Dengue and Chikungunya Infections in Children
Dengue and Chikungunya are two important mosquito-borne acute febrile illnesses in children. With increased urbanization and newer strains of chikungunya virus with improved transmission with Aedes albopictus, the at-risk population for these infections has greatly increased. Dengue fever has been classified by WHO as dengue with/ without warning signs and severe dengue. Severe dengue is associated with hemorrhagic manifestations, hypovolemia and hypotension secondary to third space loss due to capillary leak or severe end organ dysfunction. NS1 antigen detection and dengue polymerase chain reaction, [polymerase chain reaction (PCR during first 5 d)] and IgM for dengue (6th day of fever onwards) are commonly utilized diagnostic tests. Appropriate fluid therapy with timely tapering of intravenous fluid rate with hematocrit, treatment of hemorrhagic manifestations and clinical monitoring are the mainstay of dengue treatment. Chikungunya has less severe course with shorter febrile phase with prominent and persistent joint symptoms. PCR and IgM against chikungunya are appropriate investigations. Treatment is supportive for chikungunya infection with appropriate joint pain relief.
KeywordsDengue Chikungunya Hemorrhagic fever Tropical infections Aedes
ND contributed in formulating and writing the manuscript. SKK and RL contributed by formulating the plan, supervising and modifying the manuscript. RL will act as guarantor for this paper.
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- 4.Sellahewa KH. Pathogenesis of dengue haemorrhagic fever and its impact on case management. ISRN Infect Dis. 2013; Article ID: 571646, 6 pages. https://doi.org/10.5402/2013/571646.
- 6.Kabra SK, Juneja R, Madhulika, et al. Myocardial dysfunction in children with dengue haemorrhagic fever. Natl Med J India. 1998;11:59–61.Google Scholar
- 7.Pothapregada S, Kamalakannan B, Thulasingam M. Role of platelet transfusion in children with bleeding in dengue fever. J Vector Borne Dis. 2015;52:304–8.Google Scholar
- 10.Dengue: Guidelines for diagnosis, treatment, prevention and control: new edition. Geneva: World Health Organization; 2009. Available at: http://www.who.int/iris/handle/10665/44188. Accessed 13 May 2018.
- 14.Handbook for Clinical Management of Dengue. World Health Organization & UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases; 2012. Available at: http://www.who.int/iris/handle/10665/76887. Accessed 13 May 2018.
- 19.Kabra SK, Jain Y, Kabra M, et al. Role of platelet transfusion in dengue hemorrhagic fever. Indian Pediatr. 1998;35:452–5.Google Scholar
- 25.WHO. Revised SAGE recommendation on use of dengue vaccine. Available at: http://www.who.int/immunization/diseases/dengue/revised_SAGE_recommendations_dengue_vaccines_apr2018/en/. Accessed 23 May 2018.
- 27.Petersen LR, Powers AM. Chikungunya: epidemiology. F1000Res. 2016;5:84.Google Scholar
- 29.NVBDCP. National Vector Borne Disease Control Programme. Available at: http://www.nvbdcp.gov.in/chik-cd.html. Accessed 30 May 2018.
- 32.Guidelines on Clinical Management of Chikungunya Fever. Available at: http://www.wpro.who.int/mvp/topics/ntd/Clinical_Mgnt_Chikungunya_WHO_SEARO.pdf. Accessed 30 May 2018.
- 34.Goupil BA, Mores CN. A review of chikungunya virus-induced arthralgia: clinical manifestations, therapeutics, and pathogenesis. Open Rheumatol J. 2016;10:129–40.Google Scholar