DENV-3 Dominance and Paediatric Dengue: A Case Study in Triage, Counselling, and Vaccine Discussion

Which dengue warning signs most reliably justify admission in a child who still looks haemodynamically stable?

Admit a child with suspected dengue if there is any WHO warning sign, even if they are currently haemodynamically stable; the warning signs most likely to justify admission are clinical fluid accumulation, rising haematocrit with a rapid platelet fall, persistent vomiting, and mucosal bleeding because these are more pr

How should I use serial haematocrit and platelet trends to time escalation in a hospitalised child with dengue?

Trend haematocrit serially with the child’s haemodynamic state and urine output, not in isolation; a rising haematocrit with a rapidly falling platelet count is a warning sign for plasma leakage and should prompt closer monitoring and escalation before shock develops. Platelet count alone is a poor trigger for interven

When is a child with suspected dengue safe for outpatient management with daily review?

Manage as an outpatient with daily review only if the child is clinically stable, has no warning signs or severe dengue features, can tolerate oral fluids, has adequate urine output, and the caregiver is reliable for immediate return if deterioration occurs. Admit or escalate if the child is entering the critical phase

How should fluid therapy be down-titrated during the recovery phase to avoid overload in paediatric dengue?

Reduce and stop IV fluids early once recovery is clear; do not continue “maintenance” by default. In a hospitalised child with dengue, down-titrate according to improving perfusion, falling haematocrit, stable urine output, and the end of plasma leakage to prevent reabsorption-phase fluid overload. - Improving haemodyn

Which eligibility factors determine whether a child is a candidate for dengue vaccination?

Use dengue vaccination only in children who meet the vaccine-specific indication; the key filters are age, residence/exposure setting, and for some vaccines documented prior dengue infection. The child is not a candidate if they fall outside the licensed age range, have the wrong serostatus for that product, or have a