COVID-19 + Dengue in Children?

With the Omicron strain of COVID-19 raging on, and Strain 3 of Dengue having a possibility of becoming the predominant dengue virus strain in Sri Lanka, what would happen if a child is diagnosed with COVID-19 and dengue at the same time? Speaking to Daily Mirror, Dr Channa de Silva, Consultant Paediatric Pulmonologist at the Lady Ridgeway Hospital for Children shared that there is an incidence of children coming in with both infections; COVID-19 and dengue. “When a child is diagnosed as having both; COVID-19 and dengue at the same time, it means there are two viruses in the body and the child is infected with both the viruses. The immune system has to fight both the infections, therefore there is an increased risk developing complications,” Dr de Silva stated. 

He noted that in such cases, there is a risk of the child having a severe form of dengue such as dengue haemorrhagic fever or dengue shock syndrome due to the increased risk of leakage. “If fluid leakage occurs, it will cause fluid to enter body cavities such as chest and abdominal cavities which can reduce blood pressure and tissue perfusion. This can cause the child to go into a shock state. This can occur even at the early stages of the disease,” he shared adding that it was important for children diagnosed with either only dengue, or COVID-19 and dengue to be monitored carefully by the medical professionals. Through monitoring and fluid management, the progression into a severe shock condition can be avoided. In the case of the child going into shock, the body fluid levels will be controlled and maintained to control and minimize the leakage thereby normalizing blood pressure and tissue perfusion.

Dr de Silva also shared that currently there are less severe cases of COVID-19 among children but that there is an increased incidence of severe cases of dengue among children. “For children coming in with either infection or both infections (COVID-19 and dengue) together, the treatment will be dependent on their health condition and complications. Therefore, it is important that when children are unwell, medical attention is sought immediately,” he stated. 

Advice to Parents
If the child presents symptoms of fever and body ache, seek medical advice. If fever persists over 24h, seek immediate medical advice as there is a risk of the condition worsening even at the early stages. 
Do not give any medication to the child without consulting a medical professional. 

+Steroids in medication can reduce immunity resulting in complications while NSAIDs (Non-steroidal anti-inflammatory drugs) taken to reduce fever can cause complications in the case of dengue fever. 
+Avoid antibiotics unless prescribed by a medical professional as it can also result in complications.
Prevention is better than cure. 

+Reduce contact with people, avoid unnecessary gatherings and follow health guidelines regarding COVID-19. Ensure that children wear masks, are following proper hygienic practices such as sanitizing and hand- washing and are socially distancing. “If parents follow COVID-19 protocols properly, children will also follow the protocols properly. This will minimize the chances of children getting infected with COVID-19,” shared Dr de Silva stressing on the fact that parents too can be carriers of the infection and the risk can be minimized if necessary precautionary measures are taken.

+Maintain a clean environment and remove any mosquito breeding places in the surrounding so as to minimize and prevent dengue infections.