PE31.13 | Vector Borne Fever — Summary & Reflection

KEY TAKEAWAYS

Vector-borne fevers at a glance:

• Dengue (DENV 1–4, Aedes aegypti): fever + headache + retro-orbital pain + rash; CRITICAL PHASE at defervescence — plasma leakage; WARNING SIGNS = abdominal pain, persistent vomiting, hepatomegaly >2cm, rising Hct + falling platelets, mucosal bleed, lethargy; treat with paracetamol + judicious IV fluids; NO aspirin/NSAIDs; NO prophylactic platelet transfusion

• Chikungunya (alphavirus, Aedes): incapacitating symmetrical polyarthralgia (distinguishing feature); fever lasts 3–4 days; joint pain persists weeks; supportive management (NSAIDs only AFTER dengue excluded)

• Malaria (Plasmodium, Anopheles): cyclic fever paroxysms; splenomegaly; P. falciparum = ACT (artemether-lumefantrine); P. vivax = chloroquine + primaquine 14 days (G6PD test FIRST); severe falciparum = IV artesunate + glucose correction

• Scrub typhus (Orientia, Leptotrombidium mite): eschar + fever + rash; treat with doxycycline 7 days (azithromycin if <8 years); dramatic fever resolution within 24–48 hours confirms diagnosis

• Safety essentials: No aspirin in dengue; no primaquine without G6PD testing; no chloroquine for P. falciparum in India

REFLECT

Dengue, malaria, chikungunya, and scrub typhus each peak during or after the monsoon season in India — a predictable annual cycle that should enable proactive clinical preparation. Reflect on the public health dimension of these diseases: what does the continued burden of vector-borne fevers in urban India (where Aedes mosquitoes breed in stagnant water in flower pots and air-conditioner drip trays) tell you about the intersection of urbanisation, climate, and infectious disease? As a future paediatrician, how would you integrate vector control counselling into every clinical encounter during the monsoon season — not just for the child being treated, but as a community intervention that extends beyond the clinic walls?