Dengue Fever in Children: The Risks and How to Avoid Them
Dengue fever can infect anyone regardless of age. According to the World Health Organization, dengue fever can resemble a common cold and can affect babies, children, and even adults1. How is dengue fever different in children from adults? What is the risk of dengue fever in children? Let's find out more.
Recognise Dengue Fever Signs & Symptoms In Children
Keep an eye on your child when they have a high fever. Dengue fever in children may be accompanied by the following symptoms1:
- Fever that reaches up to 40°C
- Your child may complain of a severe headache
- Pain behind the eyes
- Children can also experience muscle and joint pain during dengue fever
- Nausea and vomiting may also present in children with dengue fever
- They can also get swollen glands and skin rashes
How To Diagnose Dengue Fever in Children?
As to how dengue is diagnosed in adults, the confirmation of dengue fever in children is done based on several factors. The main thing is from health history and presenting symptoms along with physical examination including vital signs2. If a child is suspected of having dengue fever based on the doctor's assessment, laboratory tests will be performed to confirm the diagnosis2.
Risk of Dengue In Children & The Associating Factors
The World Health Organization recorded an increase in dengue mortality from the year 2000 to 2015 which mostly affects younger individuals1.
In addition, children are also known to be at risk of febrile seizures during the febrile phase3, which is the first phase of dengue.
The Malaysian Ministry of Health's Clinical Practice Guide lists several signs associated with severe dengue fever2:
- Lethargy
- Stomachache
- Bleeding
- Enlargement of the liver (hepatomegaly)
The guideline also lists other predictors for dengue severity in children which are2:
- Female
- Age less than 5 years
- Obesity
- Secondary infection by dengue virus
Dengue shock syndrome is one of the causes of death for dengue patients. Dengue shock syndrome (DSS) is associated with evidence of circulatory failure manifested by rapid, weak pulse and narrow pulse pressure or low blood pressure, restlessness, and cold, clammy skin3. A study was conducted in India to identify the risk factors for dengue with shock in children. The risk factors that were identified in the study includes4:
- Children under 6 years old
- Have symptoms of liver enlargement
- The presence of abdominal pain
- Has reduced urine output
These symptoms need to be carefully monitored in children with dengue fever to avoid serious complications
How to Treat Dengue In Children & The Challenges
Children with dengue fever can be treated at home or may require hospital treatment and monitoring, depending on the severity of their condition.
There is only supportive treatment for dengue such as pain management and fever reduction with painkillers like paracetamol, fluid replacements orally or IV fluids therapy and blood transfusion if necessary2,5,6.
Fluid intake is one of the most important aspects that need to be monitored seriously in dengue patients, especially children to avoid dehydration7. Dehydration may easily occur in dengue due to certain symptoms such as vomiting and fever7.
Look out for these signs of dehydration in children7:
Signs of mild dehydration
- Lack of urination (less than 6 diapers a day)
- Dry mouth, lips, and tongue
- No tears when crying
- A sunken soft spot in the head
Signs of severe dehydration in children
- Sleepy, no energy, irritable
- Sunken eyes
- Hands and feet are cold and pale
- Very little urination (only 1-2 times a day)
Caring for children with dengue can be more challenging as it may be harder to convince them to eat and drink well when they are not well. This can make it difficult for parents or caregivers to ensure that they are getting enough fluid and food to regain their energy and recover.
Therefore, our Ministry of Health has created a guideline for dengue management in children which states that children with dengue who are treated at home (as outpatients) are required to undergo monitoring at the clinic every day until the end of the critical phase2. They will also be provided with monitoring cards and home care guides2.
How To Protect Your Children From Dengue?
Prevention is always better than cure. Protecting your child from the Aedes mosquitois very important to protect them from dengue. Here are things that you can do and practice at home8,9:
Make sure your home is not a mosquito breeding ground :
- Ensure your drain and gutter run smoothly. Make sure there is no stagnant water
- Dispose of water reservoirs such as basins, flowerpots, old tires, and others
- Dispose of your garbage properly as something small like plastics can also hold water and become a breeding container for mosquitoes
Protect your child when they play outside
- Dress your child in long-sleeved, brightly coloured clothing
- Use safe insect-repellent spray
- Avoid children from playing outside when the Aedes mosquito is active, which is at dawn and dusk
- Fix mosquito net to your child's bed when they sleep
- Use a mosquito net on a baby stroller when strolling outdoors
If your children are showing signs of dengue fever, speak to a doctor as soon as possible.
References
World Health Organization. Dengue and severe dengue | https://tinyurl.com/mr4a9tah | Accessed on September 29, 2022
Kementerian Kesihatan Malaysia. (2020). Clinical Practice Guidelines - Managament of Dengue In Children (Second Edition) | https://tinyurl.com/2jjrdu8d | Accessed on September 29, 2022
U.S. Department of Health and Human Services Centers for Disease Control And Prevention. Dengue and Dengue Hemorrhagic Fever. Information for Health Care Practitioners | https://tinyurl.com/w9uar2x3 | Accessed on September 29, 2022
Pothapregada, S., Kamalakannan, B., & Thulasingham, M. (2015, November). Risk factors for shock in children with Dengue fever. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine | https://tinyurl.com/26fudpnz | Accessed on September 29, 2022
MIMs. Dengue - Supportive Therapy. MIMS Malaysia | https://tinyurl.com/umhvnvcw | September 29, 2022
MIMs. Dengue - Treatment . MIMs Malaysia | https://tinyurl.com/7ta75jrj | September 29, 2022
Centers for Disease Control and Prevention. (2019, October 31).Caring for a child or family member sick with Dengue | https://tinyurl.com/yckpuk52 | September 29, 2022
Demam Denggi. InfoSihat | https://tinyurl.com/yjt9h78a | September 29, 2022
Kaur, J. (2021, September 29). Demam Denggi. PORTAL MyHEALTH | https://tinyurl.com/3jtzvs35 | September 29, 2022
This article is brought to you by Takeda Malaysia Sdn. Bhd. 200901025887 (868989-K)
Disclaimer: This information is available to the public for information purposes only; it should not be used for diagnosing or treating a health problem or disease. It is not intended to substitute consultation with a healthcare provider. Please consult your healthcare provider for advice
C-ANPROM/MY/DENV/0097 NOV 2022
Written By Sofia Farudz, MBBS Bch BAO, National University of Ireland, Galway on
Reviewed By DoctorOnCall Panel Doctor
