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  • Writer's pictureRuth Kvistad

Dengue and Early Childhood Protocols

As early childhood professionals, safeguarding the health and well-being of the children under our care is of utmost importance. Recently, Puerto Rico has been grappling with a concerning spike in dengue cases, prompting health authorities to declare an epidemic. This declaration serves as a wake-up call for us to heighten our awareness and take proactive measures to protect the vulnerable children in our care from this potentially life-threatening disease.

According to a recent article by ABC News, Puerto Rico is experiencing a significant spike in dengue cases, leading health officials to declare a state of epidemic. This situation demands our attention, as young children are particularly susceptible to the complications of dengue fever.

What is Dengue Fever? 

Dengue fever, transmitted primarily by the Aedes mosquito, is a flu-like disease that can pose a serious threat to the health of young children. Symptoms can range from mild fever and body aches to more severe manifestations such as hemorrhagic fever (a type of disease that interferes with the blood’s ability to clot, and therefore, affects the performance of many organs), which can be fatal if not promptly treated. With no specific treatment available, prevention is our strongest defense against the spread of this disease.  

About 1 in 4 people with dengue will develop symptoms. If you do show symptoms, they will usually begin 4–10 days after being bitten by an infected mosquito and last for 2–7 days.  


Symptoms of dengue may include: 

  • A sudden high fever, of up to 104°F  

  • Severe headache 

  • Pain behind the eyes 

  • muscle and joint pains 

  • Nausea 

  • Vomiting 

  • Swollen glands 

  • Skin rash  

Young children with dengue may act more irritated than normal and may show changes in appetite and sleep. Dengue can progress quickly from mild to severe and one of the most at-risk groups is young children. The only way to confirm dengue infection is through clinical testing.

Prevention: 

Implementing measures to control mosquito populations in and around early childhood settings is crucial. Regular inspection and elimination of potential breeding sites, such as stagnant water sources, can significantly reduce the risk of mosquito bites. Keep areas clean, empty buckets, keep containers stored upside down to prevent accumulation of water, and clear clogged drains and gutters. 

Educating staff, parents, and caregivers about the signs and symptoms of dengue fever is essential for early detection and prompt medical intervention. Encouraging families to practice preventive measures, such as using insect repellent and dressing children in protective clothing, can further mitigate the risk of mosquito bites, especially in areas experiencing outbreaks.

Some practical solutions to avoid mosquito bites recommended by UNICEF include: 

  • Avoid going outside during peak mosquito activity. (You’re most likely to be bitten during 2 hours after sunrise and just before sunset.) 

  • Wear loose clothing that covers your arms and legs. 

  • Wear socks and full shoes to minimize exposed skin. 

  • Use mosquito repellents on exposed skin (DEET based repellents are the most effective). Follow the instructions on the product label. 

  • Spray mosquito repellent around buildings.  

  • Use mosquito coils. 

  • Use mosquito nets when sleeping – especially during the day.  

  • Use air conditioning, if available. If not available, keep windows and doors closed, or use mosquito nets. 

  • Use door and mosquito screens to keep mosquitoes outside. Repair any holes in screens. 

Keep these tips in mind for protecting young children specifically: 

  • Place a properly fitted mosquito net or screens over the baby's crib, stroller, or play area to create a protective barrier. 

  • Dress children in long sleeves, long pants and socks, to minimize exposed skin. 

  • Use an age-appropriate mosquito repellent recommended by a healthcare professional. (Products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) should be avoided on children under 3 years old.) 

  • Limit outdoor activities during dawn and dusk when mosquitoes are most active. 

Protocol for ECE Professionals: 

In the event of suspected cases of dengue fever, early childhood professionals should follow established protocols for reporting and seeking medical attention. Prompt diagnosis and appropriate supportive care can make a significant difference in the outcome for affected children.

The dengue epidemic in Puerto Rico serves as a stark reminder of the importance of vigilance and proactive measures in protecting young children from mosquito-borne illnesses. By working together and prioritizing the health and safety of the children in our care, we can effectively combat the threat of dengue fever and create safer environments for the little ones in our care.

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