Dengue: How to keep children safe

Dengue is becoming more common across the Asia–Pacific, and it can be serious for children.

The good news is that taking simple steps can lower the risks.

By preventing mosquito bites, knowing how to spot dengue symptoms and when to get medical help, you can keep your family safer.

In some countries a dengue vaccine is also available for children aged 6-16, usually through private clinics.

Below, UNICEF experts answer parents’ most common questions.

What is dengue?

close up of mosquito biting a person — James Gathany The Aedes mosquito

Dengue is a flu-like disease spread by Aedes mosquitoes.

Many people who get it don’t feel sick at all, but some develop fever and feel unwell. In a small number of cases, dengue can become very serious and, without quick medical attention, can even lead to death.

Dengue is more common in tropical and subtropical climates – warm regions of the world.

How do you catch dengue?

You get dengue when an Aedes mosquito that’s carrying the dengue virus bites you.

Dengue tends to spread more during certain times of the year. It often peaks during and after the rainy season, when there are more places for mosquitoes to breed.

What time of day do mosquitoes that spread dengue bite?

Aedes mosquitoes usually bite during the day, especially 2 hours after sunrise and in the late afternoon before sunset. These are the times when the risk of dengue infection is highest.

You’re also more likely to get bitten if there are objects around your home, school, workplace, or along your daily route that water can collect in.

This is because the Aedes mosquito breeds in standing water and can lay eggs even in a very small amount. For example, in buckets, old car tyres, puddles and even bottle caps.

Is dengue contagious?

Dengue does not spread directly from one person to another. You can’t catch it by touching, sharing food, or being near someone who is sick.

However, during the first week of illness, the dengue virus is present in an infected person’s blood. If a mosquito bites them during this time, the mosquito can become infected and then pass the virus on to someone else.

Pregnant women who have dengue can also sometimes pass it to their baby before or during birth.

How dangerous is dengue for children?

Young children, especially babies, are at a higher risk of developing severe dengue compared to healthy adults. Their immune systems are still developing, which makes it harder for their bodies to fight the infection. Because of this, it’s especially important to protect infants and young children from mosquito bites and know the symptoms of dengue.

With quick medical attention, the most serious effects of severe dengue in children can often be prevented.

Pregnant women also have a higher risk of developing severe dengue and it’s possible for them to pass dengue to their babies during pregnancy or around the time of birth.

When a mother does have a dengue infection when she is pregnant, babies may suffer from preterm birth, low birthweight and foetal distress.

What are the symptoms of dengue?

Most people with dengue have mild or no symptoms at all and recover in 1–2 weeks.

About 1 in 4 people who are infected will develop symptoms.

If you do show symptoms, they usually:

Start 4–10 days after being bitten by an infected mosquito
Last for 2–7 days

Common symptoms in both adults and children include:

A sudden high fever, of up to 40°C
Severe headache
Pain behind the eyes
Muscle and joint pains
Nausea
Vomiting
Swollen glands
Skin rash

If you, or your child, have any symptoms of dengue, seek medical attention and do as advised.

What are the symptoms of dengue in children?

symptoms of dengue fever — WHO South-East Asia

The symptoms of dengue in children are similar to those in adults, but they can also look a lot like other common childhood infections, which can make them easy to miss.

As well as the symptoms above, babies and young children may show changes in behaviour, like being more irritable than usual, eating less, or having disrupted sleep.

Parents: When to act and why it matters

If your child has any symptoms of dengue, seek medical attention as soon as possible and follow the advice given by your healthcare provider.

Some dengue symptoms can look like the flu or other common infections, and it’s not always easy to tell the difference at home. Because severe dengue can become an emergency, getting help promptly ensures your child gets the right care at the right time.

What is the treatment for mild dengue?

There is no medicine that cures dengue. Treatment focuses on managing the symptoms, such as easing fever and pain. Always consult a doctor and follow their advice.

Most people with mild dengue infections can be treated at home with pain medicine, like paracetamol, and won’t need medical intervention. They will gradually return to normal little by little.

If you or your child is diagnosed with mild dengue, you can support recovery by:

Resting as much as possible.
Drinking lots of water, to stay hydrated.
Eating nutritious food.
Taking paracetamol to help with pain and fever, as recommended by your health professional.
Sponging the skin with cool water to help reduce fever.
Avoiding ibuprofen, aspirin and other non-steroidal anti-inflammatory drugs, as they can increase the risk of bleeding.

Keep a close eye on symptoms. Dengue can become severe within a few hours. If you notice any signs of severe dengue, seek urgent medical attention immediately.

What are the symptoms of severe dengue?

Some people do become seriously unwell with dengue. Young children, pregnant women and older people with other health conditions (like kidney disease and diabetes) are at the highest risk.

When a dengue infection develops into severe dengue it can happen quickly and lead to life-threatening complications. So, it’s important to pay attention to symptoms and act quickly to get medial help if they develop.

Severe dengue symptoms often come after fever has gone away and include:

Severe abdominal pain
Persistent vomiting
Rapid breathing
Bleeding gums or nose
Fatigue
Restlessness
Blood in vomit or stool
Being very thirsty
Pale and cold skin
Feeling weak
Sleepiness, lack of energy, or irritability

If your child, or anyone with suspected or confirmed dengue develops any of these symptoms, it is important to seek urgent medical attention.

People with severe dengue often need hospitalization.

It’s also important to look out for signs of dehydration in children.

Dehydration happens when the body loses too much fluid due to fever, vomiting, diarrhoea or not drinking enough fluids.

Signs of dehydration in children include:

Unusually sleepy, lack of energy, very fussy.
Dry mouth, tongue, lips.
Fast breathing.
Sunken eyes.
Few or no tears when crying.
Cool, discoloured hands or feet.
Urinates less often.
Urine is dark yellow and strong smelling.

If your child develops any of these signs of dehydration seek medical care immediately.

How likely is it that a dengue infection will become severe?

As many as 5% of people with dengue will develop severe, life-threatening disease.

Severe dengue doesn’t develop after a person is infected with a mosquito once. It takes multiple bites/infections from mosquitoes infected with the dengue virus for a person to become seriously ill with dengue.

This means you are at a greater risk of developing severe dengue if:

You have had dengue in the past and are infected again with a different dengue virus type.
You live in or travel to areas where dengue is common, so repeated infections are more likely.

Because it’s possible to be infected with dengue without ever showing symptoms, it’s important to stay alert and protect yourself and your family from all mosquito bites to reduce the risk.

How is dengue diagnosed?

Dengue can look very similar to other diseases like zika, chikungunya and malaria. Because many people with dengue have no, or mild symptoms, cases are also often misdiagnosed as other illnesses. The only way to know for sure if you have dengue is through a laboratory test.

Is there a vaccine for dengue?

Yes. The World Health Organization (WHO) recommends the Q-denga vaccine for children aged 6–16 who live in places where dengue is common. Ask your local health worker whether dengue vaccination is available, or if you can get vaccinated at a clinic.

The Q-denga vaccine is given in two injections, 3 months apart.

Unfortunately, in many countries the vaccine is not yet available in public clinics. This means you may have to pay for the vaccine at a private clinic. Check with a local health worker.

» Read the World Health Organization’s latest guidance on dengue vaccines and where vaccines may be available.

How can you avoid dengue?

The best way to avoid dengue is to prevent mosquito bites.

You can do this by taking steps to avoid mosquito bites and reducing mosquito breeding sites around where you and your family live, work and study.

Stay up to date on the dengue situation where you live and follow advice from the local health authority.

Preventing mosquito bites

You can lower the risk of mosquito bites by:

Avoiding going outside during peak mosquito activity. (You’re most likely to be bitten during 2 hours after sunrise and just before sunset.)
Wearing loose, long-sleeved clothing that covers the arms and legs.
Wearing socks and full shoes to reduce exposed skin.
Using mosquito repellent on exposed skin (DEET-based products are most effective.) Always follow the instructions on the label.
Spraying repellent around buildings where your family lives or spends time.
Using mosquito coils in outdoor or open-air spaces.
Sleeping under mosquito nets, especially during the day.
Using air conditioning, if available.
If AC isn’t available, closing windows and doors or using mosquito nets.
Installing or repairing window and door screens to keep mosquitoes outside.

If someone in your household has dengue, be extra vigilant with these measures both indoors and outdoors to reduce the likelihood of a mosquito biting the infected person and then biting someone else in the household.

Protecting babies and children from mosquito bites

Babies and children need extra protection. You can help keep them safe by:

Using a properly fitted mosquito net or screen over your baby’s crib, stroller, or play area.
Dressing them in long sleeves, long pants and socks, to reduce their exposed skin.
Using an age-appropriate mosquito repellent recommended by a healthcare professional. (Products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) should be avoided on children under 3 years old.)
Limiting outdoor activities during dawn and dusk when mosquitoes are most active.

Reducing mosquito breeding sites around you

Mosquitoes breed in standing water, so reducing places where water collects can make a big difference. You can help by:

Keeping your home and surroundings clean and clutter-free.
Removing or turning over any objects that collect water, such as bottles, plastic containers, tyres, or coconut shells.
Clearing clogged drains and gutters to prevent water from collecting.
Regularly emptying, covering, or treating containers that hold water, such as buckets, flowerpots, and trays
Covering water containers: Always place a tight lid on containers used for water storage (buckets, drums or tanks). Use tight-fitting lids, screens or wire mesh with holes smaller than an adult mosquito to prevent mosquitoes from laying eggs in them.
Regularly emptying and scrubbing water containers to remove any mosquito eggs.
Encouraging neighbours and family members to do the same so that breeding sites are reduced across the whole community.

Helping your children protect themselves from dengue

It’s helpful to talk with your children about how mosquito bites can make people sick and why it’s important to protect themselves. Encourage them to wear protective clothing, use mosquito repellent when going outdoors, and be aware of mosquito-prone areas.

Children often copy what they see, so leading by example is one of the best ways to teach them. Show them how you protect yourself from mosquito bites, explain what you’re doing, and let them know why it matters. This helps them learn good habits that keep them safe.

If your child is getting vaccinated, explain that it’s another way to help protect them from dengue. Let them know it’s normal to feel nervous, and the pinch is over quickly. Remind them the nurse is there to help, and taking slow breaths and looking away can make it easier.

» Learn more about dengue on UNICEF’s Internet of Good Things
» Learn more about dengue from the World Health Organization