Dengue is an infectious viral disease transmitted from person to person by the bite of an infected female mosquito (arbovirosis). The mosquito vector is of the Aedes genus (Aedes aegypti or Aedes albopictus, also known as the tiger mosquito currently found in mainland France). Four different types of dengue virus (DENV-1, DENV-2, DENV-3 and DENV-4), belonging to the flaviviruses (enveloped, single-stranded positive RNA viruses) have been identified.

Most dengue infections in children are asymptomatic or only mildly symptomatic. Signs may appear after an incubation period of around 1 week. These include high fever (39°/40°C), which may be accompanied by chills, headaches (typically retroorbital), muscle aches or digestive signs (abdominal pain, nausea and vomiting, diarrhea). 2-5 days after the onset of fever, the child may develop a maculopapular rash. The risk to the child is moderate and depends on fever tolerance (risk of convulsions or dehydration) and digestive signs (risk of dehydration, pain). This phase lasts 3 to 5 days, after which symptoms disappear, giving way to prolonged fatigue. Rarely (1 %), dengue fever can evolve into a severe form. Risk factors include being between 3 and 5 years old, female and black. Similarly, children who have already had dengue of one type are more likely to develop a severe form of another type. Severe dengue generally begins when the body temperature drops, between day 3 and day 7, and manifests itself either as hypovolemic shock due to capillary leakage (pleural effusions, ascites, hepatomegaly) or hemorrhagic shock due to thrombocytopenia and coagulopathy. Encephalitis, hepatitis and bone marrow failure have also been described. Convalescence from a severe form is marked by a risk of volume overload with pulmonary edema.

Vertical transmission from mother to fetus has been described in women who have developed viremia in the week preceding delivery: the newborn presents a severe form a few days after birth.

When the disease is not severe, treatment is symptomatic: bed rest, hydration and antipyretics (paracetamol). In cases of suspected dengue fever, a blood test is carried out to assess the severity of the disease and make a definitive diagnosis.

A vaccine offers imperfect protection.

Anesthetic implications:

check hydration, blood electrolytes and platelet count.

References : 

-        Gérardin P.
Aspects pédiatriques de la dengue et du chikungunya.
Arch Pédiatr 2010 ; 17 : 86–90

-        Khan AS1, Al Mosabbir A, Raheem E, Ahmed A, Rouf RR, Hasan M et al.
Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: a multicenter hospital-based study in Bangladesh.
BMC Pediatr 2021 ; 21:478 doi.org/10.1186/s12887-021-02947-y

Updated: January 2024