Dengue fever
Dengue Fever- Time To Tackle & Take Over!

Previously a threat between the months of June and November, Dengue fever is now seen almost throughout the year. It is a viral infection transmitted by the bite of a mosquito (Aedesegypti-a day biter). There are 3 phases to the illness – a fever phase, a leaky (critical) phase and a recovery phase.

Fever phase: The fever in Dengue generally follows a biphasic pattern, 3-4 days of high fever, then a fever-free period for 2-3 days, then fever again. Fever is generally accompanied by headache, pain behind the eyes, body ache, joint pain, general tiredness, pain in the abdomen, vomiting and rarely a rash and loose stools. The period to watch out for is when the fever subsides-called the critical or leaky phase.

Leaky phase: Not all children go through the severe form of this phase. During this phase, the blood vessels throughout the body become leaky, allowing the fluid component of the blood to leak out. This makes the blood thick and viscous, resulting in poor forward flow to the vital organs.

Warning symptoms towatch out for during this phase are 
  • Severe pain in the abdomen
  • Persistent vomiting
  • Cold hands and feet
  • Excessive sleepiness or restlessness
  • Decreased urine output
  • Bleeding manifestations-either nose bleed or blood in vomit/stools (rare though!)
If any of the warning symptoms are present it is imperative that you visit your Paediatrician/closest hospital with facilities for Paediatric care.

Hospitalisation may very well be necessary during this phase. The last phase of the illness is the recovery phase. If your child had a rash, it may appear ruddier and itching of palms and soles may occur during this phase. Appetite improves and there is a general feeling of well being.

When do I suspect that my child may have Dengue and what should I do?

If during the peak season (June to November), your child has fever lasting for more than 3 days without cold/cough/other localizing symptoms, do visit your Paediatrician to allay your fears. A simple blood test (in addition to examination of your child) may tell you if she has Dengue.

Note-The platelet count will fall in dengue fever and is not a reason to panic. The rise in Haemoglobin indicates how leaky your child is and how thick his/her blood is.

>Do’s and Don’t’s at home (after you have seen your Paediatrician):

  • Fortunately not all children go through the severe form, where symptoms due to excessive leakage of fluid are present.
  • Bring the temperature down with tepid sponging and paracetamol.
  • Avoid use of Mefenamicacid (meftal), aspirin and ibuprofen (ibugesic) as much as possible as these drugs interfere with platelet functioning.
  • Encourage the intake of plenty of liquids-(milk, fresh juice, tender coconut water, kanji). The ability to tolerate oral feeds in a child with dengue is a good sign!
  • Avoid commercial soft drinks during this phase.
  • Make sure she is passing adequate urine.
  • Keep in touch with your Paediatrician as and when necessary
  • If any of the warning symptoms (mentioned above) are present, do not delay in visiting the closest hospital.
Prevention
  • Easier said than done-Keep mosquitoes away by using nets, repellents, etc.
  • Eliminate mosquito breeding sites such as stagnant water bodies near the house and school.

Note: If symptoms are recognized early and managed appropriately, Dengue is just another viral illness! Dengue can recur in a child who has had the infection in the past.

Dr. Gnanam R

PediatricIntensivist and ER Consultant

Manipal Hospitals.

Disclaimer: The views expressed in this article are of the writer and not of the hospital.

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