Dengue in Children: Warning Signs for Pune Parents

When dengue is spreading in Pune, a child with fever is every parent's worry. The hard part is that young children cannot always tell you how they feel, and dengue can turn serious quietly, often just as the fever is settling. As a paediatrician, I want to give you the clear, practical signs to watch for, so you know when you can relax and when you must act.

Most children with dengue recover well at home with rest, fluids and careful watching. This guide covers the symptoms in children, the warning signs that mean hospital now, how much fluid to give, which medicines are safe, and when to call 108. Keep it handy this monsoon.

Dengue symptoms in children

Dengue in children usually begins with a sudden high fever, often with a flushed face, headache, pain behind the eyes, and body ache. Younger children may not describe pain at all; instead they become cranky, sleepy, off their feed, or unusually clingy. Some develop a rash, mild tummy pain, or vomiting. During the monsoon, a fever that lasts more than a day is reason enough to have your child seen and tested rather than waiting and watching.

The warning signs that mean hospital now

The most important thing to understand is timing. The riskier phase of dengue often begins around day three to six, and it can start just as the fever comes down. That is exactly when to watch your child most closely, not to relax. Take your child to a hospital straight away, at any hour, if you notice any of these:

• Severe or worsening tummy pain
• Repeated vomiting, or refusing all fluids
• Bleeding from the gums or nose, or blood in vomit or stool
• Unusual drowsiness or floppiness, or a child who is hard to wake
• Cold or mottled hands and feet, or a very pale look
• Fast breathing, or breathing that looks like hard work
• No urine, or a dry nappy, for six hours or more

Why a fever in Pune gets different questions after the rains start

Dengue here follows the calendar. The mosquito that carries it breeds in small amounts of clean, still water, the sort that collects in a balcony planter tray, an unused bucket on a terrace, a discarded container on a building site, or the drip tray under a water purifier. Once the monsoon settles in, and right through the weeks after the rain has stopped, those little pools sit undisturbed for days at a time. That is why a child who walks in with a sudden high fever in August or September is asked a different set of questions than the same child in March. Nothing about the child has changed, only the season the fever arrived in.

Two practical things follow from that, and both surprise parents. First, this mosquito bites in daylight. School hours, the playground, the walk back in the evening; that is when the exposure happens, so a net over the bed at night on its own does not cover much. Long sleeves and long trousers during the day do more, and so does walking your own balcony and terrace once a week and tipping out anything holding water. Second, in these months we are quicker to ask you to come back and repeat a blood count rather than wait and watch from home. In dengue the reading on day two and the reading on day four can tell very different stories, and it is the direction of travel that guides us, not the first number. A repeat test costs a little. Missing the turn costs a great deal more.

How much fluid should a child with dengue drink?

Fluids are the single most helpful thing you can do at home. Offer small amounts often rather than forcing large drinks: water, ORS, coconut water, diluted juice, soups and milk, and for babies, more frequent breastfeeds. Watch the nappies or toilet trips, because a child who is passing pale urine regularly is usually well hydrated. If your child cannot keep fluids down, or is passing very little urine, treat that as a warning sign rather than something to wait out.

Which medicines are safe, and which to avoid

For fever and discomfort, paracetamol is the only safe choice, in the dose your paediatrician sets for your child's weight. Never give aspirin or ibuprofen, or similar painkillers, when dengue is possible, because they raise the risk of bleeding. Avoid combination fever tablets and old prescriptions. There is no tonic, papaya leaf preparation, or home remedy proven to raise platelets or cure dengue in children, and leaning on them is risky if it delays real care.

When to call 108

If your child shows any warning sign, or simply seems to be getting worse quickly, call 108 for an ambulance or go straight to the nearest emergency department. Do not wait for the next blood report or for morning. Severe dengue in children is very treatable when it is caught early, and prompt hospital care with careful fluids is what keeps children safe.

If your child has a fever this monsoon, our paediatrician at Prudent International Health Clinic in Viman Nagar can examine your child, arrange the right tests, and guide you day by day. We are open all seven days, and walk-ins are welcome.