Typhoid vs Dengue: How to Know Which One You Have

When monsoon hits or hygiene lapses, waterborne and mosquito-borne diseases surge — and two of the most common culprits are typhoid and dengue. Both illnesses share symptoms like fever, weakness, and body aches, making them hard to differentiate without proper diagnosis. However, understanding the key differences can help you seek the right treatment at the right time.

In this comprehensive guide, we compare typhoid vs dengue, exploring their causes, symptoms, transmission, diagnosis, complications, and treatment options — so you can know which one you might be dealing with.

What Is Typhoid?

Typhoid fever is a bacterial infection caused by Salmonella enterica serotype Typhi. It spreads primarily through contaminated food and water and is prevalent in areas with poor sanitation.

Causes of Typhoid:

• Ingestion of food or water contaminated with the feces or urine of an infected person

• Poor hand hygiene, especially in food handlers

• Exposure during travel to typhoid-endemic regions

What Is Dengue?

Dengue is a viral infection caused by the dengue virus (DENV), which is transmitted through the bite of an infected Aedes aegypti mosquito. It is a major public health threat in tropical and subtropical regions.

Causes of Dengue:

• Bite from an infected mosquito

• Most active during early morning and evening hours

• Breeds in stagnant clean water (plant trays, uncovered tanks, coolers)

Typhoid vs Dengue: Key Differences at a Glance

Symptoms of Typhoid Fever

Typhoid symptoms develop slowly and worsen over time. Early signs may resemble flu or a stomach bug.

Common Symptoms:

• Persistent high fever (up to 104°F)

• Abdominal pain

• Constipation (in adults) or diarrhea (in children)

• Headache

• Fatigue and weakness

• Loss of appetite

• Dry cough

• Skin rashes known as “rose spots” on the abdomen or chest

• Enlarged spleen or liver in some cases

Symptoms of Dengue Fever

Dengue, also called “breakbone fever,” typically starts with sudden high fever and intense body pain.

Common Symptoms:

• Sudden high-grade fever (104°F or more)

• Severe muscle and joint pain

• Pain behind the eyes

• Intense headache

• Skin rash (often starts on limbs and spreads)

• Nausea or vomiting

• Fatigue

• Mild bleeding (nose or gums), bruising easily

• Swollen lymph nodes

Dengue Warning Signs (Seek Urgent Care):

• Severe abdominal pain

• Persistent vomiting

• Bleeding under the skin

• Blood in vomit or stools

• Difficulty breathing

• Sudden drop in blood pressure

How to Differentiate Typhoid and Dengue by Symptoms Alone?

Though both illnesses start with fever and general malaise, the onset pattern and accompanying symptoms help differentiate:

• Fever Onset: Typhoid starts gradually, while dengue has a sudden high spike.

• Pain: Dengue causes severe muscle/joint pain, typhoid causes more abdominal discomfort.

• Gastrointestinal Symptoms: Diarrhea/constipation is more prominent in typhoid.

• Skin Rash: More pronounced and widespread in dengue.

• Bleeding: Bleeding or bruising is a red flag for dengue, not typhoid.

• Mental Changes: Severe typhoid may cause delirium or confusion, unlike dengue.

Still, symptoms can overlap, especially in co-infections — making lab tests essential for accurate diagnosis.

Diagnostic Tests for Typhoid and Dengue

Typhoid Diagnostic Tests:

1. Widal Test: Detects antibodies against Salmonella Typhi (may give false positives).

2. Blood Culture: Gold standard for early diagnosis (especially in first week).

3. Stool/Urine Culture: Helpful in later stages.

4. Complete Blood Count (CBC): May show low white blood cells and platelets.

Dengue Diagnostic Tests:

1. NS1 Antigen Test: Detects virus within the first 5 days.

2. IgM/IgG Antibody Test: Confirms recent or past dengue infection.

3. CBC (Complete Blood Count):

   • Low platelet count

   • Increased hematocrit

   • Leukopenia

Always consult a healthcare provider for proper evaluation and lab interpretation.

Treatment Approaches

Typhoid Treatment:

• Antibiotics: Ciprofloxacin, Azithromycin, or Ceftriaxone

• Hydration and rest

• Antipyretics (paracetamol) for fever

• Avoid self-medication as antibiotic resistance is rising

Hospitalization may be needed for severe cases or complications like intestinal bleeding or perforation.

Dengue Treatment:

• No specific antiviral treatment

• Paracetamol for fever and pain (Avoid NSAIDs like ibuprofen or aspirin due to bleeding risk)

• Adequate fluid intake (oral rehydration or IV fluids)

• Close monitoring of platelet count and vital signs

Hospital admission is required for:

• Bleeding manifestations

• Signs of dengue hemorrhagic fever or shock

• Very low platelet count

Prevention Strategies

Typhoid Prevention:

• Drink only boiled or filtered water

• Avoid raw or street food, especially salads and cut fruits

• Maintain hand hygiene, especially before eating

• Typhoid vaccine (injectable or oral) recommended for travelers and high-risk individuals

Dengue Prevention:

• Avoid mosquito bites with repellents, nets, and full-sleeved clothing

• Eliminate mosquito breeding grounds (stagnant water, flower pots, coolers)

• Community vector control programs

• Dengue vaccines like Dengvaxia are available but have limited use due to safety criteria

Who’s at Greater Risk?

Typhoid High-Risk Groups:

• Children under 5

• People in slum or flood-prone areas

• Travelers to endemic regions

• Immunocompromised individuals

Dengue High-Risk Groups:

• Children and elderly

• People with prior dengue infection (risk of severe dengue)

• Those living in crowded, mosquito-prone areas

• Pregnant women (can transmit dengue to fetus)

Complications: Why Timely Diagnosis Matters

Typhoid Complications:

• Intestinal perforation

• Internal bleeding

• Encephalitis

• Chronic carrier state (can spread disease without symptoms)

Dengue Complications:

• Dengue Hemorrhagic Fever (DHF)

• Dengue Shock Syndrome (DSS)

• Organ failure (liver, kidneys)

• Death in severe untreated cases

Prompt diagnosis and early intervention can prevent life-threatening complications.

Co-Infection: Can You Have Both at Once?

Yes — though rare, typhoid and dengue co-infection is possible, especially during seasonal outbreaks. In such cases:

• Fever may be prolonged

• Symptoms become more severe and confusing

• Requires rigorous lab testing and specialist care

Always disclose your travel history, food intake, and mosquito exposure to your doctor to help with early suspicion.

When to See a Doctor Immediately

Seek medical help if you experience:

• High fever for more than 2 days

• Severe weakness or confusion

• Persistent vomiting or diarrhea

• Abdominal pain with bloating

• Signs of bleeding (gums, urine, stool)

• Rapid heartbeat or breathlessness

Delaying care could result in complications requiring ICU-level treatment.

Both typhoid and dengue are serious illnesses that thrive in poor hygiene and seasonal environments. Recognizing the early signs, understanding the mode of transmission, and undergoing timely diagnostic testing are your best defenses.

Quick Recap:

• Typhoid = Bacteria, dengue = Virus

• Typhoid = Slow fever, abdominal issues, dengue = Sudden fever, body pain, rash

• Lab tests are critical

• Early treatment prevents serious complications

When in doubt, don’t guess — get tested.

If you’re experiencing symptoms or have been exposed to either infection, book a diagnostic consultation today. Early intervention can save lives.