Exclusive: As Dengue Cases Rise, Expert Shares Advisory On Why Pregnant Women, Children Are At Maximum Risk

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Dengue outbreak in Bengaluru has reached alarming levels. With over 2,000 cases in the city alone; the count in total of Karnataka jumps to 7,362, enforced with six deaths, including one in the city. The situation calls for immediate attention and proactive measures to control the spread and increase awareness among the people.

In an conversation with Boldsky, Dr Vijaya Manohar, MBBS, MD (OBG), Apollo Cradle & Children's Hospital, Bangalore shares why pregnant women and kids are at maximum risk when it comes to dengue and the dos and don'ts they need to follow to keep themselves safe.

What Is Dengue Fever?

Dengue fever is an acute viral illness caused by the dengue virus, which belongs to the Flaviviridae family. There are four distinct serotypes of the virus (DENV-1, DENV-2, DENV-3, and DENV-4), and infection with one serotype provides lifelong immunity to that serotype but not to the others. This means that a person can be infected with dengue up to four times during their lifetime.

This fever is a mosquito-borne viral infection that has become a major public health concern in tropical and subtropical regions around the world. The disease is caused by the dengue virus, which is transmitted primarily by Aedes mosquitoes, particularly Aedes aegypti.

The World Health Organization (WHO) estimates that about 390 million dengue infections occur each year, with significant mortality and morbidity.

This outbreak poses the greatest health risk for Pregnant women and children due to their weaker immune systems. For pregnant women whose immune system is not functioning normally, there is an added risk of developing severe Dengue complications, such as hemorrhage or damage to vital organs in the body.

'It does not only threaten the life of the mother but an important toll on the health of the unborn child. Similarly, children whose immune systems are yet in a developing phase generally become more vulnerable to dengue symptoms,' says Dr Manohar.

Why Pregnant Women Are At Risk

a. Increased Susceptibility to Severe Disease

During pregnancy, a woman's immune system undergoes changes to support the growing fetus. These immunological changes can make pregnant women more susceptible to severe manifestations of dengue, such as dengue hemorrhagic fever and dengue shock syndrome. Severe dengue can lead to significant complications, including bleeding, organ failure, and death.

b. Complications During Pregnancy

Dengue infection during pregnancy can lead to numerous complications. These include preterm labor, low birth weight, and miscarriage. In some cases, severe dengue can cause maternal mortality. The risks are higher if the infection occurs during the third trimester.

c. Vertical Transmission

There is a risk of vertical transmission of the dengue virus from mother to baby, particularly if the mother is infected close to the time of delivery. This can result in neonatal dengue, where the newborn may present with fever, irritability, and in severe cases, hemorrhagic manifestations.

d. Increased Risk of Pre-eclampsia

Some studies suggest that dengue infection can increase the risk of pre-eclampsia, a pregnancy complication characterized by high blood pressure and damage to other organs, most often the liver and kidneys. This can pose serious health risks to both the mother and the fetus.

Why Children Are at Risk

a. Immature Immune System

Children, especially those under the age of five, have an immature immune system that is not as effective at fighting off infections as that of adults. This makes them more vulnerable to the dengue virus and its severe forms.

b. Higher Risk of Severe Dengue

In children, dengue is more likely to progress to severe forms of the disease, such as dengue hemorrhagic fever and dengue shock syndrome. These severe forms can lead to complications like severe bleeding, organ impairment, and even death if not treated promptly.

c. Difficulty in Diagnosis

Diagnosing dengue in children can be challenging as the symptoms often overlap with those of other common childhood illnesses like flu and other viral infections. This can lead to delays in diagnosis and treatment, increasing the risk of complications.

d. Nutritional Factors

Malnutrition, which is more prevalent among children in dengue-endemic areas, can exacerbate the severity of dengue. A well-nourished child has a better chance of fighting off infections, whereas malnourished children are at higher risk of severe disease and complications.

Dos And Don'ts for Pregnant Women & Kids

Dos

● Use mosquito repellent on exposed skin with lower concentrations (usually around 10-30%) contains DEET.

● Wear protective clothes that cover your arms and legs. It reduces skin exposure to mosquitoes.

● Sleep under mosquito nets, especially during daytime naps.

● Hydration is crucial. Drink plenty of fluids. In case one is infected, it will help control symptoms.

● Regular maintenance of containers, such as flower pots, tires, and bird baths, is important to avoid mosquito breeding, especially Aedes mosquitoes that can spread Dengue.

Don'ts

● Try and avoid outdoor activities in the wee hours of the night or very early morning. This is the prime time for mosquitoes to be out.

● Seek immediate medical care if anyone shows symptoms typical of the Dengue virus, such as high fever, headache, pain behind the eyes, muscle pains, and joint aches along with skin rashes. Early intervention can greatly improve treatment outcomes and prevent complications.

● All drugs should only be taken under the administration of a doctor.

● Sensitize community-wide efforts. Organize groups in the community to clean stagnant water bodies. Emphasis should be given to areas where the Aedes mosquitoes breed.

● Educational campaigns through mass media as well as in the community should be carried out to sensitize people on the prevention of Dengue, its manifestations, and its symptoms.

Prevention Of Dengue

Preventing dengue involves controlling the mosquito population and minimizing exposure to mosquito bites. Key preventive measures include:

1. Eliminating Breeding Sites: Regularly emptying, cleaning, or covering containers that can hold water helps reduce mosquito breeding sites.

2. Using Insect Repellents: Applying mosquito repellents on exposed skin and clothing can help prevent mosquito bites.

3. Wearing Protective Clothing: Wearing long-sleeved shirts, long pants, socks, and shoes can reduce skin exposure to mosquito bites.

4. Installing Screens: Using screens on windows and doors, and sleeping under mosquito nets can help keep mosquitoes out of living spaces.

5. Community Efforts: Community-wide initiatives to control mosquito populations, such as fogging and larviciding, can be effective in reducing the risk of dengue transmission.

Dengue fever is a significant public health concern, particularly in tropical and subtropical regions.While there is no specific cure for dengue, supportive care and preventive measures can significantly improve outcomes and reduce the risk of severe complications.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.