Having both experienced Dengue Shock Syndrome (DSS) before, my wife and I never imagined we would have to face this nightmare again. What made it even worse was that this life-threatening condition struck our eight-month-old baby.
A father, Bonardo Maulana, shares the story of when his child, Gatha, suffered from Dengue Shock Syndrome as a warning to other parents.
Chronology of How Our Baby Experienced Dengue Shock Syndrome
In the midst of the Covid-19 pandemic, our family had to face a bitter reality. Our baby had to lie weak in the hospital due to Dengue Shock Syndrome (DSS).
It all began last week, on a bright Thursday (March 12) in South Jakarta, where we live. Our child’s body temperature suddenly spiked after waking up from a nap. Just a few hours earlier, he had been actively playing and had even gone to the community health post (Posyandu) for a weight check.
Previously, his health had been slightly declining. He had a runny nose for almost a week. But throughout the cold, he never once had a fever. So when his body suddenly became hot, we wondered—was this a delayed effect of his cold?
My wife quickly grabbed a thermometer to check his temperature accurately. The result left us shocked. His temperature was 39°C (102.2°F).
Even though he had chills, our child didn’t seem lethargic. He was still energetic and eagerly invited us to play and laugh with him. Even during his early dinner, he was enthusiastic about eating the soft food his mother had prepared.
Sadly, 30 minutes later, he vomited. We were stunned, but not yet alarmed. We grew more concerned when he also vomited the breast milk his mother gave him shortly after that incident.
“If he still vomits after breastfeeding before bedtime, we’ll take him to the doctor,” I told my wife during our usual nighttime feeding routine.
What we feared happened. Our child vomited again after drinking breast milk before bed. It was likely that his entire stomach emptied.
A quarter of our bed—still shared with him—was soaked.
There was no more time to think. We had to decide immediately to go to the hospital. The thought of the Covid-19 pandemic, which had already spread through the city, rushed through our minds. We were extremely worried.
When we arrived at the hospital, the ER was full. Most of the patients were children. We registered with the pediatrician and got queue number two. Even so, we were only admitted an hour later.
The doctor diagnosed the vomiting as a reaction to inappropriate food choices. We were advised to be more careful about what we fed him, avoiding gas-triggering foods like sweet potatoes and legumes.
The doctor also said the fever might be related to the child’s cold. We were given prescriptions for probiotics, anti-nausea medicine, decongestants, and fever reducers.
A Persistent Fever: A Symptom of Dengue Shock Syndrome
Two days later, our child still had a fever. The temperature fluctuated. Sometimes nearing 38°C, sometimes going over 39°C, and at times dropping to 37°C.
“Let’s wait for 72 hours,” said my wife. “If it’s still high, we’ll take him back to the hospital,” she said, visibly anxious.
Before the fever reached the 72-hour mark—on the third day—he began to show other signs.
On Sunday morning around 6 AM, after waking up, his body was weak. Lethargic. He didn’t respond to our calls or other forms of stimulation. He wasn’t eating anymore—let alone breastfeeding.
Throughout his illness, his breastfeeding sessions had already drastically shortened to just 10 minutes. But that morning, he completely refused his mother’s nipple.
We were afraid he was already dehydrated. Around 10 AM, we rushed him back to the ER at the Duren Tiga hospital.
Unfortunately, we were told to go to another hospital because, according to the attending doctor, a serious case had just been handled. “We need to sterilize the room first,” he said. So we hurried to the Ampera area, Pasar Minggu.
At the ER of the hospital where he was born, the attending doctor confirmed that our baby was already dehydrated. His temperature had slightly dropped to around 37.8°C.
The blood lab results showed alarming indicators. His platelet count had dropped to 20,000. Hematocrit was at 46. White blood cells were below normal. “This is critical, sir,” said the doctor. “He’s already in shock. He needs to be admitted to the PICU immediately.”
My body suddenly felt so light.
The Difficulty of Getting a PICU Room
My wife and I felt weak upon hearing the news—especially after the attending ER doctor and the on-call pediatrician asked when exactly the fever had started.
“I’m sure it was Thursday afternoon, Doctor,” my wife said. “I’m sure this is already the third day.”
Both doctors were surprised that his condition had deteriorated this much by the third day. They said that usually, Dengue Shock Syndrome (DSS) doesn’t show up this quickly.
Dengue Shock Syndrome (DSS) is a severe manifestation of dengue virus infection that tends to affect children under 10 years old and can be fatal.
To prevent his vital signs from worsening, his body needed fluids. Unfortunately, it wasn’t easy to insert a needle into his tiny body.
Three nurses took turns trying—and all failed. More than six attempts were made on his hands and feet. Time kept ticking, and our child was becoming increasingly weak.
The on-call pediatrician then took the initiative to call an anesthesiologist to insert an IV through the femoral vein. I knew it would take serious persuasion to convince someone to come in on a Sunday.
Thankfully, the anesthesiologist agreed. He arrived before 3 PM.
“The options are the thigh or the neck. But if it’s the neck, it will be too painful for him. If we go with the thigh, there’s a higher risk of infection because it’s close to the waste outlet,” the doctor said.
In less than 15 minutes, IV fluid began flowing into our child’s body through the upper thigh.
“Now all that’s left is a PICU room—none of the hospitals have one available yet,” said a nurse.
After relentless efforts by the nurses to find an intensive care unit for our child, a glimmer of hope appeared around 4:30 PM. A hospital in the Manggarai area had an open PICU bed.
The deadly phase of Dengue Shock Syndrome was about to begin
Because we were using our own funds, I had to take care of the hospital admission myself. On the way there, I replayed everything that might have been missed during our child’s fever timeline. There was a possibility of one mistake: my wife and I were too procedural in responding to our child’s fever, without fully paying attention to his condition on the ground.
After I finished the administrative process, my child arrived by ambulance at 8 PM. A sense of relief came over me when I saw him able to smile again. His eyes were beginning to recognize us.
At 7 PM, his platelet count had dropped to 15,000, but his hematocrit level had started to decrease. “This is somewhat better, though it’s still DSS,” said the on-call ER doctor at the referral hospital.
DSS is always associated with a high mortality rate in dengue cases. The critical window after diagnosis is between 12 to 24 hours. What makes it worse is that every child shows different symptoms.
However, one thing is certain: in Dengue Shock Syndrome (DSS), bleeding can occur at any moment.
Then, the curve began to turn.
Monday morning, the night after our child was admitted to the PICU, his platelet count had continued to drop—reaching as low as 5,000. The doctor monitoring him decided to proceed with a platelet transfusion.
“I’m anticipating internal bleeding. We never know when that might happen. External bleeding is visible, but internal bleeding isn’t,” the doctor explained.
That entire night, my thoughts were racing. The image of my child’s smile and laughter became clearer and clearer in my mind.
I remembered my own critical experience with DSS when I was 10 years old. The symptoms had been completely different—I had a constant high fever, always above 39°C, and nonstop vomiting. I tried to shake off the negative thoughts and hold on to hope.
Tuesday morning, a day after the transfusion, his platelet count began to rise.
“21,000, ma’am,” said a nurse in the PICU to my wife.
Our spirits lifted again. Maybe there is a rainbow at the end of this storm, I thought to myself. Other indicators were also improving. However, he still needed another transfusion.
“I don’t want to take any risks,” said the pediatrician overseeing him.
Wednesday afternoon, our child was finally allowed to move to a regular hospital room. The doctor expressed hope that our child could go home soon, considering the risk of Covid-19 exposure in the hospital environment.
“If the platelet trend continues to rise, it looks like he can go home tomorrow,” the doctor said. And sure enough, the next day our child’s platelet count soared.
“It’s already above 100,000,” the doctor said.
Thursday afternoon, we received the most relieving news of the week—our baby was allowed to go home.
Joy and gratitude. Those two words best captured our feelings at that moment.
Don’t Take a Child’s Fever Lightly
Behind the panic and helplessness of seeing a sick child, there are valuable life lessons. One of them: never underestimate a child’s fever.
We’re used to monitoring a child’s temperature for three days before seeking further help. But in certain cases like dengue fever, that kind of approach can be dangerous.
When we were at the ER in the Ampera area, we saw a six-month-old baby who tested positive for dengue fever, even though he only had a cough and no fever at all.
That experience made us realize that young children, especially babies, can’t express what they’re feeling. Therefore, parental observation and lab tests become critical.
In our child’s case, when he started vomiting repeatedly, we should have immediately requested a blood test—instead of merely following standard observation procedures.
Hopefully, our experience can serve as a reminder for other parents:
Being vigilant doesn’t mean being paranoid—it means being ready to act quickly before it’s too late.
Because our child’s life is far too precious to risk by waiting.
Originally published on theAsianParent Indonesia
