Dengue suspected in death of 4-year-old child

A 4-year-old boy in St. Vincent and the Grenadines died around midday Friday, two days after being treated at a public healthcare facility for suspected dengue infection.

A source with knowledge of the case told iWitness News that the child had been treated at a polyclinic then discharged.

While dengue, a mosquito- borne viral disease, has not been confirmed as having caused or contributed to the death of the child, the death comes as the nation is in the midst of a dengue outbreak that has largely affected children and teen.

Spike in cases

On Sept. 2, the number of laboratory confirmed cases of dengue stood at 184, up from 74 just one week earlier, on Aug. 25.

“So we see that over the last week or so we’ve had quiet a significant increase in the number of laboratory confirmed cases,” Tamara Bobb, an epidemiologist at the Ministry of Health told VC3’s Round Table Talk.

Bobb said that as of the date of the show, Sept. 2, 62% of the reported cases had been hospitalised.

 “In terms of dengue haemorrhagic, we have just recorded about one, one or two cases. So I would say the major have been mostly mild,” she said, adding that no death had been recorded thus far.

“To date, we have noted quite a few infections in children,” Bobb said. “… we have as young as 1 month old. Zero to 15 years old, we have about 45% of the cases are in that particular age group,” Bobb said.

She ntoed that school had been closed fror an extended period — from March to September – because of the COVID-19 pandemic.

“We have been encouraging persons to stay at home. But the thing is, the mosquito loves to be around the home, it loves to be wherever there is fresh water.

“So our children are at home but they are at risk now because they are around the mosquito for longer periods of time so there is more opportunity for them to get bitten,” Bobb said.

Children more at risk

Speaking on the same programme, physician Jerrol Thompson, an infectious disease expert, said that children are more susceptible to dengue.

He said he was happy that children were returning to school after a long break as a result of the COVID-19 pandemic.

“I am glad that they are going to get their temperature taken and so forth because that’s the way in which we are going to pick this up and early cases,” Thompson said.

“The thing is that this is different from COVID where being [in the presence of] somebody you could pass it on,” he said.

[With dengue,] it is a mosquito that’s doing that job and that’s the whole thing. How do you prevent the mosquito from affecting you and how do you get rid of it in your environment?”

The last major dengue outbreak in SVG was in 2014, when there were about 240 cases.

Thompson said he is convinced that most of the nation’s young children have not been exposed to previous outbreaks and are, therefore, more susceptible. 

“They wouldn’t have any antibodies, they wouldn’t have any immunity, protection for this,” he said.

“And they are running round in short pants, in shirts and so forth and I think they are at greater risk in this regard and they have to be protected in a much more intensive way,” Thompson said.

Preventative measures

Meanwhile, Shanika John, health promotion officer in the Ministry of Health told the show that the Vector Control Unit has been fogging against mosquitos and had been focusing on schools as children were preparing to return to the classrooms.

“But a lot of the messages we are publishing right now for the preventative aspect is that we want persons to pay attention to their immediate surrounding,” she said.

“Within a community, if each individual, if each household could pay attention to what is around them, that could also help. So, we want persons to look for any sort of container, any sort of tyre that can keep water that is out of your control. We want you to tip it over and empty it of the water and if you don’t need it, toss it out at your next garbage collection period.

“And if we continue to do that more on an individual level, then it would have an effect on the general community setting.”

John said that her ministry is encouraging homeowners to have conversations with their neighbours.

“If you have a neighbours who are not compliant, to see how best you can assist in that area as well.”

She said that the use of mosquito repellents and wearing of long clothing can help protect against mosquito bites.

What is dengue?

The World Health Organization says that dengue is a mosquito-borne viral disease, transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus.

These mosquitoes are also vectors of chikungunya, yellow fever and Zika viruses.

Dengue causes a wide spectrum of disease. This can range from subclinical disease  — people may not know they are even infected — to severe flu-like symptoms in those infected.

Although less common, some people develop severe dengue, which can be any number of complications associated with severe bleeding, organ impairment and/or plasma leakage.

Severe dengue has a higher risk of death when not managed appropriately.

Dengue haemorrhagic fever

The United States Centers for Disease Control and Prevention says that some patients with dengue fever go on to develop dengue haemorrhagic fever (DHF), a severe and sometimes fatal form of the disease.

Around the time the fever begins to subside (usually 3–7 days after symptom onset), the patient may develop warning signs of severe disease.

Warning signs include severe abdominal pain, persistent vomiting, marked change in temperature (from fever to hypothermia), haemorrhagic manifestations, or change in mental status (irritability, confusion, or obtundation).

The patient also may have early signs of shock, including restlessness, cold clammy skin, rapid weak pulse, and narrowing of the pulse pressure.

Patients with dengue fever should be told to return to the hospital if they develop any of these signs.