Mosquito-borne diseases can be problematic when travelling in tropical countries with kids. While many seasoned travellers are used to taking malaria into account, it is less well known that dengue fever also poses a risk, even in countries that are malaria-free (such as Singapore). In fact there are already 7,706 new dengue cases reported in Singapore this year. Dr. Niek ter Mors from International Medical Clinic (IMC) Singapore, a family medical centre with a specialisation in travel, tells suitcases&strollers how to avoid dengue when traveling with kids. 

Dengue fever is the most common mosquito borne viral illness in the world. The virus is spread through the bite of the Aedes mosquito. It has two peak periods of biting activity: in the morning for several hours after daybreak and in the late afternoon for several hours before dark. Nevertheless, the mosquito may feed at any time during the day, especially indoors, in shady areas or when it is overcast. In order to prevent dengue fever spreading you must prevent the breeding of its carrier, the Aedes mosquito. It prefers to breed in clean, stagnant water. You can get rid of the Aedes mosquito by frequently checking and removing stagnant water in your premises, such as buckets, flower vases or pots.

Dengue is present in many tropical countries in Southeast Asia, the Indian Subcontinent, the South Pacific, South and Central America, northeastern Australia,the Caribbean and Africa. Unlike malaria, dengue is often transmitted in urban as well as in rural areas.

On the Centre for Disease Control & Prevention website you can find out more about Dengue and its spread around the globe.

On dengue.gov.sg website you can find more information about dengue and its clusters in Singapore.


What Are The Symptoms And Signs of Dengue Fever?

Symptoms usually occur 4 to 7 days after being exposed. These include:

·  Fever

·  Headaches

·  Muscle and joint aches

·  Rash that appears a few days after the onset of fever

·  Bleeding tendency – from nose, gums, and other parts of the body due to low platelets (platelets are one of the blood components which help to clot and prevent excessive bleeding)

·  Bruises from minor knocks and bumps

Generally, younger children and those with their first dengue infection will have a milder illness than older children and adults.


Watch for warning signs as the person’s temperature declines 3 to 7 days after symptoms began. 
Go IMMEDIATELY to an emergency room or the closest health care provider if any of the following warning signs appear:

·  Severe abdominal pain or persistent vomiting

·  Red spots or patches on the skin

·  Bleeding from nose or gums

·  Vomiting blood

·  Black, tarry stools

·  Drowsiness or irritability

·  Pale, cold, or clammy skin

·  Difficulty breathing

The risk of dying from dengue complications is very low; less than 1 to 5% if supportive treatment is given early.


Diagnosing Dengue Fever in Kids

If your child has any symptoms of dengue fever, call a doctor right away. You should also contact a doctor if your child has recently been to a region that has dengue fever and develops a fever or severe headache. To make a diagnosis, the doctor will examine your child and evaluate the symptoms. The doctor will ask about your child's medical history and recent travels and send a sample of your child's blood to be tested for the disease.


How To Treat Dengue Fever

There is no specific treatment or vaccination for dengue. It is usually self-limiting (will resolve in time) and requires supportive treatments with hydration and paracetamol. Aspirin and anti-inflammatory drugs such as ibuprofen should be avoided due to bleeding risk. Regular blood tests are needed to monitor platelets. In serious cases hospital admission may be required for intravenous hydration and closer monitoring.


How To Avoid Dengue Fever

It is advisable to reduce the risk of acquiring dengue by remaining in well-screened or air-conditioned areas when possible, wearing clothing that adequately covers the arms and legs and applying insect repellent to both skin and clothing. The most effective repellents are those containing N,N-diethyl-m-toluamide(DEET). The RID range of insect repellents from Australia is exclusive to International Medical Clinic in Singapore. 

RID, with its active ingredient of DEET, has been proven for decades as most effective in repelling biting insects. IMC carries the Tropical Strength range, which provides up to 4 to 6 hours of protection, while our low irritant Kids RID is suitable for children over 6 months of age and provides protection for up to 2 hours.

For infants below 6 months of age, we have available Permethrin Treatment Kits. Permethrin is a naturally occurring insecticide which can be used safely to treat your infant’s clothes. DEET repellents may be recommended from two months of age but please discuss with your child's doctor.

For more travel tips on treating malaria and other common travel-related medical FAQs see the suitcases&strollers story here

This story was sponsored by International Medical Clinic