Dengue fever in children: Preventable with a vaccine

In recent years, there have been reports of dengue fever claiming many lives of both children and adults. Dengue fever is an illness caused by the dengue virus, which is transmitted by Aedes aegypti mosquitoes. It is commonly found in tropical regions and tends to spike during the rainy season. 

Symptoms of dengue fever range from unnoticeable to extreme, and include a high fever, headache, muscle aches, nausea, and even death if not promptly treated. Additionally, predicting whether the illness will become severe or not is challenging.

Dengue fever is caused by infection with 1 of the 4 serotypes of the dengue virus, which consist of DENV-1, DENV-2, DENV-3, and DENV-4. The virus is transmitted through the bite of infected aedes mosquitoes or aedes aegypti mosquitoes. When these mosquitoes feed on the blood of individuals who are infected with the dengue virus in its incubation period and then bite others, the dengue virus spreads into the bloodstream of the bitten individuals, leading to a viral infection.

Due to the circulation of all 4 serotypes of the dengue virus, there are alternating outbreaks on an annual basis, which can lead to multiple infections in individuals. In cases of second infections, which arise from a different serotype than the initial infection, symptoms may become more severe. The symptoms of dengue fever are divided into three phases, as follows:

1. Febrile phase: This phase is characterized by sudden high fever, typically ranging from 39 to 40 degrees Celsius, lasting continuously for 2 to 7 days. During this phase, fever-reducing medications often do not work, and other accompanying symptoms may include:
   • Headache
   • Pain behind the eyes
   • Nausea and vomiting
   • Muscle aches
   • Loss of appetite
   • Joint pain and bone pain

   • Rash 

      

2. Critical phase: Following the febrile phase, which lasts approximately 3-7 days, patients may enter a critical phase where severe complications can occur, such as shock, loss of consciousness, cardiac arrest and even death. Symptoms during this phase may include:
   • Severe abdominal pain (particularly on the right side)
   • Persistent nausea and vomiting
   • Inability to ingest food orally
   • Bleeding from the gums or nose 
   • Blood in urine or stools, or vomiting blood
   • Small spots of blood becoming visible under the skin
   • Difficulty breathing
   • Fatigue, lethargy
   • Unstable blood pressure

   • Circulatory collapse or shock, which can be fatal

      

3. Recovery phase: If the patient does not progress to the critical phase or recovers from it within 1-2 days after the febrile phase, they enter the recovery phase. During this phase various symptoms start to improve and the body returns to normal functioning. It is a safe phase with the following indicators:
   • Fever subsides
   • Pulse normalizes
   • Ability to urinate independently returns
   • Appetite increases
   • A faint, white-spotted rash appears on the body

When the doctor confirms a dengue fever diagnosis, treatment begins with the aim of restoring the infected person's body to normality as quickly as possible and preventing shock. This includes:

• Administering intravenous fluids or saline solution
• Giving pain relief and fever reducing drugs
• Having the patient drink electrolytes to replenish lost fluids
• Giving a blood transfusion in cases of severe bleeding
• Treatment must involve periodic blood tests to monitor for signs of low platelets, low white blood cells, high hematocrit levels or low blood pressure

• Prevent mosquito bites, such as by using mosquito repellent and wearing long sleeved shirts and long pants
• Eliminate mosquito breeding grounds, especially stagnant or standing water

• Currently, there is a campaign to provide vaccination against dengue fever. The latest vaccine is highly effective in preventing dengue fever from all serotypes, offering an efficacy rate of up to 80.2%, and preventing severe symptoms by up to 90.4%. The vaccine is administered in two doses, three months apart, and can be given to both individuals who have previously had dengue fever and those who have not.