KUALA LUMPUR: While the Covid-19 pandemic has been on everyone’s mind over the past two years, another threat of much older origin remains a huge concern on the public health radar: dengue fever.

It is a challenge to diagnose dengue due to its overlapping symptoms with Covid-19, and their co-circulation has caused delays in diagnosis and untimely management.

Consultant Paediatrician at KPJ Damansara Specialist Hospital Datuk Dr Musa Mohd Nordin said it is crucial for parents to filter out the noise about dengue and to know the facts in order to protect their children.

Among others, common myths about dengue such as one cannot get infected with dengue and Covid-19 at the same time, and dengue is not as dangerous as Covid-19, need to be debunked.

“Due to the global magnitude of Covid-19, dengue seems insignificant next to it. Dengue and Covid-19 cases can either be mild or can cause severe illness that leads to death.

“About one in 20 dengue patients will develop severe dengue which can cause Dengue Haemorrhagic Fever and Dengue Shock Syndrome leading to internal bleeding, organ damage, or even death, if not treated promptly and appropriately. Furthermore, children under the age of 15 are more susceptible to severe dengue,” he said.

Dr Musa said as Malaysia is one of the countries with both dengue and Covid-19 circulating at the same time, it has increased the chances of a co-infection, making it possible for an individual to get infected with dengue and Covid-19 at the same time.

Furthermore, he said the symptoms for both Covid-19 and dengue are similar and overlapping, therefore, differential diagnosis is harder.

“The co-infection of dengue and Covid-19 has been associated with severe complications and death, thus, quick intervention is necessary.

“It is important for parents to be able to recognise common symptoms of dengue and/or Covid-19 and take note of them to provide healthcare professionals with as many details as possible, enabling a more accurate and timely diagnosis,” he said.

Contrary to popular belief, one dengue episode will not provide a lifetime of immunity from the disease, Dr Musa said as there are four dengue virus (DENV) serotypes or variants: DENV-1, DENV-2, DENV-3, and DENV-4, which means a person can be infected by all four serotypes in their lifetime.

“Being infected with one serotype can provide lifelong immunity to that specific variant but it will not provide immunity against any of the other variants,” he said, adding that a second dengue infection may be even worse as the immune system overreacts, causing a more serious form of dengue.

According to Dr Musa, there is a risk of getting infected with dengue indoors and outdoors where Aedes mosquitoes live.

“During the first week of infection, dengue virus is found in the blood of an infected person. If a mosquito bites an infected person, the mosquito becomes infected and the infected mosquito can spread the virus to other people through bites.

“If a family member is bitten by an infected mosquito at home, others are also at high risk of being infected. Therefore, it is important to avoid mosquito bites indoors to protect the family from getting dengue,” he said.

On public service announcements and advertisements showing mosquitoes with stripes on their legs and bodies as identifiers for Aedes mosquitoes, Dr Musa said not all Aedes mosquito bites put one at risk of getting dengue.

He said while it is true that Aedes mosquitoes are the vector that transmits the dengue virus (DENV), a person can only get infected if the mosquito had already bitten someone else who has the virus.

Regardless, one can never tell if a mosquito is infected, hence, it is crucial to take preventive measures against mosquito bites which include removing any stagnant water that can be a breeding site for Aedes mosquitoes, using a mosquito net over children’s beds, ensure children wear light-coloured clothes as dark tones are more attractive to mosquitoes, and apply child-safe mosquito repellent on uncovered skin, he said.

On the common misconception that planting lemongrass is enough to repel Aedes mosquitoes, Dr Musa agreed that while lemongrass contains citronella, a compound that masks carbon dioxide and lactic acid scents that mosquitoes look for, and is traditionally used as a natural mosquito repellent, the plant in its natural state can only provide limited protection.

“A study has shown that citronella grass extract in the form of essential oil can provide some degree of effective protection against Aedes mosquito bites, albeit for a short time.

“However, applying undiluted essential oils to children can be toxic and cause allergic reactions. When using mosquito repellent, it is advisable to follow the instructions and seek for healthcare provider’s advice if there are any concerns,” he said.

Dr Musa said that having a better understanding of the disease could help parents to protect their children from becoming infected with dengue and parents could speak to their healthcare providers for further information on dengue and effective preventive measures. - Bernama

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