Dengue: How to keep children safe
Advice for families to protect against dengue
It’s rainy season in South Asia, an ideal time for disease outbreaks from stagnant and contaminated water — including dengue that can be passed on by mosquitoes.
This year, cases of dengue have alarmingly increased in many countries in South Asia, especially among children.
As of 25 August, there have been over 209,000 reported cases of dengue in South Asia and 564 deaths. Bangladesh has reported over 21,000 cases of dengue in children under the age of 15.
It’s worrying news. And experts say the next month could have the most new cases once monsoon season reaches its peak.
But dengue can be prevented and there are things you can do to keep your children safe.
Not everyone who gets dengue will become seriously unwell and the most serious impacts of dengue can be addressed with swift medical care — so, it’s important to know what dengue symptoms to look out for and when to seek medical attention.
We spoke to our health, water and hygiene experts to answer parents' questions on the disease — and the best way to keep you and your family safe.
What is dengue?
Dengue is a flu-like disease spread by Aedes mosquitoes.
Most people infected with dengue have no symptoms. But it can cause a feverish illness and in rare cases people can become seriously unwell, need hospital care and even die from dengue.
How do you catch dengue?
You get dengue by being bitten by an Aedes mosquito that is infected with the dengue virus.
Aedes mosquitoes normally bite during the day, especially 2 hours after sunrise and just before sunset — so you're at the biggest risk of getting bitten and infected with dengue during these times.
You are also at a bigger risk if you have objects containing water or collecting rainwater around your home, neighbourhood and place where you work or study (or on your journey there).
This is because the Aedes mosquito breeds in water and can lay eggs even in a very small amount of water. For example, buckets, old car tyres, puddles and even bottle tops.
Dengue does not spread from person to person directly. But, if a person has dengue, the virus will be in their blood during the first week they’re infected. If a mosquito bites them during this time the mosquito will become infected with dengue. This infected mosquito can then spread the virus to other people through bites.
It’s also possible for pregnant women with dengue to pass it to their babies during pregnancy or around the time of birth.
How do I know if I or my child has dengue?
It can be hard to know if you have dengue, because most people infected with dengue don’t have any symptoms.
If children have symptoms of dengue, they can look similar to other common childhood infections.
Most people with dengue have mild or no symptoms and will get better in 1–2 weeks. About 1 in 4 people with dengue will develop symptoms. If you do show symptoms, they will usually begin 4–10 days after being bitten by an infected mosquito and last for 2–7 days.
Symptoms of dengue may include:
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A sudden high fever, of up to 40°C
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Severe headache
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Pain behind the eyes
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muscle and joint pains
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Nausea
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Vomiting
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Swollen glands
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Skin rash
Children and infants with dengue may also become more irritable than usual and their appetite and sleep patterns may change.
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.
If you, or your child, have any symptoms of dengue, seek medical attention and do as advised.
What is the best way to treat mild dengue?
There is no specific treatment for dengue infection. Medical treatments of dengue are essentially just treatments to manage the symptoms. For example, medicines to treat fever and pain.
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, are diagnosed with mild dengue:
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Rest.
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Drink lots of water, to stay hydrated.
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Eat nutritious food.
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You can take paracetamol to help with pain and fever, as recommended by your health professional.
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Sponge the skin with cool water to reduce fever.
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Avoid non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin, as they can increase the risk of bleeding.
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Watch for severe symptoms and contact your doctor as soon as possible if you notice any.
Symptoms of dengue can become severe within a few hours. If you, or your child, develops any symptoms of severe dengue, seek urgent medical attention immediately.
How do I know if my child needs urgent medical attention?
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 children’s symptoms and act quickly to get medial help if they develop.
Severe dengue symptoms often come after fever has gone away and include:
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Severe abdominal pain
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Persistent vomiting
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Rapid breathing
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Bleeding gums or nose
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Fatigue
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Restlessness
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Blood in vomit or stool
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Being very thirsty
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Pale and cold skin
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Feeling weak
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Sleepiness, lack of energy, or irritability
If your child, or anyone with suspected 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:
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Unusually sleepy, lack of energy, very fussy.
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Dry mouth, tongue, lips.
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Fast breathing.
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Sunken eyes.
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Few or no tears when crying.
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Cool, discoloured hands or feet.
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Urinates less often.
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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 develop into a severe illness?
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:
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you have had dengue in the past,
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you have been continuously exposed to mosquitoes.
As you could have previously been bitten by a mosquito with dengue and not have developed symptoms, you should remain vigilant against all mosquito bites to reduce your risk.
How serious is dengue for children?
Young children and particularly infants are at a higher risk of developing severe dengue illness and complications than healthy adults. This is because their immune systems are weaker. So, it’s especially important to keep infants and young children safe from mosquito bites.
With quick medical attention the worst impacts of severe dengue in children can be avoided.
>> Read about eleven-year-old Fahim’s experience with dengue in Bangladesh
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 best ways to protect my family from dengue?
Preventing mosquito bites is the best way to avoid getting dengue.
You can do this by taking steps to avoid mosquito bites (especially during the day and around dawn and dusk) and reducing mosquito breeding sites around where you and your family live, work and study.
It’s also important to stay up to date on the dengue situation in your local area and follow the guidelines provided by local health authorities.
Preventing mosquito bites
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Avoid going outside during peak mosquito activity. (You’re most likely to be bitten during 2 hours after sunrise and just before sunset.)
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Wear loose clothing, that covers your arms and legs.
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Wear socks and full shoes to minimize exposed skin.
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Use mosquito repellents on exposed skin (DEET based repellents are the most effective). Follow the instructions on the product label.
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Spray mosquito repellent around buildings.
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Use mosquito coils.
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Use mosquito nets when sleeping – especially during the day.
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Use air conditioning, if available. If not available, keep windows and doors closed, or use mosquito nets.
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Use door and mosquito screens to keep mosquitoes outside. Repair any holes in screens.
If someone in the household has dengue, be vigilant with the above measures indoors as well as 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
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Place a properly fitted mosquito net or screens over the baby's crib, stroller, or play area to create a protective barrier.
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Dress your child in long sleeves, long pants and socks, to minimize exposed skin.
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Use 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.)
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Limit outdoor activities during dawn and dusk when mosquitoes are most active.
Reducing mosquito breeding sites around you
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Keep your home clean.
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Remove or turn over any potential water containers or rubbish from around your home, workplace or children’s school. For example, bottles, plastic boxes, tyres, coconut shells or any other object that could collect water.
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Clear clogged drains and gutters to prevent water from accumulating.
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Regularly empty, cover, or treat any containers that collect and hold water, such as flowerpots and buckets.
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Cover 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.
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Empty and scrub water containers clean to remove any mosquito eggs.
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Encourage your neighbours to take steps to eliminate mosquito breeding sites and stop themselves getting bitten.
Helping your children protect themselves from dengue
Talk to your children about how mosquitoes can cause sickness and the importance of taking steps to protect themselves from mosquito bites like wearing protective clothing and using mosquito repellents when going outdoors.
Children learn from their parents and caregivers, so lead by example! Set a good example by taking steps to stop mosquito bites, explaining what you are doing and why.
Why are dengue cases rising?
Alarmingly, experts have linked the rise in dengue infections this year to global warming.
Dengue is found in tropical and sub-tropical climates. A warmer climate is thought to help mosquitoes and the dengue virus multiply faster, while longer and more intense monsoons give mosquitoes more opportunity to breed.
The world’s leading authority on climate science, the Intergovernmental Panel on Climate Change (IPCC), have also flagged that dengue is now spreading even at high elevations due to climate change.
Urbanisation and resulting sanitation problems and the increased movement of goods and people have also been identified as other factors behind the rise in cases.
The situation is expected to worsen in August and September 2023, due to the ongoing monsoon season.
>> Learn more about dengue on UNICEF’s IoGT
>> Learn more about dengue from the World Health Organization
