Dengue Fever in Children: Risk factors, Treatments and Vaccines
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Dengue (pronounced DENgee) is a debilitating viral disease caused by mosquitoes. It is a rapidly growing mosquito-borne illness caused by any of the four types of closely related dengue viruses.

Countries with maximum dengue cases 

Until 1970 severe dengue epidemics occurred in only 9 countries. At present, there are more than 100 countries which are now affected by this disease. South America, Africa, Western Pacific and South-East Asia are the regions most seriously affected by this disease. Asia alone constitutes approx 70% of the epidemics of this disease.

Dengue Pamphlet Global Map

Image source: www.cdc.gov

In the map

  • “Frequent or continuous” means that these regions have frequent outbreaks.
  • “Sporadic or uncertain” means that dengue risk is unpredictable as the data is not available at country-level.
  •  “No evidence of risk” means that there are no cases of dengue outbreak in these countries.

What are the causes of Dengue in children? 

Dengue fever in children is spread by a specific type of mosquito named “Aedes Aegypti”. This mosquito when bites an already infected person, becoming the carrier of viruses namely DENV-1, DENV-2, DEN-3 and DENV-4.

When the infected mosquito bites your healthy kid, it transmits one of the four viruses mentioned above into the bloodstream of your child and makes him a carrier of the virus and potentially suffer from symptoms such as a high fever..

How common is Dengue fever in children?

Dengue fever is widespread among the people living in tropical and subtropical regions, comprising approximately 120 countries. Around 3 billion people live in areas with a high risk of getting the disease. On average, about 100- 400 million people get affected by dengue every year with a fatality of twenty-two thousand annually.

It is complicated to know how common dengue fever in children is, as most of the kids are asymptomatic,thus cases go unnoticed. However, 1 in 5 cases of dengue is found in babies. 

Dengue is rarely seen in newborns, but some cases are detected wherein it gets passed to the infant when the expecting mother is very ill with the disease. 

Clinical presentation of Dengue in children

The clinical presentation of dengue fever mostly depends upon the age of the children. Toddlers and infants could have identical febrile dengue.Older children could have mild febrile syndrome with a high fever. So, let’s see the clinical features in the below-mentioned points:

  • 1 out of 4 children do not show any symptoms of dengue virus.
  • Majority of children affected by dengue show signs which are non-specific, mild to moderate and acute.
  • Approximately 1 in 20 patients develops severe or life-threatening dengue fever symptoms.
  •  In severe dengue illness, recognizing the signs and instantly initiating supportive therapy, drastically reduces the risk of death to less than 0.5%.

How long does dengue fever last in children?

Most children suffering from this disease don’t show any signs. However, after being bitten by an infected “Aedes” mosquito, other kids may show mild symptoms which lasts from 4 to 10 days.

Once infected by the virus, the child becomes immune to that particular virus, but he may get infected by other types of dengue virus in the future. 

The fever may lead to “Dengue Hemorrhagic Fever” (DHF), a life-threatening condition. This distinct fever needs medical attention and needs to be treated immediately. 

Stages of dengue fever in children

Dengue has 3 typical stages: 

Stage 1 – Acute fever stage or Febrile stage (1 to 5 days)

In this stage, a child suffers from high fever with nausea, vomiting, abdominal and body pain. Lots of fluids should be given to the child to prevent Diarrhoea in this stage. Antipyretic medicine named “Paracetamol” should also be given to lower down the fever and body pain. 

Stage 2 – Critical stage (5 to 7 days)

In this stage, the child’s body temperature lowers down, causing plasma leakage and low blood pressure. He may feel weak, restless and have a faster pulse rate. In rare cases, the child may have “Dengue shock syndrome” which could be life-threatening. Intravenous therapy should be given to the children at this stage.

Stage 3 – Convalescent or recovery stage (7 to 10 days)

At stage 3, the child gets rashes as a recovery sign. Apart from rashes, the patient regains an appetite, has an average pulse rate and passes more water.

How can parents recognize Dengue in children?  

Most children down with dengue fever do not show any symptoms. However, if a child suffers from the sudden onset of fever, muscle and joint pain and severe headache, he may have dengue.

Apart from these common indications, he may also have gastritis with stomach pain, vomiting, nausea or diarrhoea. 

After 4 to 8 days of fever, a child can undergo an acute symptom called “dengue shock syndrome”. This syndrome affects the children under the age of 10 and can lead to sudden collapse, weak pulse rate and blueness around the mouth. Immediate medical attention is required in this condition.

Symptoms of Dengue in children and toddlers 

Due to unbearable pain, dengue fever is also known as “Breakbone fever”. When the virus enters the bloodstream of a child, it takes 4 to 6 days to see the symptoms, which are:

  • Very High fever of around 105 F
  • Severe headache
  • Pain in the joints, bones, muscles and behind the eyes.
  • Bruising easily.
  • Bleeding from gums or nose.
  • Nausea
  • Rapid breathing and fatigue 

Symptoms of Dengue in babies 

As infants or babies can’t speak, it can be harder to recognize sengue symptoms in them because they are very similar to other common infections. Visit an emergency care clinic if your baby has a high or low temperature, including the following symptoms:

  1. Irritability, sleepiness and lack of energy.
  2. Rashes
  3. Unusual bleeding from nose and gums
  4. Vomiting 3 times or more in a day.

Dengue vaccine development status

Sanofi Pasteur developed the world’s first dengue vaccine under the brand name “Dengvaxia” (CYD-TDV) in December 2015. This is the only available vaccine which is approved by WHO and is given in 3 doses at the interval of 0, 6 and 12 months. It is registered for the people falling in the age bracket of 9 up to 45 years. 

The vaccine is approved for people who have previously been affected by this disease. If this vaccine is given to a healthy person, it increases the risk of severe dengue in them.

Apart from Dengvaxia, other five vaccines  like Takeda, named TAK-003, TV-003/005, TDENV PIV, V180 and DNA vaccine are under clinical trials at different phases.  

In which countries is Dengvaxia available? 

In the current scenario, 19 countries and few parts got the license to use the Dengvaxia vaccine. However, at present, it is approved and available in 11 countries.

Treatment of Dengue for children

There is no particular way to treat dengue fever in children; however, if your child has mild to moderate dengue symptoms then you can…

  • Give lots of fluids like water, milk, glucose and juices to prevent dehydration. Also, try to get your baby plenty of bed rest.
  •  If your kid has painful muscle or joint pain along with a high fever, then give “Paracetamol” painkillers. Kindly do not use pain relievers which contain Ibuprofen or Aspirin as they may have severe side effects.
  • One can also go for natural home remedies for increasing your child’s platelet counts and immunity by giving him Papaya leaf, guava and “Giloy” juice.

If your kid has severe dengue symptoms, immediately take him to the emergency or urgent care clinic. Doctors usually treat your child by delivering Electrolytes salts and Intravenous fluids for prevention of severe Diarrhea. 

If the symptoms become worse, then doctors may perform “Transfusion” therapy for replacing lost blood.

How can you prevent your child from getting Dengue? 

Since there is no vaccination for dengue fever in children, parents should take proper precautions if they live in or plan to visit the areas where there is a high risk of dengue. 

The only way to protect your children from dengue is to help them stay away from the bite of infected “Aedes” mosquito, which can be done by taking the following precautions:

  1. Always use the screen on windows and doors and instantly repair them if they are broken. Suppose they are remaining unrepaired try to keep them shut.
  2. When going outdoors, cover your children with pants, full sleeves, shirts, shoes and socks. Also, use a mosquito net over their beds during the night.
  3. Use natural mosquito repellent containing lemon eucalyptus oil or DEET.
  4. Try not to send your kids outside during dusk and dawn as mosquitoes are very active at these times.
  5. Do not keep water stagnated in containers and discard tyres long as mosquitoes lay eggs and breed on it. Also frequently change the water in flower vases, birdbaths and dog bowls.

Also, read our comprehensive article on “How to prevent dengue?

Conclusion 

Most children are asymptomatic or show fewer symptoms during dengue. Also, this fever can be confused with that of Typhoid fever and malaria. Prevention is a better option. By being extra cautious and opting for a good lifestyle, you can protect your kid from dengue fever.

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