Dengue Fever in Children: Warning Signs Every Hyderabad Parent Must Know

Every year between July and November, dengue cases spike sharply across Hyderabad. Children are especially vulnerable — their symptoms can be less obvious, and they can become severely dehydrated far faster than adults. Knowing what to watch for could save your child's life.

What Is Dengue?

Dengue is a viral infection spread by the bite of the Aedes aegypti mosquito — a small black-and-white striped mosquito that breeds in small amounts of clean, still water. It bites during the day, especially early morning and late afternoon.

There are four types of dengue virus (DENV 1–4). A child can get dengue more than once — and the second infection is often more severe than the first.

Dengue Symptoms in Children

In older children and teenagers, the classic dengue symptoms include:

• Sudden high fever (39–40°C) — often called "breakbone fever" due to severe body aches
• Severe headache and pain behind the eyes
• Muscle pain and joint pain
• A red rash on the skin (often appears after the fever starts)
• Nausea, vomiting, and loss of appetite

In younger children and toddlers, dengue may show as fever, irritability, refusal to eat, or crying without an obvious reason. The classic body ache complaints are often not expressed by young children.

If your child has a sudden high fever during monsoon season — especially between July and November — assume dengue until tested otherwise.

Danger Signs: Go to Emergency Immediately

These are the dengue warning signs that require immediate hospital care. Do not wait:

• Severe abdominal pain or tenderness
• Persistent vomiting (3+ times in a day, cannot keep fluids down)
• Bleeding from the nose, gums, or in the stool
• Blood in vomit
• Extreme sleepiness — child cannot be woken normally
• Rapid or laboured breathing
• Fever that breaks suddenly but child becomes worse, not better
• Child appears pale, cold, or clammy

These signs suggest the child may be entering severe dengue — which includes dengue haemorrhagic fever and dengue shock syndrome. Both are life-threatening emergencies.

How Is Dengue Diagnosed?

Following WHO and IAP dengue guidelines, the tests we use are:

• NS1 Antigen test — detects the dengue virus directly, in the first 1–5 days of fever. Most accurate when done on day 1–3.
• Dengue IgM/IgG antibody test — becomes positive from day 5 onward
• Complete Blood Count (CBC) — a falling platelet count and rising haematocrit (blood concentration) are the key markers of dengue severity

Do not wait until the platelet count drops very low. Early diagnosis means we can monitor closely and prevent complications.

Treatment: What You Should and Should Not Do

What to do:

• Give plenty of fluids — ORS, coconut water, or diluted fruit juice frequently
• Give paracetamol only for fever — check the dose for your child's weight
• Monitor for danger signs every few hours
• Come back for repeat CBC as advised by your doctor

What to NEVER do in dengue:

• Never give aspirin, ibuprofen (Brufen), or diclofenac — these increase the risk of serious bleeding in dengue
• Never give antibiotics — dengue is a viral illness and antibiotics do not help
• Never delay seeking care if danger signs appear

How to Prevent Dengue at Home

• Remove any stagnant water around your home — flower pots, tyres, roof tops, buckets
• Use mosquito nets especially during daytime sleep (Aedes bites during the day)
• Apply mosquito repellent (DEET or picaridin-based) on your child's exposed skin
• Use full-sleeved clothing in the mornings and evenings

"Never give Brufen (ibuprofen) for fever during monsoon season in Hyderabad — if it turns out to be dengue, it increases the risk of life-threatening bleeding. Paracetamol is the only safe fever medicine during dengue."

Sri Anand Child and Neuro Center, Chanda Nagar provides rapid NS1 antigen testing, CBC monitoring, platelet tracking, and dengue management for children. Emergency consultations 24/7. Serving Ameenpur, Miyapur, Lingampally, Bachupally, RC Puram and all of western Hyderabad. Call +91 90633 66983.

Medically reviewed by Dr. Sushma B, DNB Paediatrics · Fellowship PICU (IDPCCM). Follows WHO Dengue Clinical Management Guidelines 2024 and IAP dengue management protocols.