Severity Of Dengue Among Different Age Groups

Friday, 23/09/2016

We all know about the widespread disease called Dengue (pronounced as den-guee, more emphasis on the “e” at the end) . Dengue has some major effects on our society’s health and has created a havoc regarding hygiene. Knowing about the causes isn’t enough. Dengue has attacked all age groups around the world and therefore, the severity of it among different age groups is important to be discussed. Observations and tests on different age groups have thrown some light on how much it affects a person based on their age and immune system. Below are the observations on the severity of Dengue.

When it comes to the severity of Dengue, a well-known risk factor is the age at which the person gets infected with the disease. It is known that differences in clinically apparent Dengue vary by the age of individuals. It has been observed that pre-school children and infants have more often undifferentiated illnesses. While pre-adolescent children tend to develop a fever, younger children tend to have Dengue Haemorrhagic Fever (DHF). They are known to experience more severe clinical outcome than adults. It is because of the development of the immune system and the tenderness of the same.

Let’s get into the details of each age group, with the issues and severity associated with this.

1. Severity Amongst Infants and Children

To define the age-related difference in the severity of Dengue among the people, the presence of DHF/DSS as defined by the WHO along with the four severe manifestations— shock, plasma leakage and thrombocytopenia is to be detected.

• If the patients did not have one or more of these manifestations, they were considered to suffer from DF. After observations, it was noted that the presence of these symptoms was more prevalent in the younger population.
• The burden of Severe Dengue was found majorly in infants 4-9 months of age and in children 5-9 years old. There are four serotypes of the virus that cause Dengue- DEN-1, DEN-2, DEN-3 and DEN-4. The secondary DEN infection was found to be a risk factor for severity in children.
• On the other hand, the presence of internal hemorrhage was more prevalent in older people.
• Also, the signs of thrombocytopenia varied among the age groups with 45% in infants, 30% in children and almost 20% in adults.
• Those at an older age are more likely to develop Symptomatic Dengue than the younger population for both primary as well as the secondary infections. The proportion of Symptomatic patients among the total infected population was below 7% for those below 10 years of age for both primary and secondary infections and about 8–11% for those 20 years of age.

2. Severity Amongst Elderly

When it comes to the elderly, they were more likely to have hepatomegaly and malaise/lethargy. Diagnosis in the elderly may be challenging due to atypical symptoms.
• The older population is more likely to have morbidities that include Diabetes, Hypertension, Chronic Renal Impairment and Chronic Obstructive Pulmonary Disease.
• Elderly patients have worse outcomes compared to the younger population with increased rates of DHF and SD. Elderly patients have higher rates of HAI (Hospital Acquired Infection), therefore making them prone to infection-related mortality.
• On the other hand, the adults tend to have more mucosal bleeding. Notably, the elderly stay in the hospitals longer and tend to suffer more Pneumonia and even urinary infection.

It would be best to read about how to prevent dengue and avoid it, not only in children and infants but also adults. As prevention will always be better than cure.