Dengue in children

  • By Team TDO

What is dengue?

Dengue infection is a viral infection caused by dengue viruses and is transmitted in humans by the bite of Aedes aegypti, a daytime biting mosquito. Due to ample construction work and collection of stagnant water in these sites, these mosquitoes breed in urban areas, mainly in tropical regions.

Dengue outbreaks in urban areas may be explosive, involving about 70-80% of the population.

How does dengue fever manifest in humans?

  1. Dengue fever (DF): A mild disease with fever in two phases, muscle and joint pain, rash, low blood counts and enlarged lymph nodes.
  2. Dengue hemorrhagic fever (DHF): It is a severe, potentially fatal, febrile disease characterised by abnormalities in clotting of blood (low platelet count).
  3. Dengue shock syndrome (DSS): It is a severe fatal complication of dengue hemorrhagic fever, with collapse of blood pressure and shock, in addition.

What are the symptoms?

  1. Wait (incubation) period of 4-7 days (range 3-14 days)
  2. Sudden onset fever
  3. Headache
  4. Eye pain
  5. Fatigue with severe muscle, bone, joint pain (“break-bone fever”)
  6. Rash (50%)
  7. Flushed face
  8. Lymph nodes
  9. Conjunctivitis - redness of the eyes

What to look for in the laboratory?

  1. CBC: It shows low WBC and platelet count (<1 lacs/
  2. PCV: It is increased
  3. Low sodium
  4. Mild to moderate increase in SGOT/SGPT

Are there any specific tests to diagnose dengue?

  1. Dengue NS1: It detects dengue antigen. This test is effective in the first five days of illness. Then, it becomes negative.
  2. Dengue IgM: It is usually positive after 3-5 days and usually stays positive for 1-2 months.
  3. Dengue IgG: It detects past infection with dengue.

How do we treat dengue fever?

The bad news is, there is no specific therapy for dengue. So, prevention is better than cure.

Upon finding any of above symptoms, one needs to take complete bed rest with lots of oral fluids.

Paracetamol can be given for fever and body pain. However, aspirin/ibuprofen etc. should not be taken as it can cause bleeding problems.

If platelet counts are less than 1 lacs/cu mm, child should be admitted for IV fluids and monitoring.

Intramuscular injections are contra-indicated.

If the child suffers from DHF or DSS, he/she needs to be hospitalised in a tertiary care centre, with a good intensive care backup.

Always take medicines upon your doctor’s advice. Do not self-medicate.

How can we prevent dengue?

One can prevent dengue by preventing breeding of mosquitoes and taking personal care measures to prevent mosquito bites e.g. mosquito repellent coils, creams, mosquito nets etc.