Affiliation:
1. Department of Child (Pediatrics) and Adolescent Health, University of the West Indies
2. Department of Child (Pediatrics) and Adolescent Health (Infectious Diseases), University Hospital of the West Indies, Mona
3. Bustamante Hospital for Children
4. Department of Child (Pediatrics) and Adolescent Health (Neurology), University Hospital of the West Indies, Mona, Kingston, Jamaica
Abstract
Purpose of review
Dengue, chikungunya and zika have caused significant epidemics in the Caribbean in recent years. This review highlights their impact in Caribbean children.
Recent findings
Dengue has been increasingly intense and severe, seroprevalence is 80–100% in the Caribbean, children have increased attributable morbidity and mortality. Severe dengue, especially dengue with haemorrhage was significantly associated with haemoglobin SC disease and multiple organ-systems involved. These included the gastrointestinal and haematologic systems with extremely high lactate dehydrogenases and creatinine phosphokinases and severely abnormal bleeding indices. Despite appropriate interventions, mortality was highest within the first 48 h of admission. Chikungunya, a togavirus, affected 80% of some Caribbean populations. Paediatric presentations included high fever, skin, joint and neurological manifestations. Children less than 5 years of age had the highest morbidity and mortality. This maiden chikungunya epidemic was explosive and overwhelmed public health systems. Zika, another flavivirus, has a seroprevalence of 15% in pregnancy, so the Caribbean remains susceptible. Paediatric complications include pregnancy losses, stillbirths, Congenital Zika syndrome, Guillain–Barre syndrome, acute disseminated encephalomyelitis and transverse myelitis. Neurodevelopment stimulation programs for zika-exposed infants have been effective in improving language and positive behaviour scores.
Summary
Caribbean children remain at risk for dengue, chikungunya and zika, with high attributable morbidity and mortality.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Pediatrics, Perinatology and Child Health
Cited by
3 articles.
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