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Sharell Cook

My Experience: How to Tell the Difference Between Malaria, Dengue, and Viral Fever

By August 19, 2010

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During my past five years in India, I've had a wide range of monsoon related-illnesses, the latest being malaria.  Unfortunately, there's been a huge outbreak of it in Mumbai this monsoon season, as a result of the incessant heavy rain.

The troublesome thing is that many monsoon related illnesses share similar symptoms (such as fever and body ache). Initially, it can be difficult to know what you're suffering from. However, based on my experience, although the symptoms may be the same, there are some noticeable distinctions in the way that they occur.

  • Viral Fever -- a long lasting and intense fever, accompanied by severe chills and body ache. I had it twice in Varkala, Kerala a few years ago.  Both times, it lasted for three days, then went away as quickly as it came.
  • Dengue Fever -- a long lasting fever, plus swollen and painful joints, and a rash. After the fever, my finger and toe joints swelled and started hurting, and I got a pin-prick looking rash over my legs, arms and torso.
  • Malaria -- a short lasting, recurring fever, accompanied by chills and body ache.  The short duration and recurrence of symptoms are what really distinguish malaria from other illnesses. My fever and chills lasted around five hours at a time, but returned every second day (consistent with the parasite life cycle). It felt like the start of a flu that would mysteriously come and go.

The types and severity of both dengue fever and malaria are variable. I had mild cases of both (including P.vivax malaria, as opposed to the life threatening P.falciparum). However, when dealing with malaria, you must get it treated as soon as possible, before the parasite has a chance to affect too many red blood cells.  Treatment of uncomplicated cases is quite straightforward, and can simply consist of taking a series of tablets.

If you're concerned about the possibility of catching any of these illnesses in India, the most important thing to keep in mind is the climate. The prevalence of illness does vary every year, and from place to place in India. Malaria isn't a real issue in India during the dry winters, but outbreaks of it do occur during the monsoon, particularly when it's raining constantly. Last monsoon in Mumbai, dengue fever was more of a problem as the rain was intermittent. This year, dengue is spreading in Delhi.

More About Health in India:

Comments
August 23, 2010 at 4:46 pm
(1) Ahmed S Kazee says:

Hi Sharell..I ‘discovered’ your column a few months ago and I wish to congratulate you on
your excellent articles on India travel. Thank you.
I am a 58 year old South African male and I plan to depart for Mumbai next week. I am coming
over to India to attend to family business in Surat. I am aware of the extreme heat prevailing
right now in Maharastra and Gujerat, so, the last thing I want is to come over there and fall ill!
When I arrived in Mumbai two years ago, (at exactly the same time of the year), I fell severely
ill within 5 hours of my arrival. I put it down to “change of weather”!
Would you advise me to depart for India now? I can delay my trip for 3 weeks if I have to. Or
alternatively, I can arrive in Delhi if the diseases are less severe there. I do intend going back-packing
towards Kashmir after attending to business, but I am flexible enough to do things the other way
around. Your advice would be most appreciated.
(Please forgive me if I have used the incorrect channel here to contact you. I am not “internet savvy” and
I send you this note via BlackBerry. )

August 24, 2010 at 12:31 am
(2) goindia says:

Hi Ahmed, thanks for writing. I’m glad you find my articles useful. You’re most welcome to contact me using this channel. :-) This time of year really is a difficult one. Even if you delay your trip by a few weeks, you’ll be getting into the post-monsoon period which produces a dramatic change in weather conditions on its own, and tends to be really hot and uncomfortable. People continue to get ill in October due to this change in weather. I would say take the chance and come anyway. Delhi’s weather at this time of year tends to be really unstable — on-off rain, heat and humidity (there is a growing problem of Dengue there this year too). Mumbai’s weather at the moment is mild temperature wise, but very rainy (although it’s easing off these days, thankfully). I would still choose Mumbai to arrive in, but make sure you take extra precautions with your health. My view is if you’re going to get sick, you will regardless of where you land in India this time of year… it can be quite a shock to the system. Hopefully you’ll be fine though. I wish you as safe trip!

Monsoon season health tips: http://goindia.about.com/od/planningyourtrip/qt/monsoonhealth.htm

August 23, 2010 at 7:09 pm
(3) Dommi says:

Bonjour Sharell! Very interesting article, poor you that you have had all these illnesses, but i love it that you write about it, every experience is an opportunity! Love and strength to you sweetie, glad you’re feeling better. Love Dommi and tribe xox

August 24, 2010 at 1:59 am
(4) goindia says:

Bonjour Dommi!! Thanks for commenting and all your good wishes. It certainly is an adventure and gives me plenty to write about. Plus, I’m glad to have had these experiences, even though they’re not always the best! :-)

August 31, 2010 at 2:22 pm
(5) tal ravid says:

Dear shareel –
Enjoying reading your blog.

I have been to India several times (my wife is from Kerala). This year i plan to come end october to take a week course at the Yoga institute in Santa Cruz (will stay at a hotel somewhere near the int. airport in Andheri).
Never was concerened about health matters here…
but i do understand this year is different.

Ill ask you a direct question: would you avoid traveling to Mumbai this post monsoon period??

Thanks alot.
Tal

September 1, 2010 at 4:16 am
(6) goindia says:

Hi Tal, in all honesty, you know what India’s like…its difficult to actually predict what the conditions will be like then! There’s an outbreak of Dengue in Delhi at the moment and the same thing could very well happen in Mumbai… Dengue does seem to be on the rise here at the moment. You can take precautions against getting bitten by mosquitoes though, and you should be okay — there’s not a huge chance of you getting sick if you’re careful (most people living here, including me, aren’t). Plus, hopefully by the end of October, the weather should be settling down a bit, the worst of it should be over. So in conclusion, if it’s easy to delay your plans a little — do it just to be on the safe side. Otherwise, still come but just be careful. Hope this helps. :-)

June 18, 2013 at 1:00 pm
(7) Robert says:

Hello

I spent a year in India in the mid1960′s and when I returned to the UK I had the symptoms you mentioned in your blog – shivers, fever and extreme sweating – the doctor gave me some pills and after a week I recovered. I was not referred to a tropical deceases hospital!

For many years I would get a short reminder of the symptoms about every three months or so lasting for a few days only. Over a period of many years the time between the recurring bouts became longer and the tenacity subsided. I am fit and a recent visit to the doctor has not unearthed any problems with my health.

However, recently I have had the same symptoms recurring and I wonder if it is possible that the Malarial Fever can stay in the body for so many years – or is it just that I’m getting on a bit and probably suffering the aches and pains of old age?

I look forward to your reply.

King regards

Robert Atkins

June 19, 2013 at 1:21 am
(8) goindia says:

Hi Robert, yes, it’s very much possible. There are two stages to malaria. It breeds in the liver and then spreads into the blood stream. When it gets into the blood stream, the symptoms occur — so the first dose of medicine is designed to kill off the bacteria in the blood stream. However, it doesn’t have any impact on the bacteria in the liver (you need a follow up dose of different medication to kill this) which can remain there and lay dormant for a while, then start a new breeding cycle. As soon as it gets back into the blood stream, the symptoms reoccur. You might find this information interesting: http://www.niaid.nih.gov/topics/malaria/pages/lifecycle.aspx

However, when you were experiencing a re-occurrence of the symptoms, did you take malaria medicine again, or did the symptoms go away by themselves without medicine? If they only lasted a few days and then went away without treatment, it’s doubtful that it would be malaria. I’m not a doctor though. This information is just based on my experience with the disease. Hope it helps!

July 7, 2013 at 9:45 am
(9) nlkhil says:

Hi ,my sister is suffering from fever from last friday symptoms are high fever than dont give evn after taking paracetamols, shivering than too sometimes bobody pain doctor has adviced that it is viral please suggest is it is viral or malaria.

Nikhil

July 8, 2013 at 7:54 am
(10) goindia says:

Hi Nikhil, are her symptoms constant or do they lessen and then come back? If they remain constant, with no change, it is probably viral. Malaria symptoms tend to have a cycle where they subside for a while, then return. I hope she gets better soon. You could try taking her to another doctor for a second opinion.

August 23, 2013 at 3:21 am
(11) gurleen says:

Hi,
I am staying in punjab (india) and I am having fever since past 2 days. The temperature hovers around 100_101 ‘ F. I dont feel too chilling but whenevr I get fever I feel like turning of d fan but there is no kind of shivering as such. And d fever occurs usually 1 or max 2 times a day. Can you please help me with it?

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