Detailed_Dengue_in_Children_Updated.pptx

Dengue

1. Dengue in Children An Overview of Symptoms, Diagnosis, Prevention, and Treatment

2. What is Dengue? Dengue is a mosquito-borne viral infection caused by the Dengue virus (DENV). There are four serotypes of the virus: DENV-1, DENV-2, DENV-3, and DENV-4. Transmitted by Aedes mosquitoes, primarily Aedes aegypti and Aedes albopictus. Endemic in tropical and subtropical regions, affecting millions annually. Can cause a spectrum of illness ranging from mild dengue fever to severe dengue (Dengue Hemorrhagic Fever/Dengue Shock Syndrome).

3. Symptoms in Children Initial symptoms appear 4-10 days after a mosquito bite. High fever (104°F or 40°C), often biphasic. Severe headache, retro-orbital pain (pain behind the eyes). Muscle and joint pain (often called 'breakbone fever'). Skin rash (may appear on days 3-5 of illness). Mild bleeding manifestations (nosebleeds, gum bleeding, easy bruising). Severe cases: Plasma leakage, organ impairment, and circulatory failure.

4. Phases of Dengue Infection 1. **Febrile Phase**: High fever, headache, vomiting, rash, mild bleeding. 2. **Critical Phase**: Occurs after defervescence (drop in fever), plasma leakage, risk of shock. 3. **Recovery Phase**: Fluids reabsorbed, hemodynamic stabilization, potential rash ('white islands in a red sea').

5. Severe Dengue - Warning Signs Severe abdominal pain or persistent vomiting. Rapid breathing or respiratory distress. Bleeding from nose, gums, or gastrointestinal tract. Cold, clammy skin, restlessness (signs of shock). Enlarged liver, fluid accumulation in chest or abdomen. Altered mental status, seizures (suggesting encephalopathy).

6. Diagnosis of Dengue 1. **Clinical Diagnosis**: Based on symptoms, travel history, and warning signs. 2. **Laboratory Tests**: - NS1 antigen test (early detection within 5 days of fever onset). - Dengue IgM and IgG antibodies (serological tests). - PCR (detects viral RNA, confirms serotype). - CBC: Thrombocytopenia (low platelets) and hemoconcentration (high hematocrit).

7. Prevention of Dengue Eliminate mosquito breeding sites: Empty stagnant water containers. Use insect repellents containing DEET, picaridin, or IR3535. Wear long-sleeved clothing and use mosquito nets. Install window and door screens to prevent mosquito entry. Community-based vector control programs are essential. Dengue vaccine (Dengvaxia) available but recommended only for seropositive individuals.

8. Management of Dengue Fever Supportive care is the mainstay of treatment. Encourage adequate oral fluid intake to prevent dehydration. Use **paracetamol** (acetaminophen) for fever and pain relief. Avoid **aspirin, ibuprofen, and NSAIDs** due to bleeding risk. Monitor for warning signs and seek medical attention if necessary. Severe cases require hospitalization with IV fluids and close monitoring.

9. When to Seek Emergency Care? Persistent vomiting or inability to tolerate oral fluids. Severe abdominal pain and lethargy. Bleeding from the nose, gums, or gastrointestinal tract. Cold extremities, fast and weak pulse, or signs of shock. Altered consciousness or seizures. Hospitalization is required for severe dengue cases.

10. Key Takeaways Dengue is a major public health concern in tropical regions. Prevention is key: mosquito control and personal protection. Early diagnosis and supportive care improve outcomes. Severe dengue requires timely medical intervention. Community awareness and vector control are critical to reducing dengue incidence.