Introduction:
Dengue and typhoid are both well-known infectious diseases. Although they occur worldwide, their prevalence is more in developing countries. They mostly occur during the rainy season because the rainy season promotes the breeding of mosquitoes and also can lead to poor sanitary conditions which harbor various bacteria and viruses. Both these diseases are considered serious and dangerous as they pose several health hazards. Sometimes they both can occur at the same time, which can make the condition even more dangerous and can lead to the death of the affected individual. Because these concurrent infections exhibit similar symptoms and occur during the same season, physicians have difficulty distinguishing them accurately and making accurate diagnoses. Although rainy weather brings a lot of infectious diseases, dengue, and typhoid are the most fatal ones. Every year millions of people lose their lives because of these two fatal diseases.
What Is Dengue?
Dengue is a viral infection that is spread by a mosquito bite. The mosquito that is responsible for the spread of this disease is called the Aedes aegypti mosquito. These mosquitoes are infected with the dengue virus. DEN1, DEN2, DEN3, and DEN4 are four serotypes of the dengue virus that cause dengue disease. The mosquitoes infected with the dengue virus usually bite during day time. In tropical and subtropical countries, it is frequently seen during the monsoon season.
What Are the Symptoms of Dengue?
Fever, rash, myalgia (muscle pain), anorexia (loss of appetite), joint and bone pain, and headaches are the main symptoms of the illness. Some patients may experience deadly consequences like bleeding and shock. With dengue fever, it is typical to experience thrombocytopenia (low platelet count), leukopenia (low white blood cell count), and raised liver enzyme values, especially alanine transaminase (ALT).
Thrombocytopenia can be minor, requiring only close observation and no special care, but it can also occasionally be severe and even fatal. In severe cases, the count may get reduced up to 50,000. The average count of platelets in humans is between 150,000 and 250,000 platelets per microliter of blood. The data says around 80 to 90 percent of dengue patients may have levels under 100,000, and 10 to 20 percent of patients may have severely low levels of 20,000 or below.
Since the majority of individuals only have a minor form, thus they do not require hospital care. However, if symptoms are ignored or if the individual is immunocompromised like children, elderly individuals, or individuals with underlying medical conditions, dengue could be life-threatening. Additionally, neurological (brain-related) and gastrointestinal (abdomen-related) symptoms may appear in dengue fever patients.
What Is Typhoid?
Unlike dengue which is a viral disease, typhoid is a bacterial illness. The bacteria that causes this disease is called Salmonella typhi and it may also be caused by Salmonella paratyphi and Salmonella choleraesuis. These bacteria get access to the human body through contaminated food and water. When an individual eats or drinks these contaminated meals, they get this illness. Typhoid fever is also called enteric fever. The spread of this disease is common in the rainy season as contamination is at its peak during this time, especially in street foods.
What Are the Symptoms of Typhoid?
Fever, anorexia, body aches, and gastrointestinal symptoms like diarrhea and abdominal pain are all signs of typhoid. Gastrointestinal bleeding and neurological problems that affect the brain, such as encephalopathy, may make it more difficult. Leukopenia and increased ALT levels are the typical test findings in patients with typhoid.
Why Is It Difficult to Distinguish Between Typhoid and Dengue?
Dengue fever and typhoid fever have similar initial presentations and some of the same consequences. When there is a dengue fever outbreak, it can be difficult to diagnose typhoid fever in a patient with acute fever. Both dengue fever and typhoid fever are characterized by a high prevalence of body pains, myalgias, changed bowel habits, and sore throats. Typhoid fever and dengue fever share similar test results and physical symptoms, such as rash, moderate splenomegaly (enlargement of the spleen), relative bradycardia (slow heart rate), and neutropenia (low neutrophils count), which makes a distinction nearly impossible.
What Symptoms Distinguish Typhoid From Dengue?
Typhoid fever has an incubation period (the number of days between contracting an illness and possibly exhibiting symptoms) of 10 to 14 days before symptoms start to appear. In typhoid, saddleback fever causes temperature spikes without a subsequent return to normal.
Dengue fever, on the other hand, causes a wide range of symptoms, from inapparent or mild febrile illness to severe and deadly hemorrhagic disease. The patient often has a high fever for five to seven days when they have dengue fever. Severe frontal and retro-orbital headaches, myalgias, particularly discomfort in the lower back, arms, and legs, malaise, arthralgia (joint pain), and anorexia may also occur concurrently. During the first two days of the fever, typhoid fever patients experience a dull, constant frontal headache; they may also experience mild arthralgia affecting several joints and nonspecific, poorly localized back discomfort.
In comparison to diarrhea, which affects about 30 percent of typhoid patients, constipation affects roughly 50 percent of patients. Constipation is occasionally seen in dengue fever; diarrhea and respiratory symptoms are generally reported and may be linked to concomitant illnesses. Prominent temperature and pulse dissociation is a characteristic of typhoid that is well-known but not specific, and it can also occur in dengue disease.
How Is Dengue and Typhoid Co-infection Diagnosed?
Dengue and typhoid are diagnosed on the basis of clinical signs and symptoms and blood tests. If the physician suspects either of the two diseases, a blood test is conducted. The Dengue IgM antibody capture ELISA (Enzyme-linked Immunosorbent Assay) test detects dengue-specific IgM antibodies. Another test for detecting the dengue virus is the nucleic acid amplification test (NAATs) test.
On the other hand, the bacteria of typhoid are detected by culture tests. Salmonella typhi is typically identified in a culture of the blood or another body fluid or tissue. Additionally, the Widal test is used to diagnose Salmonella typhi infection since it shows agglutinating antibodies against the O and H antigens of S. typhi as well as the H antigens of S. Paratyphi A and S and Paratyphi B.
How Is Dengue and Typhoid Co-infection Treated?
Since dengue is a viral disease, it does not require antibiotics. Symptomatic treatment is preferred. The patient is advised to take rest, have plenty of fluids and take fever reducers for fever and painkillers for body aches. If the symptoms do not improve or the patient is unable to eat or drink, hospitalization is preferred.
Typhoid is a bacterial disease. Hence antibiotics are required. However, antibiotic resistance has developed with some of the antibiotics. Currently, the prescribed antibiotics are Ciprofloxacin, Azithromycin, and Ceftriaxone. As this disease affects the intestine, sometimes intestinal surgery may be needed if the patient suffers massive destruction by the bacteria in the intestine.
Conclusion
To conclude, no fever should be ignored. Dengue and typhoid both start with fever and then progress further. Both diseases can be prevented by practicing hand hygiene, keeping good sanitary conditions, eating clean and hygienic food at home and even outside, and preventing oneself from mosquitoes. The mortality rate of these diseases can be prevented by timely diagnosis and treatment.
