Difference between Dengue, Malaria and Chikungunya and Its Preventions

Mosquito-borne fevers, especially malaria, dengue, and chikungunya, have shown a significant rise recently. If unchecked, these diseases can lead to the death of the patient.

Unlike malaria (caused by the Anopheles mosquito), dengue and chikungunya are infections spread by the Aedes mosquito. While both dengue and chikungunya are insect-borne viral diseases, malaria is a parasitic ailment caused by Plasmodium, and it’s transmitted through infected mosquitoes.

According to WHO, half of the world’s population is at risk of contracting dengue and malaria, with over 400 million dengue infections and around 230 million cases of malaria reported in 2019. Cases of chikungunya have also seen an increase over the past few years.

How can one differentiate between dengue, malaria and chikungunya?

For all the three diseases, the main common factor is what causes them, which is through mosquito bites. However, each disease has its own set of symptoms that needs to be treated in a particular way. To understand this better, let’s take a look at each condition individually – 

Dengue Fever

Dengue fever is an infectious disease carried by the Aedes mosquito. DEN-1, DEN-2, DEN-3, and DEN-4 are the four main viruses that cause the illness. Dengue fever is also known as break-bone fever because it sometimes causes severe muscle and joint pain that feels like your bones are breaking.

Nearly 400 million people fall prey to this disease every year, taking the death toll to over 22 000 mortalities worldwide. 

Symptoms of Dengue Fever

The exact symptoms of dengue fever depend on age and usually start with fever symptoms within 4 to 7 days after an infected mosquito has bitten a person.  The most common symptoms of classic dengue include:

• High fever, up to 105ºF
• Severe muscle and joint pain
• Severe headache
• A red rash that starts on the chest, back, or stomach and spreads to the limbs and face
• Pain behind the eyes
• Nausea and vomiting
• Diarrhea

Some patients with dengue fever develop dengue hemorrhagic fever, a more severe form of viral illness. This form of dengue fever can be life-threatening and may progress to dengue shock syndrome, the most severe form of the disease. Symptoms include:

• Headache
• Fever
• Rash
• Hemorrhage (evidence of bleeding) in the body
• Petechiae (purple splotches or tiny red spots, blisters under the skin)
• Bleeding in the nose or gums
• Black stools
• Easy bruising

Malaria

Malaria is a life-threatening mosquito-borne infectious disease caused by a parasite called Plasmodium, transmitted to humans via infected female Anopheles mosquito bites.  In the human body, the parasites multiply in the liver, enter the bloodstream, and then infect the red blood cells. However, this condition is both preventable as well as curable.

In the year 2019, there were around 229 million cases of this mosquito-borne disease worldwide. And the estimated cases of deaths were 409000.

Symptoms of Malaria

Symptoms of malaria are divided into two categories: Uncomplicated malaria and severe malaria.

• Uncomplicated malaria. In uncomplicated malaria, the following symptoms progress through hot, cold, and sweating stages:

• • • The sensation of cold with chills or shivering.
    • Headaches, fever, and vomiting.
    • Sometimes, seizures can occur.
    • Sweats, followed by a return to normalcy (in temperature) with fatigue or tiredness.

• Severe Malaria. If laboratory or clinical evidence points towards the dysfunction of vital organs, it is severe malaria. Severe malaria symptoms include:

• • Fever and shivers/chills
  • Impaired consciousness
  • Respiratory distress and deep breathing
  • Multiple convulsions
  • Signs of anemia and abnormal bleeding
  • Evidence of vital organ dysfunction and clinical jaundice

Chikungunya

The word ‘chikungunya’ means ‘to walk bent.’ Fever and joint pain are significant symptoms of chikungunya. A bite predominantly transmits the chikungunya virus from an infected female, “Aedes aegypti,” commonly called the ‘yellow fever mosquito.’ The most affected places are the countries located in Asia, Africa, Europe, and Pacific, and the Indian oceans.

Symptoms of Chikungunya

While the incubation period of chikungunya disease is between two to six days, the symptoms usually start appearing four to seven days post-infection. Other classic symptoms include:

• High fever (40 °C or 104 °F) which typically lasts for two days and then ends abruptly
• Viral rashes on the trunk or limbs
• Joint pains affecting multiple joints (for as long as two years)
• Other non-specific viral symptoms such as headache, loss of appetite, etc.

What Are the Similarities Between Dengue, Malaria, and Chikungunya?

Chikungunya and dengue are tropical fevers with almost common symptoms, causative agents (mosquito-borne viral diseases), geographical distribution, and incubation period. Malaria is a parasitic infection with similar signs and symptoms as chikungunya and dengue.

Similarities between malaria and dengue include the following symptoms:

• Headaches
• Lower back and muscle pain
• Body chills and coughs
• Nausea
• Diarrhea

Similarities between dengue and chikungunya include the following characteristics:

• Primarily found in tropical and sub-tropical climates
• Both diseases can lead to fatalities, if left untreated

How Does Treatment for Dengue, Malaria, and Chikungunya Differ? 

The Anopheles mosquito causes malaria. However, chikungunya and dengue are caused by the Aedes mosquito. Also, chikungunya and dengue are mosquito-borne viral infections, whereas malaria is caused by a parasite known as Plasmodium. This way, the treatment procedures for the conditions are also different.

Tips to Prevent Dengue Fever, Chikungunya and Malaria

While the Aedes mosquito (also referred to as ‘daytime’ feeder’) that transmits dengue fever and chikungunya tends to be more active during the day, the Anopheles mosquito that transmits malaria tends to be active chiefly at night. Therefore, the most critical measure that you can take against these diseases is trying to avoid mosquito bites during the day and at night. Other preventive measures include:

Preventive Measures of Dengue Fever

• Keep your bodies covered with long-sleeve shirts and full pants.
• Apply EPA-approved mosquito repellent to avoid dengue infection from mosquito bites.
• If possible, apply fabric-friendly mosquito repellents.
• Make sure to close your home or office doors and windows to avoid the mosquitoes from entering. You can also install window or door nets.
• Do not keep stagnant water in and around your home. 
• Avoid going to places with stagnant water, especially during dusk and dawn, to prevent dengue fever.

Preventive Measures for Chikungunya

• Make sure to wear clothes that cover your body properly, such as long pants and full-sleeve shirts.
• Make sure to use EPA-approved mosquito repellents.
• Install nets on the windows and doors of your home and office to limit the entry of mosquitoes. 
• Keep the surroundings of your home neat and clean so that mosquitoes cannot breed there. 

Preventive Measures for Malaria

• Cover your arms and legs
• Wear light-colored clothes
• Avoid traveling to areas with outbreaks of any one or all these three diseases.
• Use mosquito repellents
• Fix mesh on windows and doors of the house to keep mosquitoes out
• Use mosquito nets over the beds to avoid bites
• Eliminating the sites that breed mosquitoes by emptying stagnant water from buckets, flowerpots, and barrels.
• Keeping the surrounding areas free from garbage

Conclusion

All three diseases – malaria, dengue, and chikungunya, overlap in distribution largely, and their symptoms can make them difficult to distinguish in the early stages. To prevent these endemic diseases, we need to understand them first.

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Frequently Asked Questions

Can one be infected by malaria after dengue?

Both malaria and dengue have their distinct mosquito vector. However, the habitat of these vectors is not the same. While the malaria mosquito vector (Anopheles) is mainly prevalent in forests and areas of dense vegetation, the dengue mosquito vector (Aedes) can be commonly found in cities. And, habitat overlapping is not seen easily.

What type of virus causes dengue?

The dengue virus belongs to the Flaviviridae family.

Is dengue worse than malaria?

According to WHO, dengue is one of the fastest spreading viral conditions globally and dangerous too.

How long does chikungunya last in your body?

In most cases, the signs and symptoms of chikungunya last for 3-days to 10-days.

What is the difference between dengue and chikungunya? 

Both dengue and chikungunya are viral infections. However, the former is caused by the Flaviviridae flavivirus, whereas the latter, by the Togaviridae alphavirus.

References:

https://www.askapollo.com/physical-appointment/internal-medicine-physician
https://www.apollohospitals.com/patient-care/health-and-lifestyle/our-doctors-talk/monsoon-safety/
https://www.apollohospitals.com/events/take-care-this-monsoon/