Due to heavy rainfall and increased humidity this year, India has been struck by various illnesses and infections. Dengue is one of the most prominent viral infections that spreads from mosquitoes to people. Scrub typhus, also known as bush typhus, is another bacterial infection that has reportedly claimed five and nine lives in Odisha and Himachal Pradesh, respectively.
Both these infections require accurate diagnosis and timely treatment, as negligence can prove fatal. Although the symptoms of the two illnesses can be identical in some cases, treatment approaches may vary for the two. We spoke to leading experts to understand the characteristics of dengue and scrub typhus and ways to differentiate between them.
Also Read: What Time Of Year Is Dengue Most Common In India? Measures To Stay Safe
What Is Scrub Typhus Versus Dengue?
According to Dr Neeti Pravesh, Consultant-Internal Medicine, Max Super Speciality Hospital, Shalimar Bagh, Scrub typhus is a life-threatening infection caused by the bacterium Orientia tsutsugamushi (Rickettsia), which is spread to people through the bites of infected chiggers (larval mites).
Dr Tribhuvan Gulati, Lead Consultant, Diabetes, Obesity & Internal Medicine at the CK Birla Hospital (R), Delhi, tells OnlyMyHealth that the disease is highly prevalent in Asia, the Pacific Islands, and Northern Australia, whose outbreak occurs as per climatic conditions. The bacterium thrives in hot and humid environments and is more common during the rainy season.
On the other hand, dengue dengue is a mosquito borne viral illness, primarily caused by the bite of the Aedes aegypti mosquito, says Dr Manoj Vithlani, MBBS, MD (Internal Medicine), Senior Consultant Physician and Diabetologist, HCG Hospitals, Ahmedabad, adding that it is most prevalent in India during the monsoon season. This includes the period from June to September.
According to the World Health Organization (WHO), about half of the world's population is now at risk of dengue with an estimated 10–40 crore infections occurring each year.
Key Differences Between Scrub Typhus And Dengue
Dr Pranjit Bhowmik, Director-Internal Medicine, Asian Hospital, Faridabad, says, "Scrub typhus spreads through the bite of infected larval mites in people, which lead to an incubation period of 10-12 days (but can vary between 6-21 days)"
On the other hand, dengue symptoms usually begin abruptly after an incubation period of 5-7 days often ranging between 3-10 days, says Dr Bhowmik, adding, "The disease has a 3 phase clinical course namely, febrile, critical and convalescent. Dengue fever can be biphasic and typically lasts 2 – 7 days."
According to the doctor, early diagnosis of scrub typhus is crucial for the rapid administration of the proper medications. Fever, headache, body aches and rash are some of the most common symptoms of scrub typhus. Other less common symptoms present as enlarged lymph nodes, confusion, and in severe cases coma, bleeding and organ failure, which can be fatal, if left untreated.
Dengue can cause mild or severe symptoms ranging from high fever, headache, body aches, nausea and rash. Some people may go on to develop severe dengue that can be life-threatening and often requires hospitalisation, says Dr Bhowmik.
Moreover, Dr Pravesh adds, "Leukopenia is a feature of dengue, while leukocytosis is found in scrub typhus."
Leukopenia, also known as low white blood cell count, occurs when you have lower-than-normal number of white blood cells. On the other hand, leukocytosis is when you have an elevated white blood cell count, typically above 11.0x10^9/L.
How Are Bacterial And Viral Infections Different?
The key difference between dengue and scrub typhus is that while the former is a viral infection, the latter is caused by a bacterium.
Dr Bhavini Shah, Head of Microbiology, Neuberg Supratech Reference Laboratories, says, "Bacterial infections are caused by bacteria, for instance, strep throat, whereas viral infections are caused by viruses, which include the common cold,” adding that differentiating between them is important to determine appropriate treatment and avoiding antibiotic misuse, which can lead to antibiotic resistance.
The risk of antibiotic misuse is becoming more prevalent, with the WHO suggesting that new resistance mechanisms are emerging and spreading globally. The global health organisation shares that a growing list of infections, such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and foodborne diseases, are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.
Hence, Dr Shah says, "Correct diagnostic tests can also guide the doctor to differentiate between bacterial and viral infection."
Treatments And Preventive Measures
Dr Pravesh shares, "Antibiotics, such as Doxycycline, are usually given for 7 days to treat scrub typhus in patients, whereas dengue is a viral infection and antibiotics have no role to play.”
While there is no specific treatment for dengue, the US Centers for Disease Control and Prevention (CDC) suggests taking pain relieving medications for fever (as prescribed by the doctor), resting and drinking plenty of fluids.
Currently, no vaccine is present to prevent either of the two diseases but prevention is key when it comes to curbing the spread of the infections.
Also Read: Dengue Alert! Natural Mosquito Repellents That Can Prevent Infections
Some ways to prevent scrub typhus and dengue include:
- Avoid coming in contact with insects, mites, and mosquitoes
- Maintain good hygiene practices
- Keep your surroundings clean and use repellents to keep insects, mosquitoes and mites at bay
- Do not get closer to bushes and riverfronts especially during monsoons
- Avoid travelling to areas where scrub typhus and dengue are prevalent
- Use insect-repellents on exposed skin and clothes
- Cover your arms and legs when going out
Bottomline
As mentioned above, there are no vaccines to prevent scrub typhus and dengue. However, one can reduce the risk by following necessary hygiene measures and using insect and mosquito repellents. If you develop symptoms, make sure to get an accurate diagnosis and consult with a healthcare provider for the way ahead. Do not self-medicate as it may cause more complications.
