Dengue in children: why early detection is crucial

Free Malaysia Today

3 days ago

Diagnosing dengue in children can be challenging as its symptoms often overlap with those of other viral infections. (File pic)
KUALA LUMPUR : Dengue remains a significant public health concern in Malaysia, with cases widespread across all regions. Among those most at risk are children, who are particularly vulnerable to severe dengue, which can cause bleeding.
Without prompt treatment, young patients can deteriorate rapidly and face life-threatening complications. Consultant paediatrician Dr Gan Chin Seng, however, points out that diagnosing dengue in children can be challenging as its symptoms often overlap with those of other viral infections.
'Common symptoms such as fever, headache and vomiting are not unique to dengue, making it difficult for healthcare providers to pinpoint the virus without a high level of suspicion,' he told Bernama.
He said dengue should always be considered if a child has a persistent fever with no clear cause, particularly in locations where cases have already been established.
'Blood tests are essential in confirming a diagnosis, with various tests available to detect the virus early. Still, the challenge with dengue in children is that it can progress rapidly.
'While the fever may subside, this can be misleading as it could signal the start of the dangerous plasma-leakage phase, which can cause a drop in blood pressure and inadequate blood supply to vital organs. This leads to shock and potentially multiorgan failure,' he cautioned.
Warning signs in children who may be at higher risk of severe dengue include abdominal pain, persistent vomiting, fluid accumulation in the lungs or abdomen, gum bleeding, lethargy, liver enlargement, and rapidly dropping platelet counts.
'They may present with shock, severe bleeding, or excessive fluid accumulation, causing breathing difficulty. By identifying these signs, it will help doctors with decision-making and treatment,' Gan said.
Areas with stagnant water serve as breeding grounds for the Aedes mosquito, which spreads the virus. (Pixabay pic)
He also noted that severe dengue can affect the brain, leading to encephalitis (when the brain becomes inflamed); the heart, leading to myocarditis (when the heart becomes inflamed); and the liver, leading to hepatitis (when the liver becomes inflamed and congested).
Gan pointed out that multiple factors contribute to the risk of severe dengue, which can be categorised into patient-related and environmental. 'Patient-related risk factors include obesity, being five years old and above, a previous history of dengue infection, and pre-existing health conditions.
'Environment plays a significant role in dengue transmission: areas with stagnant water serve as breeding grounds for the Aedes mosquito, which spreads the virus. Living in such areas or having neighbours with dengue cases heightens the risk. Community efforts are also crucial in eliminating mosquito breeding sites,' he added.
Early diagnosis and intervention, he stressed, are critical in managing severe dengue. 'Fluid management is key to preventing kidney damage and other complications. If a child cannot drink fluids due to vomiting, they need to be hospitalised for intravenous hydration.
'After the fever subsides, continuous close monitoring is essential, as this period can be deceptively calm before more serious complications arise.'
He noted that the appearance of a rash during the recovery phase is a positive sign, as it indicates the child is improving.
Parents are encouraged to ensure their children receive the dengue vaccine, which has been shown to reduce severity of the disease by up to 90%. (Freepik pic)
Finally, Gan emphasises that family and public education play a crucial role in preventing severe dengue. 'Recognising the symptoms early, understanding when to seek medical help, and ensuring proper fluid intake are key messages that need to be conveyed to the public.
'Moreover, the introduction of the dengue vaccine has been a significant step forward in prevention. The vaccine, which has been shown to reduce the severity of dengue by up to 90%, is available for children aged four and above.'
Despite the availability of the vaccine, uptake in Malaysia has been relatively slow compared with neighbouring countries such as Thailand and Vietnam.
'Public health campaigns are, therefore, necessary to encourage parents to vaccinate their children, as this provides a vital layer of protection against severe dengue,' he concluded.