As 3,035 cases of dengue has affected children aged between 1-18 in Karnataka till June 2024, doctors on what parents and schools can do.
Published Jul 13, 2024 | 7:00 AM ⚊ Updated Jul 13, 2024 | 7:00 AM
Representative image
In Karnataka, a whopping 3,035 children and minors (aged 1-18) have tested positive for dengue, just in the last six months.
While no health departments in other states have shared age-wise data with the media, doctors warn that children are the most vulnerable group and that parents, caregivers, and schools must be well-prepared and know how to handle and protect children from the viral infection.
“Children spend most of the time at school, travel inside a bus, play on the grass, be in the play area, use toilet space that might have stagnant water, etc. School uniforms tend to be shorts and half shirts most of the time. They commute by bus which would be parked through the night in a parking lot where a lot of mosquitoes might have entered, all this can make them very vulnerable to being bitten by mosquitoes,” explains Dr CN Manjunath, former director of Jayadeva Hospitals in Bengaluru and a BJP MP from Karnataka.
Speaking at a webinar on ‘Dengue Crisis: Are the Southern States Prepared?’ Dr Manjunath said that the schools must take responsibility for clearing any potential spaces where mosquitos can breed. He also said that schools can even think of taking a week’s break and ensure that all such areas in the school are cleared. He further suggested the fumigation of buses that kids travel to school in and the use of mosquito repellant sprays every night when the buses are parked.
Dr. Sivarajani Santosh, a renowned pediatrician from Hyderabad says dengue’s clinical symptoms in pediatric cases are similar. She says high fever, severe headache, muscle and joint pain, rash, nausea and vomiting, fatigue, refusing to feed/eat, and bleeding are some of the symptoms for early detection of dengue.
However, she adds, the government as well as the school management must teach children on not only what dengue fever is and the importance of preventing it but also on how dengue mosquito breeding can occur, places it could happen in, and the reasons why the premises around them must be kept clean.
Along with this, Dr Sivaranjani says the government and schools must make parents aware of warning signs indicating that dengue is becoming severe in their wards. These include symptoms like extreme lethargy, extreme drowsiness, severe pain below the ribs, persistent vomiting, bleeding from the nose or other areas, and noticeable bleeding marks on the body.
Recognising these signs early is crucial for timely medical intervention. A parent should not wait at home for a long time and then bring the child to the hospital.
Upon diagnosis, careful management and supportive care are vital for the recovery of children afflicted with dengue fever. Here are the key steps:
Hydration: Encourage intake of plenty of fluids, including oral rehydration solutions, coconut water, and clear soups to prevent dehydration.
However, Dr Sivaranjani warns of ensuring the kind of fluids that is being given to children for hydration.
She says “The most important thing is that a parent has to be educated about the importance of hydration, what to give and what not to give. Many parents do not know that they must not give sugar loaded glucose water or liquids available in tetrapacks which has similar names like ORS but is not that. ORSL is not the same as ORS,” she warns.
Giving these can aggravate the situation and will not help the child to get hydrated.
Rest: Ensure ample rest to aid the child’s body to recover.
Medications: Administer paracetamol (acetaminophen) for fever and pain relief, while avoiding aspirin and NSAIDs, which can increase bleeding risks.
However, Dr Sivaranjani also adds that, in some cases there could be Macrophage Activation Syndrome (MAS), which is a potentially life-threatening complication that can occur in the context of dengue fever, although it is more commonly associated with autoimmune diseases and other infections. MAS is characterised by an excessive immune response, leading to widespread inflammation and tissue damage.“
In such MAS cases, there might be the need to take immunosuppressants to control the overactive immune response. However, this treatment should be administered under close supervision in an ICU only,” she warned.
Monitoring: The child’s condition should be vigilantly monitored and seek immediate medical help if severe symptoms, such as intense abdominal pain, persistent vomiting, rapid breathing, or bleeding, occur.
Meanwhile Dr Sivaranjani also warned the government to not endorse papaya tablets. She said that a lot of times, officials themselves distribute these tablets and parents tend to give all sorts of alternate medicine to their children. This could be dangerous and lead to gastritis or nephrotoxicity in the child, she added.
Dr Sivaranjani says the best way to prevent mosquito bites in school is to ensure the children are covered completely in dull coloured clothes. “The best approach is to dress children in long-sleeved shirts and long pants with socks. Dull-colored clothing is preferable as bright colours can attract mosquitoes,” she said.
She says, ideally mosquito repellent containing DEET should be applied on exposed skin areas when children are outdoors. However, DEET-containing repellents must be avoided indoors. This can lead to problems.
She also adds, “While mosquito patches are convenient, wearing them indoors can potentially trigger asthma symptoms and may have other long-term effects. Therefore, it is advisable to use these patches with caution and preferably only when children are outdoors.”
(Edited by Neena)
(South First is now on WhatsApp and Telegram)
