What is dengue?

Dengue is an acute viral infection characterized by fever and a rash. It is one of the most common mosquito-borne diseases. It is a major health concern today, especially during the rainy season. Often, dengue outbreaks are caused by poor sanitation and crowded living conditions.

How does dengue spread?

The dengue virus is spread through the bite of the Aedes aegypti mosquito. These mosquitoes typically bite during the day and remain close to their breeding area. They lay eggs in clear and stagnant water found in flower vases, plastic food containers, cans, drums, rain barrels, old rubber tires, even leaves that catch water.The adult mosquitoes like to rest in dark places.

Is dengue a seasonal disease?

Dengue is widespread in most parts of the country and is most active after the rains. During the rainy season (June to September), cases of dengue shoot up. At this time, the warm humid weather and stagnant water provide a perfect breeding ground for the mosquitoes.

However, as rain is not limited to the rainy season, and because of poor sanitation practices, we actually do encounter dengue cases all year round.

What are the dengue symptoms to watch out for?

The typical dengue symptoms are:

sudden onset of high fever which may last two to seven days joint and muscle pain pain behind the eyes weakness skin rashes -- maculopapular rash (large red area with small bumps) or red tiny spots on the skin called petechiae

nosebleeding as fever starts to subside abdominal pain

vomiting of coffee-colored matter dark-colored stools

Dengue in infants and toddlers usually starts with the symptoms of a viral illness:fever, runny nose, cough, and a mild skin rash.

Older children usually have the typical symptoms like adults -- high fever, pain behind the eyes and in the joints, headaches, and a red and white patchy skin rash.

These may be followed by a loss in appetite, nausea and vomiting, itchiness in the soles of the feet. Severe weakness may be experienced during the illness and even after it.

What do I do if my child has dengue symptoms?

If your child comes down with high fever which does not respond to medication for a couple of days, and if it is accompanied by skin rashes or pain in the joints, contact your doctor immediately. Timely medical attention can avoid complications. Your doctor may ask for a blood test to confirm if your child has dengue.

Your doctor will perform quick-check antibody dengue tests. After this, your child will be monitored in case of a dengue infection. Usually, regular blood tests will be performed to test for the dengue virus. It is usually for a period of five to seven days, but it can be up to 10 days in some cases.

There is no one specific treatment for dengue infection. Rather, treatment is directed towards the signs and symptoms it manifests, as well as the possible complications. Your doctor will closely monitor vital signs, hydration status, overall well-being and laboratory test results. This information will help him determine the course of the illness (and its complications, if any). Your doctor will inform you about tests needed as part of monitoring the illness. He will also advise you on what to look out for and how often you should check for them.

Treatment to alleviate dengue symptoms usually consist of anti-inflammatory drugs for joint pain. Your doctor may also prescribe medicine to bring down the fever. Let your child have plenty of rest and light and nourishing food. Sponge baths can make your child feel comfortable.

Dengue infection may last up to ten days but if there are other complications like bleeding, hospitalization may be required. Prevention and early treatment is very important since dengue, if left untreated, can cause hemorrhage, liver failure, and convulsions and in severe cases it can be fatal.

After having dengue, will my baby be immune?

Unfortunately, no. There are four closely related but distinct dengue viruses. As these four viruses are different, infection caused by one virus does not guarantee protection or immunity to the others.

Dengue infection results in long-term immunity to the infecting virus serotype, but only short-lived immunity to the other serotypes, so that six months or more after a first dengue infection, one is again fully susceptible to secondary dengue infection with any of the other serotypes.

Also, dengue hemorrhagic fever (DHF), which is a severe type of infection, usually develops in people who are already sensitized with dengue virus. Therefore, prevention is a safer option.

What can I do to prevent a dengue infection?

There is no vaccine against dengue. Your best bet to protect your child is to take preventive measures against mosquitoes that spread the virus.

Mosquitoes breed in stagnant water and warm, humid weather. Make sure your house and the surrounding area are free of uncovered stagnant water, rotting vegetation, and old flower pots especially during the rainy season.

You can take these preventive measures:

Dress your child in long-sleeved clothing and pants, especially if he plays outdoors. Choose light-colored clothing instead of dark clothing. Install mosquito screens on windows. Use citronella oil-based creams and sprays or other mosquito repellents. Use mosquito nets while sleeping. Air conditioning also helps prevent mosquitoes to a certain extent. Cover water drums and water pails at all times to prevent mosquitoes from breeding. Replace water in flower vases once a week.

Clean all water containers once a week -- scrub the sides well to remove mosquito eggs sticking to the sides.

Empty gutters of leaves and debris so that rain water will not collect and become breeding places of mosquitoes.

Puncture or slash old tires being used as roof support to avoid accumulation of water. Dispose all unusable tin cans, jars, bottles and other items that can collect and hold water.

Coughs and Colds in Children

Coughs and colds are usually caused by a viral infection. They normally clear away on their own, and antibiotics are usually of no use. Paracetamol or ibuprofen may ease some of the symptoms. Make sure the child has enough to drink.

On this page

What causes coughs and colds and what are the symptoms? What are the treatments for coughs and colds? Recent research What symptoms should I look out for? References

What causes coughs and colds and what are the symptoms?
Most coughs and colds are caused by viruses. Many different viruses can infect the nose and throat. They are passed on by coughing and sneezing the virus into the air. An average pre-school and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

The common symptoms are a cough and a runny nose. The cough is often worse at night. Coughing does not damage the lungs. In addition, a child may have: a raised temperature (fever), a sore throat, headache, tiredness, and be off their food. Sometimes children vomit after a bout of coughing. A build-up of mucus behind the eardrums may cause dulled hearing or mild earache.

What are the treatments for coughs and colds?

There is no magic cure! Typically, symptoms are worse in the first 2-3 days, and then ease over the next few days as the immune system clears the virus. An irritating cough may linger for up to 2-4 weeks after other symptoms have gone. Antibiotics do not kill viruses, so are of no use for common coughs and colds. Coughs and colds often do not need any treatment. Make sure your child has enough to drink. Dehydration (low body fluid) may develop if a child has a fever and does not drink much. Treatment aims to ease symptoms. Paracetamol can ease aches and pains, headaches, and fever. Ibuprofen is an alternative. Both are sold in pharmacies in liquid form for children. There are various brands - ask the pharmacist if you are unsure what is suitable. A popular treatment for nasal stuffiness (blocked nose) in a baby is to put a few drops of saline (salt water) into the nose just before feeds. Some people feel that this helps to clear the nose to make feeding easier. There is little scientific evidence as to how well this works, but it may be worth a try if feeding is difficult. You can buy

saline drops from pharmacies. Vapour rubs are another popular treatment. They can be applied to the chest and back (avoid application to the nostril area in small children, for safety reasons). Again, there is little scientific evidence as to how well they work.

What about cold and cough remedies?

Cough or cold remedies may be advertised and are sold in pharmacies. They contain various ingredients or combinations of ingredients such as paracetamol, decongestants, antihistamines and cough remedies. However, there is no clear evidence that these cough and cold remedies work. Also, they may have side-effects such as allergic reactions, effects on sleep or hallucinations. In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency, saying, that parents and carers should no longer use over-the-counter (OTC) cough and cold medicines in children aged under 6. For 6 to 12 year-olds these medicines will continue to be available (as there is less risk of side-effects in older children). However, they will only be sold in pharmacies, with clearer advice on the packaging and from the pharmacist. Note: paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.

Recent research
Zinc supplements
Previous research studies suggest that a mineral called zinc appears to reduce the severity of cold symptoms in healthy children. A recent review of the research on zinc supplements and the common cold found that zinc supplements may reduce the length and severity of cold symptoms, when taken within 24 hours of the first symptoms of a cold. However, there were possible side-effects such as unpleasant taste and nausea. The review concluded that it is not yet clear whether zinc should be recommended as treatment for colds. See the reference at the end for details.

Vitamin C
There has also been research looking at vitamin C for preventing or treating colds. A recent review found that taking vitamin C regularly did not seem to prevent colds in the ordinary population. However, it did seem to reduce the length and severity of symptoms. Also, in trials where people were exposed to short periods of extreme physical stress (for example, marathon runners and skiers) vitamin C halved the risk of developing a cold. More research is needed to answer the question of whether vitamin C can help once the cold symptoms have already started.

Other treatments
Echinacea (a herbal treatment) and garlic have traditionally been used for treating colds. However, recent reviews of research could not find any clear evidence about whether or not they are helpful.

What symptoms should I look out for?

Most coughs and colds get better without complications. Sometimes a more serious secondary bacterial infection develops from an initial viral infection. For example, an ear infection, pneumonia, etc. Symptoms to look out for that may mean more than just a cold include:

Breathing problems - wheeziness, fast breathing, noisy breathing (stridor) or difficulty breathing. Being unable to swallow (this may show up as excessive drooling). Drowsiness. Unusual irritability or persistent crying, in a baby, or if the baby is not taking feeds. A rash. Chest pains. Persistent high temperatures, particularly if a baby aged less than three months has a fever higher than 38C. Severe or persistent headache, sore throat, earache or swollen glands. A cough that persists for longer than 3-4 weeks. Symptoms getting worse rather than better after about five days of a cold. Symptoms (other than a mild cough) lasting more than about ten days, particularly if your child has mucus or sputum (phlegm) which is green, yellow or brown - this may indicate a bacterial infection. Any symptom that you cannot explain.

See a doctor if any symptoms develop that you are concerned about. This is particularly important if your child has a long-term illness or medical condition - for example, chest/breathing/heart problems or neurological disease. Doctors are skilled at checking children over to rule out serious illness. They may not be able to prescribe anything more effective for a common cough or cold, but a check-over can be reassuring