Understanding & Caring for Dengue Fever in Children
1.What is Dengue Fever?
Dengue is a mosquito-borne viral disease that has rapidly spread in Sri Lanka. Dengue virus is transmitted by female mosquitoes mainly of the species of Aedes. Once the mosquito is infected, it remains infected for its life span. There are distinct, but closely related, four types of viruses that cause dengue. Recovery from infection by one provides lifelong immunity against that particular type. However, subsequent infections by other types increase the risk of developing severe dengue. Symptoms appear 4-10days after infected mosquito bite. It is not transmitted by direct spread from one person to another.
2. What are the symptoms and signs of Dengue fever?
Headache and pain behind the eye
Nausea and vomiting
Muscle and joint aches
Rash- different types of rash (usually diffuse, red patches), may be itchy and appears a few days after the onset of fever.
Bleeding tendency – from nose , gums and bruises
Sometime, Dengue infection can present in the more serious form, known as Dengue haemorragic Fever(DHF) or Dengue Shock Syndrome (DSS), whereby serious complications can occur, resulting in:
Low Blood Pressure/shock due to bleeding or leaking blood vessels
Organ( liver, Kidney) failure
The risk of dying from dengue complications is very low. It is less than 1%, if supportive treatment given early.
3. How can a child be managed at home?
Rest in bed and reduce activities
Fluid replacement -
children about 1 year old or >10kg – at least one liter a day
Children >40kg- at least two liters a day
Make sure child passes enough urine for a day
Give fluid with salt and sugar (Oral rehydration fluid, king coconut
water, soup, Kanji, fruit juices, porridge)
Paracetamol 15mg/kg 6hrly can be given to relieve pain and to control fever.
Tepid sponging can be done to control fever.
Don’t give any other drug to control fever.
Medication may be given for nausea and vomiting
May need a blood test (Full Blood Count)daily to assess the progress of the disease
Get the Dengue Antigen test done on fever Day 1or 2
4. When does a child need to get admitted to the hospital?
Day 3 fever
If platelet count dropping below 150000
Abdominal pain/ vomiting
Any evidence of bleeding
Unwell (lethargy, drowsy/breathing difficulty)
5. What do you do in the hospital?
Blood tests are done daily to assess the platelet level and blood concentration(PCV/HCT)
Vital signs ( pulse rate, Blood pressure, urine amount) are monitored to detect any complications of Dengue fever
Intravenous Fluid drip (iv saline) may be needed
Platelet or blood transfusion may be given if the spontaneous bleeding or if the platelet count is critically low
6. When is it safe for a child to go home?
No fever for preferably for 48hrs without any paracetamol
Good general condition with improving appetite
Blood concentration(PCV/HCT) is normal
When platelet count which is definitely rising and has risen above 50,000
When start passing more urine
No other complications
7. How are the chances being reduced of getting infected by Dengue fever?
Change water in vases/bowls (including pet water containers) on alternate days
Remove water from flowerpot plates on alternate days
Dispose properly all possible containers where water can collect
Clean gullies and drainages regularly
Maintain the garden properly to prevent mosquitos accessing egg laying habitats
Using of personal household protection such as window screens, long-sleeved clothes, insecticide treated materials, coils and vaporizers
Improve community participation and mobilization for sustained mosquito control
8. What is Dengue Immunization?
No dengue vaccine is available in the Sri Lankan market yet. First Dengue vaccine, Dengvaxia(CYD-TDV) by Sanofi Pastteur, was registered in several countries for use in individuals 9-45 years of age living in endemic areas. This is not registered in Sri Lanka. Sri Lanka is one of the locations for the upcoming Phase iii Takeda dengue vaccine clinical trial.