Background Dengue fever (DF) infects between 50 and 100 million people each year. Local DF transmission was first reported in Europe in 2010 and WHO now warns of a possible DF outbreak in Europe.
DF is usually self-limiting in the population (overall mortality rate of <1%.) However, 90% of patients with dengue haemorrhagic fever (severe dengue) are under 15 years old. The initial presentation of both is similar in children. Mortality rate in severe dengue is 2.5%.
Aim To describe DF presentation in a child cohort
Method During an 8 week period, data were collected for 19 children diagnosed with DF and included demography, previous dengue infection, clinical presentation and time interval between symptom onset and admission.
Results All children with DF were under 15 years old. None had previous episodes, complications or progression to dengue haemorrhagic fever. 74% of children were living in red flagged areas when symptoms occurred. Close contacts with a recent DF diagnosis were identified in 37%. Pyrexia was a first symptom in 84%. Other symptoms included rashes (42%), cough (37%), loss of appetite (37%), vomiting (37%), dizziness (37%) and headache (37%), as well as 14 other symptoms of lower frequency. An average of 5 days separated initial symptoms and admission.
Conclusion In considering differential diagnosis in children presenting in Europe with non-specific symptoms such as those found in this study, the possibility of DF should not be omitted. A travel and contact history is even more important if this potentially serious infection is to be recognised.
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