By Dr. Celeste Gomez
Q: Everyone seems to be under the weather these days and my kids are having on and off high grade fever. I’m so afraid that my kids might already have the dengue virus whenever they have fever! How will I know if it is the dengue fever already? What are the signs I have to watch out for? When do I need to bring her to the hospital?
A: Fever is our body’s natural reaction to an infection that challenges our body. Our immune system releases certain cells like cytokines and cells that fight of viruses and bacteria and these consequently raises the temperature of our body—thus we experience a fever.
The dengue virus
To a highly anxious parent living in a dengue-endemic country like the Philippines, it’s hard not to consider the dengue virus as the cause of our child’s high fever. The dengue virus has four strains, so that means you can get infected four different times. Most of the time, the first infection is very mild or sometimes asymptomatic or does not cause any symptom at all. However, the more you get infected, the manifestation will be more severe.
Signs and Symptoms of dengue
Children with the dengue virus usually presents with fever for 2-7 days. Sometimes fever is every four hours, but sometimes you have longer intervals in between. The most common manifestation of a dengue infection in children are the following:
- Fever (temperature 37.8 degrees Celsius and above)
- Headache (in younger children it is mostly irritability)
- Feeling of pain behind the eyes or retro-orbital pain
- Not having appetite to eat or anorexia
- Muscle or joint pains
- Vomiting and/or diarrhea
- Flushed skin
- Petechial rashes or pinpoint red rashes due to bleeding
It is suggested that if you have at least two out of these symptoms (plus the fever), you might need to see your pediatrician right away to be examined. Tests to catch the dengue virus may vary depending on the timing of the fever and the timing of your consult. Blood tests such as the dengue NS1 and/or the dengue IgG and IgM may be requested by your doctor.
When to go to the ER
For babies, children with special needs, pregnant women and the elderly with lots of sickness, hospitalization is immediately warranted once the dengue virus is suspected. There are some cases that children may also present with mucosal bleeding or bleeding at the inner parts of the body such as the nose bleeding, gum bleeding, blood seen at stools or vomiting of coffee ground particles. If these are experienced together with a positive dengue test, hospitalization is also necessary because these are already some of the “warning signs” of the dengue virus.
However, even if there are no warning signs, a child with fever who has a very poor appetite might also be dehydrated. A visit to the doctor might be needed to see if hospitalization is beneficial.