Source: www.bbc.co.uk
Recognizing and Preventing Dengue- A must parenting skill nowadays!
We always hear that in combatting dengue we need to empower the community. I personally would like to advocate that dengue prevention should start from home. If every family understands these simple concepts and takes responsibility in safeguarding their family from Aedes mosquito attack, automatically we will be able to link one family with another and form chains of protection within our community. Here are some basic concepts which can be practiced by parents in relation to safeguarding your children and family from dengue and the death threats it may bring.
Educate yourself and your children about dengue fever.
In this case, ignorance is no longer bliss. Understanding some crucial points about dengue helps in decision making for parents and family members of a dengue patient. Yes, cases are so rampant now that parents need to be their own ‘Doc Mc Stuffin’ to their family and kids in order to be able to act with any slightest inkling of a possible dengue case. Although there is no specific treatment for dengue but early detection and seeking proper medical care may reduce death caused by dengue 3
What must I know about dengue? The danger time is usually when fever settles after 3-4 days.
In a typical dengue fever, one will present with high grade fever (>38 degrees) in the first 3 days1. The problem arises when on the fourth day after the fever disappears many parents assumed everything is back to normal and their child is recovering. If it is not dengue then resolving fever is good news but if it is dengue this is where parents may overlook things. They are not aware that in dengue patients when fever settles, this is the critical time and water leaks out from cells in the body which manifest in different ways and if not control can lead to organ failure and death1. So dear parents, when your child’s fever settles it does not mean that she is dengue free. It’s after the fever that you need to be extra cautious and watch out for other symptoms.
Look out for warning signs
This usually surfaces when fever settles or may occur together during the fever. In children this can be especially challenging as they may not speak up or able to tell you exactly what is the matter. Even in adult this phase is usually missed what more in children. They can go from manifesting vague symptoms such as feeling uneasy, uncomfortable, fidgety, very tired, loss of appetite, not active or just as not being themselves1 2. They can also clearly complain of abdominal pain, shortness of breath, light-headedness, persistent vomiting, diarrhoea and bleeding 1 2. You probably think I am mentioning almost everything under the sun which is true because when the water leaks out of the cell, it may occur in every part of our body. A patient I knew only presented with 3 days fever and poor appetite. Guess what? It turned out to be dengue. The hint here is, do not take things for granted. When in doubt just bring your child to see the doctor, for all you know it could be dengue and a doctor’s suspicion can be confirmed with simple blood test done immediately.
Are all the blood taking necessary for my poor child?
When it comes to dengue, yes.
Normally what happen is, when you bring your child to the clinic and the doctor suspects your child has dengue (based from history taking and physical examination) the first blood taking is done to confirm this. Nowadays most of the public primary health clinics are equipped with the dengue diagnosis kit. Now, the next part is pivotal. If from the doctor’s judgement your child’s condition is serious (which takes into account any warning signs present together with the blood result and children is unable to drink/take water) then the doctor would get your child admitted to the hospital1. However if this is not the case, then doctors would advise parents to take care of their child at home ensuring adequate water intake and will require parents to bring their child immediately if there is any warning signs and if not to come again on the same day or the next day depending on the doctor’s clinical judgement.
To many parents, the subsequent visits are usually their main concern. Some parents are too worried about the blood taking that they resort to self-treat at home. Circumstances are, parents fail to realise that the subsequent visits are actually crucial for doctors to assess your child’s condition and the blood result helps in monitoring your child’s recovery. In many dengue cases children deteriorate fast and we don’t want this to happen to our child. A few pokes are nothing when your child’s life is worth everything.
If your neighbour has it most likely you can too!
Be aware of any recent dengue cases in the neighbourhood. If your neighbours have suffered from it, most probably the breeding places are nearby and mosquitos are within the neighbourhood. There is a big chance you might get it too. So knowing this should alarm you to have high suspicion whenever your family or children has fever. This is exactly what I mean by combating dengue is for everyone in the community to join forces. We always think, my house is clear of Aedes breeding place then I am safe but no, that is not the case. Your neighbours mosquito may have just busy bodied around your house and bitten your children instead of their children. And bear in mind fogging only kills the mosquito but does not destroy their eggs. Hence getting rid of their breeding places is crucial.
Nurture basic health and cleanliness concept in your children while reviving your own.
- Teach your children to tell parents or teachers immediately when they are not well. Explain to them what not well means.
- Not well to children can carry different meanings than adult. It ranges from feeling hot (fever), having cough/cold, nauseated, I don’t feel like eating, don’t feel like playing, can’t sleep. This is something parents can explain to their children. Sometimes we missed the fever and come to the other vague symptoms. When we teach our children to express we anticipate dengue cases better.
- Teach your children simple things they can do when they are not well like taking lots of water (yes ideally plain water but when it comes to children and dengue fever, getting them to drink any fluids is good), taking fruits, taking medicine prescribed by their doctor and washing their hands appropriately.
- Talk to your children about Aedes mosquito and the dengue fever it causes. We should start somewhere and looking by the escalating number of dengue cases in Malaysia perhaps Aedes Mosquito is a must know insect for all children as early as kindergarten.
- Lastly, let us lead by example. Firstly, we must not throw rubbish out of our car window; start to recycle our rubbish and clean up any potential mosquito breeding places at our own homes. Our kids observe us especially the young ones and good habits are nurtured early from our actions.
Dengue is not a guessing game of what the culprit is and how to prevent it. These points are already crystal clear. By clearing up the breeding places, you destroy the eggs and consequently this reduces Aedes mosquitoes which then reduces chances of human being bitten and logically this should reduce the number of dengue cases. Notice the starting point of this chain? Yes it begins with good cleanliness habits – nothing mysterious about it. Dear parents out there, now that you know, you can definitely impart this knowledge to your family and it all begins with you and I.
Dr. Dalila Roslan (MB Bch BAO (NUI) Master in Community Heath (UKM) is a DrPh candidate in a local university.
Reference:
- Draft CPG Management of Dengue Infection in Adults (3rd Edition) 2015
- Management of dengue fever in children, CPG, December 2004 MOH/P/PAK/95.04
- WHO dengue and severe dengue fact sheet http://www.who.int/mediacentre/factsheets/fs117/en/
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]