Dengue and Young Children: A Practical Guide for Singapore Parents

Quick answer: dengue is spread by Aedes mosquitoes, which bite mainly during the day, so prevention is about removing standing water at home and protecting your child from bites. If your child has a fever, see a doctor, use paracetamol rather than ibuprofen or aspirin, and keep fluids going. Watch closely for warning signs such as bleeding gums or unusual drowsiness, especially as the fever starts to come down.

Dengue is part of life in Singapore. Most families know someone who has had it, and dengue alert banners are a familiar sight in many neighbourhoods. For parents of small children it can feel like a constant low-level worry, particularly after a run of wet weather.

The good news is that much of the risk is in your hands. Aedes mosquitoes breed in small amounts of clean standing water, often inside homes or right next to them, and a few minutes of checking each week does more than any spray.

The weekly Mozzie Wipeout

The National Environment Agency asks every household to do the Mozzie Wipeout at least once a week. The steps spell B-L-O-C-K:

• Break up hardened soil in potted plants, so water cannot pool on the surface.
• Lift and empty flowerpot plates.
• Overturn pails and wipe their rims, since eggs can stick to the sides.
• Change water in vases regularly.
• Keep roof gutters clear and place BTI insecticide in them.

Weekly matters because a mosquito can go from egg to adult in about a week. Pick a fixed moment, such as Sunday after breakfast, and make it routine.

Children can help with this, and many enjoy it. A four-year-old can tip out the pail on the balcony and check the dish under the pot plant. It turns a chore into a small job they own, and it teaches them why still water matters.

Other spots worth checking around a flat or house:

• Dish racks and the trays under them.
• Toy buckets and sandpit moulds left outside after rain.
• Pet water bowls, which should be changed daily.
• Scupper drains and anything with a lip that holds rainwater.
• Plastic bags and covers that collect water in their folds.

Protecting your child from bites

Aedes mosquitoes are mainly day-biting, which is exactly when young children are out playing. Some sensible habits:

• Dress for the park. Light, loose clothing that covers arms and legs helps when you are going somewhere green or shady, and it is cooler than people expect.
• Use repellent correctly. Choose a product labelled as suitable for children and follow the age guidance on the pack. KK Women's and Children's Hospital advises that babies under two months should not use DEET repellent. Apply it yourself rather than letting a young child do it, and keep it away from hands that go into mouths and eyes.
• Screen the home. The National Environment Agency suggests mosquito screens on windows and doors.
• Protect daytime naps. A mosquito net over the bed or cot helps, especially for a child who naps at home in the afternoon.
• Check your area. The NEA's myENV app sends notifications about dengue clusters, which is useful for deciding where to play during an outbreak.

What dengue looks like in a young child

In adults, dengue usually means a sudden high fever with a severe headache and aching muscles and joints, sometimes with a rash. Young children are often less obvious. A preschooler may simply have a fever and seem miserable. Babies and toddlers may become more irritable than usual or go off their food, and their sleep is often disrupted.

Because the early signs overlap with so many other childhood illnesses, there is no need to assume every fever is dengue. Any fever in a young child that lasts more than a day or two, or that comes with a rash, deserves a visit to your family doctor, who may order a blood test.

Caring for a child at home

Most dengue cases are mild and are managed at home under a doctor's guidance. There is no specific medicine for the virus itself, so care is about comfort and fluids.

• Paracetamol for fever and pain. KK Women's and Children's Hospital advises avoiding aspirin and other medicines such as ibuprofen, because they can increase the risk of bleeding. Check with your doctor before giving any medicine and follow the dose for your child's weight.
• Fluids in small, frequent amounts. Water counts, and so do milk and soup. KKH's guidance gives a minimum of at least one litre a day for children around a year old or over 10kg, so ask your doctor what your child needs.
• Rest. Books and audiobooks on the sofa are ideal. There is no need to keep a child in bed if they feel like moving around.
• Follow-up blood tests. Platelet counts can be normal in the first few days, so doctors often repeat them. Keep the appointments even if your child seems better.

Warning signs that need urgent care

This is the most important section of this article. Dengue can become serious, and in some children it worsens around the time the fever settles, when parents naturally relax.

Take your child to the hospital emergency department straight away if you notice:

• Bleeding from the nose or gums without injury, or easy bruising.
• Repeated vomiting, or refusing to drink.
• Unusual drowsiness, or difficulty waking.
• Restlessness or irritability that is new and will not settle.
• Severe tummy pain.
• Fast or difficult breathing.
• Skin that feels cold and clammy, or looks very pale.
• Passing very little urine.

Trust your instinct. If your child seems to be getting worse rather than better, go in.

Keeping school and home in step

If your child is diagnosed with dengue, let the preschool know. It helps teachers watch for anything unusual in the class, and it allows the school to check its own grounds. Keep your child home until the doctor says they are well enough to return and the fever has gone.

At Shaws, every child has a temperature check on arrival each morning, along with a look at their hands and mouth, and a child with a fever is sent home until it clears. You can read more about how we handle health checks in our FAQs.

When to seek advice

See your doctor for any fever in a baby under three months, any fever that lasts more than two days in an older child, or any of the warning signs above at any time. If your child has had dengue before, mention it, because a second infection can be more serious.

Shaws Preschool has looked after children across the East Coast and Serangoon since 1989, outdoors every day and with health checks every morning. Come and see how our day runs: book a tour.