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Here Are the Symptoms of Dengue You Need to Watch Out for in Your Baby
  • The kids may like the rainy season because of playing in the weather (or class suspensions!). Unfortunately, it also makes our surroundings the perfect breeding ground for mosquitoes that carry the disease dengue. Just this month, on August 6, 2019, the Department of Health declared a dengue epidemic following more than 146,000 cases of the disease recorded nationwide, including over 600 deaths.

    Dengue and its symptoms

    The Centers for Disease Control and Prevention (CDC) defines dengue as “a viral illness spread through mosquito bites.” This disease is transmitted by female mosquitoes of the species Aedes aegypti, which also carry other fatal diseases such as yellow fever and Zika infection, according to the World Health Organization (WHO). Dengue is also a leading cause of disease and death in tropical and subtropical countries.

    The dengue symptoms manifested by adults and older children differ from the symptoms of dengue in babies. The dengue symptoms most commonly seen in infants, according to a review published in the journal FEMS Immunology & Medical Microbiology in 2010, are the following:

    • Dengue hemorrhagic fever (DHF) and shock syndrome (DSS)
    • Thrombocytopenia (low platelet count)
    • High white blood cell count
    • Abnormally high count of lymphocytes (a subtype of white blood cells)
    • Severe clinical manifestations (i.e. shock, plasma leakage, internal hemorrhage)
    • Cyanosis (a bluish or purplish discoloration of the skin or mucous membranes)
    • Convulsion
    • Hepatomegaly (liver enlargement) and hepatic dysfunction (liver failure)
    • Splenomegaly (spleen enlargement)
    • Ascites (fluid in the abdominal cavity)
    • Nausea and vomiting
    • Rashes or petechiae (tiny patches on the skin)
    • High-grade fever (38° C or 100.4° F, or higher)
    • Edema (swelling) of the lower limbs
    • Retrobulbar puffiness (swelling behind the eyeball)
    • Coryza (runny nose)

    Aside from the symptoms listed above, according to the CDC, dengue may also be signified by low body temperature (less than 36° C or 96.8° F) accompanied by any of these symptoms: irritability, fussiness, over-agitation, or sleepiness; a rash; unusual bleeding in the gums, nose, or bruises; or vomiting more than 3 times in a day.

    Dr. Faith Buenaventura-Alcazaren, a pediatrics specialist at Stratum Health Partners in Centuria Medical Makati, tells SmartParenting.com.ph that infants, especially those between 4 and 9 months of age, are more prone to developing severe dengue and that babies’ symptoms are different from adults’ symptoms. Signs such as convulsions and hepatic dysfunction (liver failure) more commonly affect babies, and the fatality rate is four times higher in infants. On the other hand, adults and adolescents ages 14 years and above are less prone to developing severe dengue.

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    Treatment for babies with dengue

    For now, there is no cure for dengue, which is why it is so important for parents to be vigilant when looking for their child’s symptoms — especially for babies, who cannot yet inform their parents verbally if they are uncomfortable or in pain.

    According to Dr. Alcazaren, when a baby has an acute high-grade fever, that’s when he should be brought to the hospital. It is at this time when health care providers can begin to observe the child’s fever pattern for two to three days.

    “There are many cases where an infant only has roseola infantum (tigdas hangin), which is common in this age group — [the] baby would manifest…high-grade fever for three consecutive days then manifest with a rash after defervescence (or when fever subsides),” Dr. Alcazaren says.

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    She emphasizes how critical it is for parents to look for persistent symptoms of dengue. “Since infants are at higher risk for developing severe dengue, a higher index of suspicion will help rule in or rule out the disease. This means getting tested for dengue as soon as there is clinical suspicion.”

    An infant who does not receive prompt medical attention “may decompensate (a term doctors use to describe deterioration in a person’s organ funtions ) faster than bigger children or adults,” says Dr. Alcazaren.

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    What you do at home to care for your baby who has dengue is just as vital. The CDC has the following recommendations: First, give him paracetamol to help control his fever and relieve his pain. Cool water sponge baths may also be helpful.

    Second, make sure your child is properly hydrated because he might lose too much water due to fever, vomiting, and loss of appetite. Talk to your doctor about his fluid intake — breast milk or formula for babies under 6 months of age, sips of water for babies 6 months of age and above, and a rehydration liquid for babies 3 months of age and older. If you spot any of these signs of dehydration in your baby, bring him to the hospital immediately:

    • sunken soft spot on his head
    • dry mouth, tongue, or lips
    • sunken eyes
    • few or no tears when he is crying
    • decreased urination

    Dr. Alcazaren says, “If the infant is breastfeeding, offer the breast more frequently, give more fluids orally. If [the] baby is too irritable and unable to take in fluids, IV management may optimize hydration.”


    Finally, BabyCenter recommends giving babies with dengue as much opportunity to rest as possible.

    How to protect your baby from dengue

    According to the CDC, it only takes one bite from a dengue-carrying mosquito for a baby between 0 and 12 months old to be infected with the disease, especially if the child lives in or travels to an area with dengue. Parents are encouraged to keep their babies protected from being bitten by mosquitoes.

    First, dress your baby in loose clothing that covers his arms and legs completely. It can also help to cover his crib, stroller, and baby carrier covered with mosquito netting, both indoors and outdoors.

    Insect repellent should be used only on babies 2 months of age and above. The CDC recommends insect repellents with up to 30 percent DEET or IR3535.

    Dr. Alcazaren also suggests using insect repellents with the active ingredient picaridin for babies 6 months of age and older. Apply repellent to your hands first, then spread it on your child’s skin. Don’t forget to follow the instructions on the product’s packaging.

    Lastly, Dr. Alcazaren says, “Manage the environment at home by getting rid of potential breeding grounds.”

    Dengue-carrying mosquitoes can breed in stagnant water, so empty items in your home that may hold water, such as pails, buckets, trash containers, and toys. Add screens to your doors and windows, and stay in screened rooms whenever possible.

    To learn more about the symptoms of dengue in older children, click here.

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