BODY WATCH : Bugged in the Tropics : Dengue fever sounds exotic, and indeed it’s found in many exotic locales. But its effects--chills, vomiting, racking pain, even death--can travel back home.

It’s been called breakbone fever and with good reason. Its original name was ki denga pepo , Swa hili for “it is a sudden overtaking by a spirit”--an evil spirit, no doubt.

After the high, dry fever, racking chills, diarrhea and vomiting stop, the headaches begin, and your bones feel as if they’re fracturing, one by one. That’s the severe form of dengue (pronounced DEN-gay) fever. In my delirium, I envisioned the sources of the extreme pains tearing through my joints, bones and muscles as the sand worms of the planet Dune. At the end of 10 days, I was exhausted to the point of collapse. It took a month before I had enough energy to work again; still, for six months I was plagued with severe exhaustion--an effect of the disease that’s known as post-viral syndrome.

But it could have been worse. Dengue hemorrhagic fever combines all of the above plus hemorrhaging that appears as red spots on your legs, while dengue shock syndrome fills your lungs, brain and gastrointestinal system with blood, often resulting in shock and death. Luckily, I did not contract either while in Indonesia last year, although I met two people who did.

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As is the case with the many “emerging diseases” that are spreading around the world, there is no vaccine for dengue fever. There is no cure, except time and luck. Insecticide spraying programs have failed to control the mosquito that transmits it. And now, the disease, which is found in almost every tropical and subtropical city in the world, has become a major threat to U.S. citizens traveling abroad.

The first outbreaks of dengue fever were reported in 1779, in Jakarta, Indonesia, Cairo and Philadelphia. Its symptoms range from a mild flu to the “breakbone” version. Before the 1950s, epidemics of dengue fever were rare, popping up every 10 to 40 years, following the sea routes plied by slow ships.

Since World War II, however, a combination of factors has caused dengue fever to become one of the world’s worst pandemics. The migration of millions of people to cities, increased air travel among countries and the elimination of mosquito eradication programs offered a concentrated mosquito and human soup in which dengue could thrive. Eventually the various types of the dengue fever virus produced the more deadly versions of dengue hemorrhagic fever and dengue shock syndrome.

In 1953, in Manila, the first epidemic of dengue hemorrhagic fever appeared. Currently, there is an epidemic in Puerto Rico that has affected 15,000 people so far this year. The disease generally infects children, requires hospitalization for blood transfusions and kills 5% to 10% of those infected.

Three times the number of dengue hemorrhagic fever cases have been reported in the last 15 years than in the previous 25, says Dr. Duane Gubler, director of the division of vector-borne infectious diseases for the Centers for Disease Control and Prevention in Ft. Collins, Colo. Some estimates put the number of people who contract dengue fever at up to 100 million annually, and unknown tens of thousands come down with the hemorrhagic version in epidemics in nearly every major city in the tropics, from Africa to Asia, from the Caribbean to Central and South America.

The first serious epidemic in the Americas occurred in Cuba in 1981, when 344,000 people came down with dengue fever, 24,000 with the hemorrhagic version and 10,000 with dengue shock syndrome. In three months, 116,000 people were hospitalized in Havana, sometimes at a rate of 11,000 a day. The aggressive response on the part of the medical community kept deaths to only 158.

A uniquely urban disease, dengue fever is usually transmitted by the female Aedes aegypti mosquito. Gubler calls it a “domesticated” mosquito. It is uniquely adapted to modern urban life because it breeds in small reservoirs of water, such as those that linger in tires or plastic containers, in the water jars of city dwellers who have no running water, in large ornamental pots that hold water plants.

A. aegypti, which also spreads yellow fever, is one of the more voracious mosquito species. “If there’re five people in a room, she’ll probably feed off all five people before she gets enough blood,” Gubler says. Another species, Aedes albopictus, which found its way to the Americas in a shipment of tires from Asia, also spreads the disease. Both mosquito species are nearly universally distributed around the world, mostly in the subtropics and tropics.

In the United States, A . aegypti has migrated as far north as Washington, D.C., while A. albopictus has ventured to Chicago.

No severe epidemics have occurred in the United States, but public health officials suspect that about 200 people bring in dengue fever each year, including many to California. But because the infected individuals encounter no mosquitoes to spread the disease, the infection usually ends with them. However, twice--in 1981 and in 1986--small outbreaks of the disease occurred in Texas.

“These incidents underscore the fact that the southeastern U.S. is still at risk for epidemic transmission of dengue virus,” says Gubler, especially since the mosquitoes that spread the disease are prevalent in the region.

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Many of those who bring dengue fever into the United States are travelers, but most are unaware that they are infected because their symptoms resemble the flu, says Dr. Carolyn McCloud, a tropical disease specialist in Miami.

But in a quirk of nature that has tropical disease specialists like McCloud shuddering, many of those who have contracted a mild version may be at risk for a more severe version of dengue fever or dengue hemorrhagic fever if they travel abroad again.

Unlike some other diseases that provide immunity with mild infection, mild forms of dengue fever can produce enhancing antibodies. If a person is bitten again by a mosquito carrying the virus, these enhancing antibodies actually help it invade the immune system to a more severe degree.

Researchers at Mahidol University in Thailand are working on a vaccine, but a vaccine is at least five to 10 years away.

Travelers need to take precautions. In the early mornings and late afternoons when mosquitoes are hunting, wear long-sleeved shirts and long skirts or pants, and cover any exposed skin with an insect repellent such as DEET.

Avoid wearing dark blue or black clothes--mosquitoes find them quite attractive. Look for standing water in which mosquitoes might be breeding and eliminate it.

And if you see a small striped mosquito that flies fast and erratically . . . kill it.