Dengue is an old enemy that often strikes when our guard is down. Keeping us on our toes and claiming countless lives.
As long as mosquitoes continue to be a part of our ecosystem, Malaysians will continue to battle this deadly disease.
The youngest in our community are often the most vulnerable victims.
Childhood dengue is an ongoing problem in the country but we are slowly formulating new ways to slow down its spread and hopefully future children from being infected.
To answer our questions about dengue fever, join us as Motherhood chats with Consultant Paediatrician and Paediatric Cardiologist at KPJ Selangor Specialist Hospital, Prof. Datuk Dr. Zulkifli Ismail.
Here’s his invaluable insight on this disease and what parents should know.
Q1: Have dengue cases in Malaysia increased or decreased these past few years? What about dengue cases in children?
It’s not looking so great, I’m afraid.
Current reports show that dengue cases are increasing at an alarming rate. Almost 148% percent compared to the same period in 2021.
The number of dengue cases in children over the years have not dropped either. But there is some good news.
We are currently seeing less severe dengue in children and the number of children dying from dengue has also dropped over the last two decades.
Unfortunately, in Malaysia and most of our neighbouring countries, there has been a shift of severe dengue and deaths from children to young adults since the last decade.
Q2: What makes mosquitoes (including Aedes mosquitoes) more attracted to some people over others?
There are a variety of reasons why mosquitoes may be attracted to some people over others.
First, surprisingly, is our skin.
Human skin is host to a variety of microbiota, from non-pathogenic bacteria to fungi that live in our pores and hair follicles.
Mosquitoes are attracted to the chemicals that are created by these microorganisms. This means the more skin bacteria you have, the more mosquitoes you attract.
Second, the presence of carbon dioxide, heat and water vapour.
Mosquitoes are attracted to this specific condition particularly around individuals or groups who may be sweating a lot. Such as after an exercise, for example.
Third is colour. Mosquitoes are attracted to darker colours like black. Those who enjoy dressing in dark colours tend to attract more mosquitoes.
Q3: What is a foolproof, scientifically proven method of preventing our kids from getting mosquito bites?
Unfortunately, a single foolproof and scientifically proven method to prevent dengue doesn’t exist yet.
However, we can lower our children’s chances of being bitten with a variety of methods.
Dengue management methods which have been partially successful so far includes vector control mechanisms such as fogging to reduce the population of adult mosquitoes.
Also, the deployment of Wolbachia infected mosquitoes in selected localities to prevent the breeding of mosquitoes
At home, we also recommend prioritising removal of stagnant water to prevent potential breeding habitats around the house. Using insect repellents and wearing long sleeved clothes are also recommended.
Q4: Why is dengue fever so dangerous, especially for children?
Dengue is incredibly dangerous in children as they can easily get dehydrated if they do not consume enough water and food.
And this is on top of symptoms faced as a result of dengue such as high fever, rashes, and vomiting.
They can also go into shock due to dengue infection or bleed from dengue haemorrhagic fever.
While this can also happen in adults, children are more susceptible owing to their smaller size and lesser blood volume.
Q5: What are the symptoms parents should look out for?
Typically lasting between two and seven days, the most common symptom is fever along with vomiting, rashes, aches and pains.
Other warning signs include bleeding from the nose or gums, vomiting blood or having blood in stool, and feeling tired or restless.
It is important for parents of children who are experiencing symptoms of dengue to seek medical attention immediately.
Q6: There are so many old wives’ remedies for dengue. Is there any truth to these remedies?
More often than not, these old wives’ remedies are aimed at invoking an immune response that may support the body’s fight against dengue.
Rather than relying on these old wives’ remedies alone, it is recommended to support these remedies with healthcare interventions and medicines, which can be prescribed by your doctor.
Fluid therapy and supportive care are usually needed for dengue management.
Q7: Please share your view on myths and facts concerning dengue and its co-infection with COVID-19 in children.
During the peak of the COVID-19 pandemic, many countries documented a decline in dengue cases and deaths except Singapore.
While there were fewer cases, many of the construction sites and other facilities were left unattended, allowing an increase in mosquito-breeding areas.
It is not unexpected that when people started gathering and travelling again that the new population of mosquitoes, some of which carried the virus, will have new victims to choose from.
Co-infection of COVID-19 with dengue fever is rare with two reports in the medical literature among adults, one being in Reunion Island, a French overseas department in the Indian Ocean.
Diagnosis can be confusing but co-infection in children is rare with only one report of a six-year-old.
Q8: What are some preventive measures that parents can take to protect their children?
Controlling the number of mosquitoes inside and outside the home is key.
Dispose of solid waste and keep an eye out for environments that promote dengue breeding (puddles, water storage containers, flower pots) by removing stagnant water collection areas and applying insecticide to prevent breeding of mosquitoes.
Install window meshes to keep mosquitoes out of the home environment.
And to protect from mosquito bites, dress children in light coloured clothing that minimises skin exposure to mosquitoes and apply insect repellent regularly.
Q9: How does a parent care for a child with dengue?
At this point, there is no medicine to treat dengue.
Healthcare interventions are currently the best means of managing symptoms (i.e. painkillers to relieve pain and reduce fever) and other advice is shared to speed up recovery (i.e. hydrate to mitigate the impact of dehydration that may occur as a result of vomiting).
For those battling dengue, symptoms such as high fever, skin itching, bleeding from the nose or gums, restlessness and irritation are common.
For the best chances of recovery, ensure your child get plenty of rest, eat nutritious food to boost immunity and avoid activities that may be strenuous.
Daily blood investigations may be needed to monitor for impending shock or low platelet count.
Q10: Singapore currently employs biological pest control to reduce their Aedes population using Wolbachia-infected mosquitoes. Does Malaysia have something similar? If not, what other methods are we using and how effective are they?
Yes, Malaysia also has its own Wolbachia project, but only in selected areas. The programme shows great promise but only time will tell.
Other efforts for dengue control aim to reduce infection rate through vector control methods.
Things like personal protection, biological control, chemical control and environmental management of mosquitoes.
These existing methods have only been partially effective at controlling dengue infections and have not stopped the increasing incidence of dengue.
We are reliant on the government-funded programme which includes garnering community support through health education activities.
The approaches have not been successful at preventing dengue outbreaks, however.
The creation of a possible dengue vaccine somewhere in the future could prove to be a potential way to reduce infections in the country.
Our target is to achieve zero dengue deaths by 2030.
Source: Prof. Datuk Dr. Zulkifli Ismail, Consultant Paediatrician and Paediatric Cardiologist at KPJ Selangor Specialist Hospital
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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