Is dengue fever exclusively a pediatric illness?

Is Dengue Fever Exclusively a Pediatric Illness?

No, dengue fever is absolutely not a "kids sickness"—it affects all age groups, though children under 15 years represent the majority of cases in endemic regions and face higher risk of severe disease. 1

Epidemiology Across Age Groups

• While the vast majority of dengue cases occur in children less than 15 years of age in endemic areas, this reflects exposure patterns and population demographics rather than age-specific susceptibility 1
• Dengue affects people of all ages living in tropical and subtropical areas, and the disease can occur from neonatal period through adulthood 2
• The disease has been documented across the entire age spectrum, including neonates who can acquire infection through vertical or horizontal transmission 2

Why Children Are Overrepresented in Case Counts

• Children, particularly those with secondary heterologous dengue infections, are at highest risk for severe dengue disease due to antibody-dependent enhancement 1
• In endemic regions, children accumulate their first and second dengue infections during childhood, making them more visible in case series 1, 3
• The apparent pediatric predominance in published literature reflects where most studies are conducted (endemic areas with high childhood transmission) rather than biological age restriction 3, 4

Clinical Presentation Is Age-Independent

• The core clinical features—fever, headache, retro-orbital pain, myalgia, arthralgia, and rash—occur across all age groups 5
• Warning signs of severe dengue (persistent vomiting, abdominal pain, clinical fluid accumulation, mucosal bleeding, lethargy, hepatomegaly, hematocrit rise with thrombocytopenia) are age-independent indicators requiring immediate attention 6, 5
• The spectrum of illness from mild febrile disease to dengue hemorrhagic fever and dengue shock syndrome occurs in both children and adults 6, 1

Management Principles Are Universal

• Treatment remains supportive across all ages, with emphasis on close hematological monitoring, recognition of warning signs, and appropriate fluid-replacement therapy 1
• Acetaminophen is the recommended analgesic for all age groups, with aspirin and NSAIDs contraindicated due to bleeding risk 5
• The same diagnostic approach applies universally: PCR/NAAT for symptoms within 1-7 days, IgM capture ELISA after 5-7 days 5

Special Considerations by Age

• Neonates can present with dengue fever and require the same critical management strategies as other pediatric patients, including judicious fluid and inotrope use 2
• Pregnant women represent a high-risk population requiring hospitalization due to risks of maternal death, hemorrhage, and vertical transmission 5
• In children, acetaminophen dosing must be carefully weight-based, but the disease itself behaves similarly across ages 5

The bottom line: Dengue is a mosquito-borne disease affecting anyone exposed to Aedes mosquitoes, regardless of age. The misconception that it's a "kids sickness" likely stems from epidemiological data showing higher case numbers in children in endemic areas, but this reflects exposure patterns and immune status rather than age-specific disease susceptibility. 1