Should Your Child See a Doctor?

Mosquito-Borne Diseases From Travel

Is this your child's symptom?

  • Questions about diseases in the tropics that are spread by mosquitoes
  • Includes malaria, yellow fever, dengue fever and chikungunya fever
  • Your child has no symptoms of tropical disease. If your child has symptoms, use other guides. These diseases start with high fevers.
  • Tropical diseases occur in people who travel to or live in high-risk countries. These mainly are developing countries near the Equator. You may have traveled to a high-risk country recently.
  • West Nile Virus is not included in this guide. See the Mosquito Bite guide.

If NOT, try one of these:

How Tropical Mosquito-Borne Diseases are Detected by this Symptom Checker

  • These diseases can't be diagnosed over the phone. But, they can be suspected based on their symptoms. They are then referred to a medical setting where a diagnosis can be made.
  • Malaria will be picked up by the Fever guide. High fevers, prolonged fever and shaking chills will refer the child to be seen. The Headache or Leg Pain guides will also work. Reason: Malaria can also cause severe headache or muscle pain.
  • Yellow fever will be picked up by the Fever guide. High fevers, prolonged fever and shaking chills will refer the child to be seen. The Headache or Leg Pain guides will also work. Reason: Yellow fever can also cause severe headache or muscle pains.
  • Dengue fever will be picked up by the Fever guide. High fevers, prolonged fever and shaking chills will refer the child to be seen. The Headache or Leg Pain guides will also work. Reason: Dengue fever can also cause severe headache, joint pain or muscle pains.
  • Chikungunya fever will be picked up by the Fever guide. High fevers, prolonged fever and shaking chills will refer the child to be seen. The Arm Pain or Leg Pain guides will also work. Reason: Joint pains in the hands and feet are common. So are muscle pains.
  • Travel to a high risk country should raise the concern. However, common diseases that cause fever such as colds also must be ruled out. They occur more commonly in these countries than the serious diseases. But, severe symptoms or symptoms that last too long make us think about these other diseases.

Worldwide Causes of Death in Children Under Age 5

  • 6.3 million children under the age of 5 died in 2013 worldwide.
  • These 5 infections account for over 50% of all early child deaths:
    1. Pneumonia and other respiratory diseases 19%
    2. Diarrhea disease 18%
    3. Malaria 8%
    4. Measles 4%
    5. HIV/AIDS 3%
  • Poor nutrition is a factor in over half who die older than one month of age.
  • Over 80% of deaths occur in Africa and Southern Asia. India accounts for 21% of under-five deaths.
  • More than half are due to diseases that we could prevent or treat.
  • Resource: WHO report, September 2014

Tropical Countries

  • Countries in the tropics are near the Equator. They have hot and humid climates.
  • The tropics are also defined as regions without a cold season.
  • Many diseases in these countries are spread by an insect bite.
  • In the tropics, insects never hibernate. They are present in large numbers year round.
  • Other diseases here are spread by germs that multiply in warm water. The water in the tropics usually stays warm.
  • Tropical diseases occur in people who live in or travel to high-risk countries.
  • Climate change is a factor that has allowed these diseases to spread.

Internet Resources

Call 911 Now (Your Child May Need an Ambulance) If

  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Tropical disease suspected and fever present
  • Tropical disease has been diagnosed and getting worse
  • Tropical disease has been diagnosed and fever returns after gone for several days
  • Tropical disease has been diagnosed and shaking chills return
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent 

Call Doctor Within 24 Hours

  • Tropical disease suspected, but no fever
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Malaria, questions about
  • Yellow fever, questions about
  • Dengue fever, questions about
  • Chikungunya fever, questions about
  • Preventing mosquito bites during travel, questions about

Care Advice

Malaria Questions

  1. What You Should Know About Malaria:
    • It is a parasite disease spread by the bite of mosquitoes. The parasites enter red blood cells and destroy them.
    • World Impact: There are over 200 million new cases per year. It is a leading cause of death in the world. In Africa, one child dies every minute from it. It causes almost 1 million deaths per year.
  2. Symptoms:
    • Bouts of high fever occur every 2 to 3 days.
    • Shaking chills come before the fever.
    • The fever is followed by profuse sweating.
    • Severe headache, muscle pains and feeling very tired is common.
    • Sometimes, jaundice yellow skin occurs.
  3. Cause:
    • Malaria is caused by a tiny parasite protozoan carried by some mosquitoes.
    • Spread is mosquito to human.
    • The disease is carried by an infected mosquito. The mosquito becomes infected when it bites a human infected with malaria. The parasite is then passed on to healthy humans in the spit from a bite. It then enters the person's red blood cells.
  4. Time Period to Get Sick:
    • The time from the bite to symptoms is 5-15 days.
  5. Contagious Period:
    • Person to person spread of the illness does not occur.
    • Kissing or sharing a glass with a person who has malaria is safe.
  6. Tests and Treatment:
    • Blood smears and other blood tests are done to diagnose it.
    • It is treated with Chloroquine and other malaria drugs.
    • For severe symptoms, patients will need care in a hospital.
  7. What to Expect:
    • Patients have good outcomes if treated early.
    • Deaths are highest in infants: up to 3%.
  8. How to Prevent:
    • Use insect repellents such as DEET.
    • Bed nets can help protect you at night during sleep.
    • Malaria drugs are often prescribed before travel to a high risk zone.
    • There is no vaccine to prevent it.
  9. Countries with Malaria:
    • It occurs in Africa, lower Asia, Central and South America. Over 90% of cases occur in Africa. o It does not occur in the US except in travelers coming back. This results in about 1500 US cases per year.
    • For more info and for current high-risk countries, see the CDC website
  10. Call Your Doctor If:
    • You have other questions or concerns

Yellow Fever Questions

  1. What You Should Know About Yellow Fever:
    • It is viral disease spread by the bite of mosquitoes. The virus attacks the liver and kidneys.
    • World Impact: Africa has 200,000 new cases each year. There are over 30,000 deaths each year. Now, it is rare in travelers because of the yellow fever vaccine.
  2. Symptoms:
    • High fevers with shaking chills occur.
    • Other symptoms are severe headache, backache and muscle pains.
    • Jaundice yellow skin is common. Hence, the name yellow fever.
    • If the disease progresses, bleeding from the skin, nose, gums and gut will occur.
  3. Cause:
    • Spread is mosquito to human.
    • The virus is carried by an infected mosquito. The mosquito becomes infected when it bites a human infected with yellow fever. The virus is passed on to healthy humans in spit from a bite.
  4. Time Period to Get Sick:
    • The time from the bite to symptoms is 3-6 days.
  5. Contagious Period:
    • Person to person spread of the illness does not occur.
    • Kissing or sharing a glass with a person who has yellow fever is safe.
  6. Tests and Treatment:
    • Blood tests are needed to diagnose it.
    • Patients need care in a hospital.
    • There are no anti-viral drugs for treating it.
  7. What to Expect:
    • The death rate in people with complications can be high.
  8. How to Prevent:
    • Vaccine: There is a yellow fever vaccine to prevent the illness.
    • Use insect repellents such as DEET.
    • Bed nets can help protect you at night during sleep.
  9. Countries with Yellow Fever:
    • Mostly occurs in Africa.
    • Less common in South America 100 cases per year. Reason: Wide use of the vaccine.
    • It does not occur in the US except in travelers coming back.
    • For more info and for current high-risk countries, see the CDC website.
  10. Call Your Doctor If:
    • You have other questions or concerns

Dengue Fever Questions

  1.  What You Should Know About Dengue Fever:
    • It is a viral disease spread by the bite of an infected mosquito.
    • World Impact: 50 million new infections each year in the world. It causes 20,000 deaths per year.
  2. Symptoms:
    • High fever with shaking chills occurs.
    • Patients can also have severe headache, eye pain, joint pain and muscle pains.
    • Bone pain can be severe.
    • A widespread pink rash is common.
    • If the disease progresses, bleeding from the skin, nose, gums and gut can occur.
  3. Cause:
    • Spread is mosquito to human.
    • The virus is carried by an infected mosquito. The mosquito becomes infected when it bites a human infected with dengue. The virus is passed on to healthy humans in spit from a bite.
  4. Time Period to Get Sick:
    • The time from the bite to symptoms is usually 3-7 days. Sometimes, it can be up to 14 days.
  5. Contagious Period:
    • Person to person spread of the illness does not occur.
    • Kissing or sharing a glass with a person who has dengue is safe.
  6. Tests and Treatment:
    • Blood tests are needed for people with severe disease.
    • Treatment consists of rest and lots of fluids.
    • For severe symptoms, patients need care in a hospital.
    • There are no anti-viral drugs for treating it.
  7. What to Expect:
    • Fever lasts up to 7 days.
    • Symptoms last up to 2 weeks.
    • Most people recover fully.
    • If bleeding occurs, the death rate can be 1%.
  8. How to Prevent:
    • Use insect repellents such as DEET.
    • Bed nets can help protect you at night during sleep.
    • There is no vaccine to prevent it.
  9. Countries with Dengue Fever:
    • It occurs in Asia, Africa, South America and the Caribbean islands.
    • It does not occur in the US except in travelers coming back.
    • For more info and for current high-risk countries, see the CDC website.
  10. Call Your Doctor If:
    • You have other questions or concerns

Chikungunya Fever Questions

  1. What You Should Know About Chikungunya Fever:
    • It is a viral disease spread by the bite of an infected mosquito.
    • World Impact: It is a common disease, but rarely any deaths.
  2. Symptoms:
    • Most common symptoms are fever and joint pain.
    • The joint pain starts in the hands and feet.
    • This can progress to swollen joints.
    • Other symptoms are headache and muscle pains.
    • A widespread pink rash may occur.
  3. Cause:
    • Spread is mosquito to human.
    • The virus is carried by an infected mosquito. The mosquito becomes infected when it bites a human infected with Chikungunya. The virus is passed on to healthy humans in spit from a bite.
  4. Time Period to Get Sick:
    • The time from the bite to symptoms is 3-7 days.
  5. Contagious Period:
    • Person to person spread of the illness does not occur.
    • Kissing or sharing a glass with a person who has chikungunya is safe.
  6. Tests and Treatment:
    • Blood tests are done for people with severe disease.
    • Treatment is mainly rest and lots of fluids.
    • Medicines are given for pain and fever.
    • For severe symptoms, patients will need care in a hospital.
    • There are no anti-viral drugs for treating it.
  7. What to Expect:
    • Most symptoms are gone within a week.
    • In some people, the joint pain can last for months.
    • Deaths are very rare.
  8. How to Prevent:
    • Use insect repellents such as DEET.
    • Bed nets can help protect you at night during sleep.
    • There is no vaccine to prevent it.
  9. Countries with Chikungunya:
    • It is common in Africa and Asia.
    • In 2013, the disease was first reported in the Caribbean islands.
    • It then spread to South America.
    • Does not occur in the US except in travelers coming back.
    • No signs of the disease yet in US mosquitoes.
    • For more info and current high-risk countries, see the CDC website.
  10. Call Your Doctor If:
    • You have other questions or concerns

Mosquito Bites: How to Prevent

  1. Tips to Prevent Bites:
    • Wear long pants, a long-sleeved shirt and a hat.
    • Avoid being outside when the bugs are most active. Mosquitoes are most active at dawn and dusk. Limit your child's outdoor play during these times.
    • Get rid of any standing water. Reason: It's where they lay their eggs.
    • Keep bugs out of the home by fixing any broken screens.
    • If exposed to outside air, use bed nets to protect you during sleep.
    • To prevent mosquito bites, use insect repellents that have DEET. These products work well to protect you from bites. Read the label before using.
  2. DEET Products - Use on the Skin:
    • DEET is a good mosquito repellent. It also repels ticks and other bugs.
    • The AAP approves DEET use over 2 months old. Use 30% DEET or less. Use 30% DEET if you need 6 hours of protection. Use 10% DEET if you only need protection for 2 hours.
    • Don't put DEET on the hands if your child sucks their thumb or fingers. Reason: Prevent DEET from being swallowed.
    • Warn older children who apply their own DEET to use less. A total of 3 or 4 drops can protect the whole body.
    • Put on exposed areas of skin. Do not use near eyes or mouth. Don't use on skin that is covered by clothing. Don't put DEET on sunburns or rashes. Reason: DEET can be easily absorbed in these areas.
    • Wash it off with soap and water when your child comes indoors.
    • Caution: DEET can harm clothing made of man-made fibers. It can also harm plastics eye glasses and leather. DEET can be used on cotton clothing.
  3. Permethrin Products - Use on Clothing:
    • Products that have permethrin such as Duranon work well to repel mosquitos and ticks.
    • Unlike DEET, these products are put on clothing instead of on the skin.
    • Put it on shirt cuffs, pant cuffs, shoes and hats. Can also put it on mosquito nets and sleeping bags.
    • Do not put permethrin on the skin. Reason: Sweat changes it so it does not work.
  4. Call Your Doctor If:
    • You have other questions or concerns

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.