How to Know if a Child’s Fever is Dengue or Chikungunya
Dr.ASM. Mahamuduzzaman
This is a season of fever, with cases spreading rapidly from home to home. When a child develops a fever, parents often grow anxious—is it dengue, chikungunya, or just a common viral fever?
It’s important to remember that both dengue and chikungunya are viral illnesses. Their early symptoms can look very similar to other viral fevers, and in most cases, doctors rely on physical examination and symptom patterns to make a diagnosis.
♦️How to Identify?
Dengue: Typically causes fever along with headache and muscle pain. A skin rash usually appears after three to five days. In some cases, complications such as minor bleeding from the nose or conjunctiva (the thin, clear membrane covering the eye) may occur.
Chikungunya: Fever is accompanied by intense joint or bone pain, sometimes with swelling of the joints. A red rash often appears early in the illness, unlike dengue, where the rash is delayed.
♦️Blood tests may also help: chikungunya often shows a drop in lymphocytes (a type of white blood cell), while dengue may show a decrease in platelets. Dengue can also cause hemodynamic problems such as plasma leakage, rising hematocrit, or low blood pressure. Antigen tests are useful in the early stages of dengue, while antibody tests are done later. However, a negative test result does not rule out the disease completely. Greater attention should be given to symptoms and warning signs.
♦️Treatment and Care
The treatment approach for dengue and chikungunya is nearly identical:
• Ensure plenty of fluids and proper nutrition.
• Use paracetamol to reduce fever (avoid other painkillers).
• Continue breastfeeding if the child is nursing.
• Provide simple, easily digestible, and nutrient-rich foods in small, frequent portions.
• Encourage rest and monitor closely.
♦️ Seek immediate medical attention if you notice:
• Low blood pressure or weak pulse,
• Extreme tiredness or drowsiness,
• Signs of dehydration,
• Any bleeding,
• Vomiting & abdominal pain.
Sponging the body may help with fever, and warm compresses can relieve joint pain. Antibiotics are not effective, as these are viral diseases. With proper care, most children recover at home, though hospitalization may be needed if complications develop.
♦️Important to Remember
Flu and other viral fevers are also common during this season. If fever is accompanied by a blocked nose, cough, or sore throat, it may simply be flu.
Therefore, there is no need to panic if a child develops a fever. Whether dengue, chikungunya, or flu, the care process is almost the same. As long as there are no complications, home management is usually sufficient—just keep monitoring blood pressure and watch carefully for warning signs.
The writer is a Assistant Professor (Department of Pediatrics) Shaheed Suhrawardy Medical College & Hospital, Dhaka.
