Dengue Fever as a Children’s Game

Dengue fever is no laughing matter. But several Yale students and others are hoping that the potentially lethal tropical disease makes for an entertaining children’s game.

A group of students from the schools of public health and forestry and environmental studies are working with colleagues at Parsons The New School of Design in New York City and officials from the Red Cross/Red Crescent’s Climate Centre to promote an educational program that teaches children about the dangers posed by dengue and what to do to keep themselves and their communities healthy.

The mosquito-borne disease is found in more than 100 countries and takes a heavy toll on human health and economic development. There is no vaccine, cure or specific treatment for disease and in severe cases dengue can result in death.

So how do you educate children about complex and abstract health and environmental concepts in a way that is appealing, fun and will make a lasting impression? The students think the answer is a new game known as Humans Versus Mosquitoes.

The game can be played in an open field or on a tabletop. It requires no special or expensive equipment or uniforms and has no complex rules. And its objective is simple—either the humans or the mosquitoes are left standing in the end.

“This game is an innovative public health tool that empowers children to learn about the dangers of dengue fever, how it spreads and, more importantly, how they as children can become leaders in reducing dengue in their communities,” said Sophia Colantonio, a second-year M.P.H. student at the School of Public Health who helped design the game as part of a class project at Yale. “We hope that the children playing the game will then go and teach their siblings and parents about ways to curb dengue transmission at home.” 

Humans Versus Mosquitoes emphasizes the importance of dengue prevention, especially through clearing breeding grounds, and incorporates the element of climate change and how that is affecting patterns of the disease.

Players form into two teams—mosquitoes and humans—that face off against one other. Each mosquito gets 3 eggs (using everyday materials such as stones) to create a breeding ground. When the breeding grounds have been setup, the mosquitoes receive two extra eggs to carry. Each human, meanwhile, gets four health tokens. The game is played in rounds and each player decides whether to play offense or defense. Humans seek to clean up the egg from a breeding ground and protect themselves against infection. Mosquitoes, meanwhile, try to bite humans and lay additional eggs in their breeding grounds.

If humans remove all eggs from all breeding grounds first, they win. If the mosquitoes kill all the humans first, they win. The game requires a minimum of six players and takes between 15 to 30 minutes to play. It is geared toward children ages 8 to 12 and the game can also be easily modified so that other tropical diseases—such as malaria—become the focus.

“I think a game is the best way to reach a younger audience and pique their interest on important health and environmental matters,” said Maria Diuk-Wasser, an assistant professor at the School of Public Health and an adviser on the project. “We picked dengue because climate can influence its transmission, both directly, through modifying mosquito and virus development and survival, and indirectly, through humans storing water to deal with uncertainty in the water supply.”

Worldwide, some 2.5 billion people are at risk of dengue and it is estimated that 50 to 100 million cases of dengue fever and 250,000 to 500,000 cases of dengue hemorrhagic fever occur annually. The virus is transmitted through infected female mosquitoes (Aedes aegypti) and the only effective ways to check its spread is to control mosquito populations through biological, chemical and environmental methods.

The Yale students provided the content for the game and the Parsons students came up with the design. The game was presented earlier this month United Nations climate change conference in Durban, South Africa. The Red Cross/Red Crescent is looking to develop the game further by incorporating it into health curriculums in developing countries such as Argentina and Uganda.

In additional to Colantonio, the design team included Vanessa Lamers, a YSPH/ School of Forestry & Environmental Studies student, Kanchan Shrestha and Lauren Graham, both FES students, and four current Parsons students: Lien Tran, Mohini Freya Dutta, Ben Norskov, Eulani Labay and Clay Ewing, a recent graduate.

Michael Greenwood