Son told mum 'I've got to go now' with final breath before he died in Thailand

Bob Toulson-Burke
-Credit: (Image: Jane Toulson-Burke)


A heartbroken mum told of the last conversation she had with her son before he died of dengue fever.

Jayne Toulson-Burke has issued a warning to travellers to take precautions after the Foreign Office issued a health alert last week amid 'an unexpected rise’ in cases of dengue and deaths caused by the virus. Jayne's son Bob died of dengue fever in a hospital in Thailand on December 7, 2016.

Bob's last words to his mum during a phone call home as he was in the back of an ambulance were: "I've got to go now. I can't breathe and they are putting a tube down my throat."

Jayne was in the passport office in Liverpool trying to arrange for a replacement for her expired passport so she could fly out to Asia when she learned the devastating news of her son's death from one of her two other sons, Mark, who had travelled to Thailand to be with Bob.

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Tearful Jayne, from Stockport, told the Manchester Evening News: "That's the last time I ever heard from him. He went into a coma and never regained consciousness."

She said her son sounded worried and died about a week later in hospital in Phuket, Thailand. Bob had started to feel ill when he and his friends were flying from Laos to Thailand and he sought treatment at another hospital in Pa Tong, where medics thought it was "just a flu". He was transferred to Phuket but never recovered.

Jayne, 59, who works as a teaching assistant, asked if her son's outcome may have been different had he known more about the virus.

She said: "I have got absolutely no doubt in that. He's a sensible boy.

"He's not going to be foolish. He doesn't even like heights.

"He's a sensible lad. Had he known, had I known, the outcome I'm sure would have been completely different because when he was ill the first time he would have gone and demanded a test."

Jayne urged travellers to become familiar with the symptoms of dengue fever and to "demand" a blood test in hospital to confirm the presence of the virus and then treat it.

The World Health Organisation said approximately four billion people in 130 countries are at risk of dengue – a virus spread by mosquitoes found in tropical and subtropical regions worldwide, including parts of Europe. Travel Health Pro, a subdivision of the Foreign Office, has warned that dengue has "spread into regions previously thought to be dengue free".

As of April 2024, over five million dengue cases and over 2,000 dengue-related deaths have been reported worldwide since the beginning of 2024. An increase in dengue cases has been flagged around the world, including in Asia, central and south America and across the Caribbean.

Dengue is not endemic in Europe, said Travel Health Pro. But if environmental conditions are favourable in parts of Europe where mosquitoes which can carry dengue live, then travel-related cases may cause the spread of dengue locally.

Several European countries have previously reported locally acquired cases of dengue. In 2023, locally acquired cases were reported in France, Italy and Spain, according to Travel Health Pro

Jayne, who now campaigns to raise awareness of dengue, said: "You might think this is only in the tropics or in Asia. It's not.

"It's in Europe now. If Bob had known, if I had known more about this, he would have had more of a chance. People think it won't affect them, but it may affect them if they travel."

Jayne's son had quit his job as a personal assistant at a vitamin shake business to go travelling around Asia, first visiting Vietnam before moving on to Laos and then Thailand with his friends. They planned to visit Cambodia.

Jayne, who urged travellers to visit the World Mosquito Program for more information, added: "I want people to see that we were just an ordinary family and it's hit us. You don't have to be university educated to go and travel and find yourself and to have a wonderful experience. If this happened to us, it can happen to anybody."

What is dengue?

Dengue is caused by a virus and is spread by the bite of an infected mosquito which mainly feed during daytime hours, says the alert published at the start of May on Travel Health Pro’s website. There are four different types of dengue virus: DENV- 1, DENV- 2, DENV- 3 and DENV- 4.

What are the symptoms?

The majority of people infected with dengue will not have symptoms, said Travel Health Pro.

The alert said: “If illness develops, it usually begins suddenly with a high fever, severe headache, muscle and joint pain, nausea, vomiting and a rash. Most infections are self-limiting, with a rapid recovery three to four days after the rash appears."

The World Health Organisation says approximately four billion people in 130 countries are at risk of dengue – a virus spread by mosquitoes found in tropical and subtropical regions worldwide, including parts of Europe. Travel Health Pro, a subdivision of the Foreign Office, has warned that dengue has ‘spread into regions previously thought to be dengue free’.

As of April 2024, over five million dengue cases and over 2,000 dengue-related deaths have been reported worldwide since the beginning of 2024. An increase in dengue cases has been flagged around the world, including in Asia, central and south America and across the Caribbean.

Travel Health Pro said dengue is not endemic in Europe. But if environmental conditions are favourable in parts of Europe where mosquitoes which can carry dengue live, then travel-related cases may cause the spread of dengue locally.

Are there treatments for dengue?

A small number of infected people can go on to develop a severe form of the illness – called severe dengue, although previously sometimes referred to as dengue haemorrhagic fever.

The symptoms of the severe illness include dangerously low blood pressure (shock), fluid build-up in the lungs and severe bleeding (haemorrhage). All four types of dengue virus infection can lead to either dengue or severe dengue, according to Travel Health Pro.

There is currently no specific drug treatment for severe dengue illness, but there are ‘supportive’ treatments for shock and bleeding, which improves survival. Without this help, severe dengue illness can kill.

Advice for travellers

  • Travel Health Pro said all travellers, including cruise passengers, who are visiting areas where dengue cases have been reported or where dengue is believed to be present, are at risk of infection

  • Refer to the 'other risks' section on Travel Health Pro's country information web pages to assess the dengue risk at your destination and for specific advice about other health risks

  • Check the Foreign, Commonwealth and Development Office (FCDO) country advice for safety and security information for your destination

  • Consult your GP, practice nurse, pharmacist or travel clinic to ensure all your recommended travel vaccines and UK routine vaccines, including MMR, are up-to-date

  • There is a live, attenuated (weakened) dengue vaccine called Qdenga licensed in the United Kingdom, but it is not suitable for all travellers

While you're abroad:

  • Minimise your risk of all insect-borne illnesses, including dengue, by wearing long-sleeved tops and long trousers and regularly applying insect repellent, according to Travel Health Pro

  • Adhere to insect and tick bite avoidance advice at all times

  • As dengue is transmitted by day-biting mosquitoes, take extra precautions during the day, especially around dawn and dusk

  • Remember that dengue poses a risk throughout the year in tropical countries

  • Insect repellent should be applied after sunscreen and reapplied regularly following any activities, including swimming

  • Insect repellents containing 50% DEET (N, N-diethyl-m-toluamide) are currently the most effective and can be used by pregnant or breastfeeding women, as well as children from two-months-old

  • If DEET is not suitable, alternative insect repellents containing Icaridin (Picaridin); Eucalyptus citriodora oil, hydrated, cyclized; or 3-ethlyaminopropionate can be used instead

  • When staying with friends or family, it's important to reduce mosquito breeding sites around the home by eliminating any stagnant water in plant pots, gutters, drains and rubbish

  • Insecticide treated bed and cot nets offer good protection against mosquito bites when sleeping during the day

Upon your return:

Travel Health Pro said if you experience symptoms such as high fever, severe headache or a rash within two weeks of returning from a country with a risk of dengue, seek urgent medical help. Remember to inform your GP or nurse about every country you visited.

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