Dengue Fever in Children – Symptoms, Treatment and Prevention

More than 500 million people worldwide are affected by mosquito-borne diseases, which result in approximately 2.7 million deaths each year. Among the most dangerous and widespread illnesses transmitted by mosquitoes are malaria, Zika virus, chikungunya, yellow fever, and dengue fever. Dengue fever, in particular, is a major public health concern in tropical and subtropical regions. Fortunately, while dengue can be severe, it is often treatable with proper medical care and has a relatively low mortality rate when detected early. However, dengue fever in children tends to spike during peak transmission seasons, making it crucial for parents to recognize dengue symptoms in kids and seek prompt treatment. This article provides essential information to help you understand dengue fever, its symptoms, treatment, and prevention methods to keep your family safe.

What Is Dengue?

Dengue fever is carried by the female Aedes mosquito. This mosquito species can be identified by a striking striped pattern on its abdomen, giving them the name tiger mosquitoes. Usually found in warm, tropical and humid climates, these mosquitoes thrive in the presence of stagnant water (1). This makes dengue far more prevalent at the peak of the monsoons. Interestingly, the Aedes mosquito attacks during the day, unlike other disease-carrying mosquitoes. These mosquitoes usually bite in the early morning and the evening right before and after sunset, according to WHO (2).

It is important to note that the mosquito is simply a carrier, known as the disease vector. The cause of dengue in children as well as adults is not the mosquito itself but rather a viral pathogen known as the dengue virus. There are five strains of dengue viruses, any of which can cause the disease. However, dengue caused by one of the strains will grant total immunity to the disease caused by that particular strain but only partial resistance to the other viruses.

How Does It Spread?

The disease spreads when an infected mosquito bites an individual, transferring the dengue virus into the bloodstream. The virus then attaches itself to the white blood cells, slowly penetrating them as they are carried throughout the body. After replicating inside the white blood cells, they emerge and infect other organs such as the liver, bone marrow, skin, and so on. The disease usually passes in two to ten days as the body sets off an immune response that kills all the viruses. However, in around five per cent of all cases, a more dangerous version of dengue fever can arise, known as Dengue Haemorrhagic Fever. This case has far more complications and requires immediate treatment.

While dengue is not usually present in newborns, mothers with the disease are liable to pass the infection during labour. The virus can also be transmitted through blood transfusion and organ transplants but cannot spread from one person to another (3).

The prevalence of dengue is tricky to calculate, as most cases of the disease are unreported. According to WHO, around three million dengue people are infected with dengue every year, but the actual number might be more than 400 million.

How Long Does It Last?

Dengue fever in kids typically lasts 7 to 10 days, with symptoms like high fever, headache, body aches, and fatigue appearing 4–7 days after a mosquito bite. In mild cases, children recover within a week, but severe dengue (dengue hemorrhagic fever or dengue shock syndrome) may prolong illness and require hospitalization.

Types of Dengue in Kids

Dengue in kids can classified into four categories, including:

1. Dengue Fever

This type is one of the most commonly observed types of dengue fever. The signs and symptoms are detailed in this article. Do not ignore the warning signs of dengue fever in a child.

2. Dengue Fever With Warning Signs

This type of dengue fever accompanies warning symptoms, including severe abdominal pain, bleeding, and persistent vomiting.

3. Dengue Shock Syndrome

This is one of the most dangerous type of dengue fever where the blood pressure drops critically low, leading the individual into shock (4).

4. Dengue Hemorrhagic Fever

If not given prompt treatment, this type of dengue fever can cause shock, bleeding, and even death. It usually occurs in children below 15 years (5).

Stages of Dengue Fever in Kids

Dengue fever progresses through distinct stages in children, each with varying symptoms and risks. Recognizing these phases helps parents provide timely care and prevent complications. Below are the three key stages of dengue fever in kids.

1. Febrile Phase (Days 1-3)

The illness begins with a sudden high fever (104°F or higher), accompanied by headaches, muscle pain, joint pain, and flushed skin. Some children may also experience nausea, vomiting, or a mild rash. Proper hydration and fever management are crucial during this stage.

2. Critical Phase (Days 4-7)

The fever may drop, but this is the most dangerous stage due to the risk of plasma leakage, leading to severe dengue (hemorrhagic fever or shock syndrome). Warning signs include severe abdominal pain, persistent vomiting, bleeding gums, rapid breathing, and fatigue. Immediate medical intervention is essential to prevent life-threatening complications.

3. Recovery Phase (Days 7-10+)

If managed properly, kids gradually recover as their platelet count rises and symptoms improve. Weakness, fatigue, and a lingering rash may persist, but energy levels slowly return to normal. Continued hydration and a nutritious diet support full recovery.

Causes of Dengue in Children

Dengue fever in children is caused by the dengue virus, which is transferred to humans when the infected Aedes mosquitoes bite human flesh. Aedes aegypti and Aedes albopictus are the most common vectors known to spread the dengue virus (6).

Dengue Symptoms in Children

Dengue fever is usually asymptomatic in nearly eighty per cent of all cases, even babies and small children. However, the younger the child is, the more severe the symptoms are, which usually materialise around four days after the infection. Here is a list of dengue symptoms in babies that you should keep an eye out for (7):

1. Flu-Like Illness

In most cases, dengue fever in infants begins with the symptoms associated with viral influenzas, such as high-temperature fever, runny nose, cough, and fatigue.

2. Change in Behaviour

Your child might exhibit more agitation and irritability than usual, even without an apparent reason. He is also likely to cry often and throw tantrums. His appetite will drop, and his sleeping pattern will change drastically. This is because of the fever and flu-like symptoms that your child is experiencing.

3. Physical Discomfort

Affected children might experience muscle and joint aches, dull throbbing pain behind their eyes, back pain, splitting headaches, and so on. The pain feels like the bones are being broken. Dengue, therefore, is also known as “Breakbone Fever”.

4. Gastrointestinal Problems

Your child might complain of shooting pains in the abdomen along with nausea, vomiting, and diarrhoea, which can be mistaken for symptoms of gastroenteritis. Vomiting is an early sign that the child may develop complications; hence he needs to be closely monitored.

5. Skin Problems

A common symptom of dengue is an itchy skin rash that appears in patches. It has been described as a measles-like rash that resembles white islands in the sea of crimson. Another symptom to look out for is a constant itch that appears on the soles of the feet. However, the rash is transient and may disappear even before you see it.

6. Bleeding

Children experience bleeding from their gums or noses due to a drop in the platelet count. The virus slows down the clotting rate of blood, resulting in bleeding. At times, bleeding can also occur in the gastrointestinal tract. However, this happens in complicated cases only and is not experienced by everyone suffering from dengue.

As mentioned above, in rare cases, dengue can turn into far more dangerous conditions, such as Dengue Haemorrhagic Fever and Dengue Shock Syndrome. The symptoms associated with these diseases are listed below.

• Abrupt and excess blood loss due to tears in the blood vessels.
• A rapid shock that occurs due to the bleeding.
• A drastic fall in blood pressure.
• Possible organ failure leading to coma.

If you have observed your child showing some or all of these symptoms, you must take him to a medical practitioner immediately. However, if you can’t consult a doctor, the next sub-head should help you out.

Things to Do If Your Child Shows Symptoms of Dengue

There are several things to keep in mind if you observe any of the symptoms given below. Here’s what you must do.

• Put your child to bed, so that he doesn’t get exhausted, and gets the rest that he needs. He might need to be on bed rest for a certain period of time, depending on the severity of their symptoms.
• Give him whatever he likes to eat. Give more liquids than usual and check his urine. Urine should be light and clear.

• If your child is still being breastfed, make sure you do not skip his feeds. Breast milk is nutritious and provides enough fluids to the baby. For older kids, you’ll need to ensure they drink enough water. Oral Rehydration Therapy (ORT) is also recommended to help balance the electrolytes. If you aren’t sure about feeding your little one ORT, you may check with a paediatrician. Oral rehydration salts, which are available at most pharmacies, can be mixed in filtered/boiled water to make the solution. You may feed it to your child all through the day to hydrate him. Other natural ways to rehydrate include tender coconut water and citrus fruit juices. All liquids help in improving the condition.
• In case the baby has a high fever, in addition to paracetamol, soak a cloth in cold water and place it on his head. This will help reduce his body temperature.
• Avoid medicating your child with over-the-counter painkillers like ibuprofen or similar drugs that work to reduce swelling. This is because these medications can lower the platelet count further and can potentially lead to more blood loss.

When you do consult a medical practitioner, your baby will be checked thoroughly for signs to confirm dengue. Here’s how the diagnosis will be made.

Diagnosis of Dengue in Children

As mentioned earlier, if you think your child is exhibiting any of the signs or symptoms as described above, consult a paediatrician as soon as possible. This is especially important if your child shows signs of fatigue, fever, joint pain, and rash. The doctor will conduct a physical examination and blood tests to identify the symptoms. They might ask for your child’s medical history and details about their vaccinations. Further, the paediatrician will ask about the places you have visited with your child. This is because several regions in the country and the world are known to be hotbeds for dengue. If your child has travelled in these regions, the paediatrician will be able to evaluate the situation better. Post this, your baby’s blood sample will be sent to a diagnostic lab to test for the presence of the dengue virus (8).

If dengue is confirmed, the doctor will be able to begin a treatment protocol, which we shall talk about in the next section.

Treatment of Dengue Fever in Children

When it comes to dengue treatment in kids, currently, there is no medication for dengue fever; however, dengue has a very low mortality rate and tends to resolve in a few days to a month by giving symptomatic treatment (9) (10). Only in complicated cases is the mortality rate high. However, there are ways you can reduce the discomfort caused by dengue and speed up your baby’s recovery from the illness.

• Make sure your child drinks enough water and fluids along with healthy meals. He must sleep well, too, as it is important for his recovery. So, try to keep him on a sleep schedule, and ensure he doesn’t get worn out. A healthy diet and rest will help strengthen his immune system and destroy the virus.
• If the muscle and joint aches get unbearable, they can cause unnecessary distress to your child. Ask the paediatrician to prescribe analgesic medications like acetaminophen, which, unlike ibuprofen, do not bring about a drop in the blood platelet count.
• If your child’s symptoms do not improve even after getting enough rest, the paediatrician needs to be notified. There is a chance that it could be Dengue Haemorrhagic Fever. In that case, your child might have to be admitted to a hospital for intravenous (IV) therapy to provide fluids and salts lost due to vomiting and diarrhoea.
• The paediatrician may prescribe oxygen therapy, too, and continue monitoring your baby’s blood pressure frequently.
• If the symptoms of dengue do not resolve even after hospital treatment, the paediatrician might recommend a series of blood transfusions, which will compensate for the blood lost during the disease.

While most children recover when they are diagnosed with dengue, there are some cases wherein the child may suffer from complications, mainly due to dengue hemorrhagic fever.

Complications Due to Dengue Hemorrhagic Fever

Dengue, if not managed well in time, could lead to a severe condition called Dengue Hemorrhagic Fever, which further could lead to health complications such as:

• Blood clots
• Seizures
• Damage to the heart, liver, lungs and brain
• Shock due to excess blood loss
• Death

Clearly, dengue can create quite a havoc, especially when it affects a baby. But there are ways you could prevent your little one from contracting the disease. Read on to know more.

Ways to Prevent Dengue Fever

Prevention is better than cure in the case of dengue fever. There are several ways you can avoid getting your baby bitten by mosquitoes that could carry the dengue virus. Here are a few ways to protect both yourself and your family from this illness:

• Mosquitoes prefer stagnant water so get rid of any still water lying around your house or locality. Join forces with your neighbours if necessary as this is a public hygiene matter. This will help avoid other mosquito-borne illnesses as well.
• Remove any objects that could hold water, such as mugs, buckets, basins, pots, etc. This includes draining sinks and bathtubs. Ensure you remove all the water and wipe them dry.
• For standing water that cannot be removed, such as drains, fountains and ponds, you can add small amounts of kerosene to the water to prevent mosquitoes from laying eggs in it. Kerosene is toxic for mosquitoes. It floats over water and prevents oxygen from entering the water, thus killing hatched larvae, if any, in the water.
• Pest control professionals could fumigate your house and neighbourhood. Take care that you and your family are not around when this is being done, as the fumes could be harmful. For a natural alternative, burning coconut husks and shells or neem leaves has been known to drive mosquitoes away.
• Have your child wear clothing that covers his body entirely for personal safety. This includes long-sleeved shirts, pants, socks and even gloves if the weather permits.
• Ensure your family performs basic hygiene practices such as showering, as body odour is believed to attract mosquitoes.
• Use mosquito nets while sleeping, even during the day. They are a safe alternative to mosquito sprays and vaporisers, which may affect your child’s breathing and even cause problems with the functioning of his nervous system.
• Mosquito-repellent creams are a good choice if protective clothing and nets are unavailable. Ensure they are safe for children before applying them on exposed skin.
• You can also install screen meshes on your window and door frames to keep the mosquitoes out. Buy good quality ones that are less likely to rip as mosquitoes can enter through the smallest openings. Remember to fix any tears in the mesh as soon as possible.
• Reduce his outdoor time during the rainy season; instead, introduce him to fun indoor activities like board games, video games and so on. If he does go out to play, teach him to avoid areas with bushy foliage and stagnant water.

When to See a Doctor

Dengue can progress quickly in children, making early medical care crucial. Watch for these warning signs and seek immediate help if they appear.

• High fever (104°F/40°C or above) lasting more than 24–48 hours
• Severe stomach pain or persistent vomiting
• Bleeding (nosebleeds, bleeding gums, or blood in vomit/stool)
• Cold, clammy skin or extreme fatigue/irritability
• Difficulty breathing or rapid pulse
• Refusal to eat/drink or signs of dehydration (dry mouth, no tears, reduced urine)
• Drowsiness, confusion, or seizures (indicates severe dengue)

FAQs

1. What is the most common way of diagnosing dengue in children?

The most common and typical way to detect the incidence of dengue in children is through blood tests, which look for either the virus or the antibodies produced in response to the virus.

2. How do you differentiate between dengue and similar other illnesses?

Dengue can be distinguished from other illnesses by specific symptoms such as severe headache, eye pain, and joint pain, especially if the person has been exposed to mosquito bites in areas where dengue is common.

3. Are dengue vaccines safe for children?

There are vaccines available for dengue. However, the availability and the jurisdiction vary with the country and the requirements of the healthcare providers. It is best to consult your doctor for personal guidance on the requirements of the dengue vaccine.

4. Can dengue in children be treated at home?

Home remedies can be undertaken to mitigate and soothe the effects of dengue in children. However, it is best to consult a doctor for proper and timely treatment.

5. Are rashes severe in dengue?

Dengue rashes in kids are one of the common symptoms that come with the infection and go away with the help of treatment.

Dengue is common in tropical zones where the climate allows mosquitoes to thrive. The epidemic is also more likely to spread in third-world countries where public sanitation is given little or no importance. Therefore, it is imperative that you take the required precautions to prevent your child from contracting the disease, especially due to the lack of a cure. Interestingly, there is a vaccine available for dengue fever in some Southeast Asian and Latin American countries, but it remains only partially effective. Research to develop a vaccine for all five types of dengue viruses is still ongoing.

References/Resources:

1. Mayo Clinic – Dengue fever

2. WHO – Dengue: How to keep children safe

3. KidsHealth – Dengue Fever In Children

4. ScienceDirect – Dengue Shock Syndrome

5. National Library of Medicine – Dengue and dengue hemorrhagic fever

6. CDC – Dengue

7. Health New Zealand Te Whatu Ora – Dengue

8. Nemours Kids Health – Dengue Fever

9. WHO – Dengue and severe dengue

10. American Academy of Pediatrics – Dengue Vaccine & Kids: FAQs for Families Who Live Where Dengue Disease Commonly Spreads

Also Read:

Norovirus in Children
Measles(Rubeola) in Kids
Dengue in Babies and Toddlers
Home Remedies of Dengue for Kids
Respiratory Syncytial Virus (RSV) in Kids

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