night, I couldn't sleep because I itched so badly. I went to the emergency department at the admitting. I actually sat down and started crying. Now, I was convinced convinced by this time that I had influenza, and that was negative, and other viruses that they checked for was negative. Essentially, the possible diagnosis was an infection, an autoimmune immune disease or cancer. I had been texting this whole time with my ex-husband, Ray, who is a physician assistant and has training in wilderness medicine, and he said, I wonder if it's Dengue. Dengue fever is a viral illness. It is caused by transmission from mosquitoes, particularly a certain type of mosquitoes called the Aedes mosquido. I Went and messaged my doctor the night I'd seen her and asked if she could order a Dengue test. Two days later, the test came back positive for Dengue. In my medical career, I have never dealt with Dengue, and this is why it was so surprising to me when I got the illness. Dengue currently isn't very prominent in North America. However, with climate change, the Aedis mosquito is being seen more often, and it's migrating farther north, and it may become more prevalent once the mosquito is in these areas.

It's just unknown what's going to in the future, but I think that the healthcare system has to be prepared for this. Travelers and people who live in the Southern US currently need to be aware of this and think about it as a possibility when they become ill. There needs to be a mechanism to get this information to all providers. In medical school, they're starting to talk more about climate change, about illnesses related to that. But there are those of us who have been practicing for a long time who are not going to get that message. I wonder if it would be possible for states to make a mandatory training for tropical illnesses like this. So vaccines to Dengue are not readily available, and there are many that have been in development. Some have been taken off the market after after research and trials were started. In the United States currently, there is a vaccine. It is only available to children ages 9 through 16 who have laboratory confirmed previous Dengue infections and live in an area where it's endemic, such as Puerto Rico, or are going to be traveling to areas where it is endemic.

Pandemic. The problem with the vaccine, and one of the reasons that they will only give it to people who have had Dengue previously, is because getting the vaccine can actually stimulate the immune system. And there have been cases where those who get the vaccine who have never had Dengue actually have more severe Dengue. In summarizing my experience with Dengue infection, I have never experienced an illness like this. It was not an experience I'd want to go through again. However, I think that knowing about it can protect me, of course, in the future. But friends, colleagues, people who have read my story, heard about my story, will now have the awareness to protect themselves. Maybe that's the silver lining of the infection that I had.

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