Dengue Vs. Malaria: Key Differences In Symptoms, Diagnosis & Treatment

Monsoon brings more than just rain. It brings mosquitoes, and with them, the rising threat of dengue and malaria. Every year, countless people fall sick, unsure of which of the two they have caught. Both start with fever. Both can leave you drained. However, when it comes to dengue and malaria, knowing the difference is critical. Why? Because their causes, symptoms, and treatments are different.

Misreading their symptoms could delay the right care. And in severe cases, that delay can be dangerous. This guide cuts through the confusion. It will walk you through the key differences between dengue and malaria. Keep reading to explore their causes, symptoms, diagnostic tests, treatment, and prevention tips.

What Is Dengue?

Dengue is a viral infection caused by the dengue virus, DENV. An infected female Aedes aegypti mosquito transmits the virus through its bite. This mosquito species stays most active during daylight hours and breeds in clean, stagnant water. 

There are four strains of the dengue virus: 

• DENV-1
• DENV-2
• DENV-3
• DENV-4

Infection with one of these offers lifelong immunity to that specific strain but not to the others. Therefore, a person may get infected multiple times, and a second infection may carry a higher risk of complications such as dengue hemorrhagic fever or dengue shock syndrome. ¹

Dengue Symptoms

Luckily, for most people, dengue gets better in 1-2 weeks. Many do not even know they have had it because their symptoms are either very mild or completely absent. However, if dengue symptoms do appear, they start 4-10 days after the mosquito bite and last for about 2-7 days. These symptoms may include: ^{2, 3}

• High fever
• Eye pain
• Muscle and joint pain
• Nausea
• Vomiting
• Rash
• Headache 

These symptoms are mild and are often confused with other illnesses that cause fever. They may go away within a week as your infection clears. However, 1 in 20 people may develop severe dengue, which is a medical emergency. In this case, you may notice the following symptoms: 

• Stomach pain
• Vomiting
• Fatigue
• Weakness 
• Blood in vomit or stool
• Nose or gum bleeding
• Pale and cold skin
• Fast breathing

If you experience any of these symptoms, consult a doctor right away.

What Is Malaria?

Malaria is a serious illness caused by Plasmodium parasites. An infected female Anopheles mosquito spreads the disease through its bite. Once inside the body, the parasite multiplies in the liver, then enters the bloodstream and infects red blood cells. This infection can cause high fever, chills, and, in severe cases, coma or death.

Five types of Plasmodium parasites cause malaria, each with a different incubation period and symptom progression. These include:

• P. falciparum: 8-11 days
• P. vivax: 8-17 days
• P. ovale: 10-17 days
• P. malariae: 18-40 days
• P. knowlesi: 9-12 days

Some parasites can even hide in the liver and reactivate months or years later. With timely treatment, most people recover quickly. However, if not treated early, malaria can cause complications like brain infection, severe anaemia, and organ failure. ⁴

Malaria Symptoms

You might start noticing malaria symptoms anywhere from 8 days to several weeks after being bitten. In some cases, symptoms may appear months later, especially with certain malaria types, such as P. vivax or P. ovale, that can stay dormant in the liver. These symptoms include: ^{5, 6}

• Fever
• Chills
• Sweating
• Headache
• Muscle pain
• Nausea
• Vomiting
• Diarrhea
• Bloody stools
• Upper respiratory symptoms

Without proper treatment, you may also notice these serious malaria symptoms that require immediate medical attention: 

• Anemia
• Seizures
• Jaundice 
• Mental confusion
• Coma
• Death 

As the infection progresses, a classic pattern called malaria paroxysm may develop. This comes in three stages:

• Cold Stage: This stage lasts for 15 to 60 minutes. You may suddenly feel very cold and start shivering.
• Hot Stage: It lasts for 2 to 6 hours. This is when the fever spikes, and you may notice symptoms like a flushed face, dry skin, headache, and nausea.
• Sweating Stage: This stage lasts for 2 to 4 hours. During it, the fever drops rapidly, and you sweat a lot.

This cycle of fever can repeat every 48 or 72 hours, depending on the Plasmodium parasite. P. falciparum, however, does not follow a regular fever pattern, especially early on. So, if the fever is not cyclical, you still can not rule out malaria. ⁷

Dengue Vs. Malaria: Quick Comparison Table

Here is a side-by-side comparison to help you differentiate dengue and malaria.

Feature	Dengue	Malaria
Cause	Dengue virus	Plasmodium parasite
Transmitted By	Aedes aegypti mosquito	Anopheles mosquito
Incubation Period	4–10 days after the bite	8–40 days, depending on parasite type
Common Symptoms	High fever, eye pain, joint/muscle pain, rash, nausea, headache	Fever, chills, sweating, headache, vomiting, diarrhoea, muscle pain
Severe Symptoms	Stomach pain, blood in vomit or stool, nose bleeding, pale and cold skin	Anaemia, seizures, jaundice, confusion, coma
Fever Pattern	Continuous high fever	Cyclical fever (every 48–72 hours); P. falciparum may not follow a pattern

Diagnostic Tests For Dengue Vs. Malaria

Since some dengue and malaria symptoms often overlap, lab tests are essential to confirm the diagnosis. Here are some of the tests your doctor may suggest to tell them apart: ^{8 9 10}

Dengue Diagnosis

There are three main types of tests for dengue:

• NS1 Antigen Test: This test looks for the dengue virus protein in your blood. It is most effective within the first 7 days of symptoms. A positive result means the virus is actively in your system.
• PCR Test: This test detects the virus’s genetic material. It works best early in the illness, typically within the first week after symptoms begin.
• IgM Antibody Test: This test checks if your immune system has started producing IgM antibodies against dengue. A positive result usually indicates a recent infection.

Malaria Diagnosis

There are three main types of tests for malaria: ¹¹

• Blood Smear Microscopy: This test requires examining a small blood sample under a microscope to detect malaria parasites accurately and identify their exact species.
• Rapid Diagnostic Test: This detects malaria proteins from a drop of blood and gives results in under 15 minutes. It is useful where lab access is limited, but it is less sensitive than microscopy. Also, all RDT results, positive or negative, must be confirmed with a blood smear.
• PCR Test: It detects the parasite’s genetic material with high sensitivity and works best after diagnosis to guide treatment.

Treatment Options & Recovery

Here is everything you need to know about dengue vs. malaria treatment:

Dengue Treatment

There is no specific antiviral medicine to treat dengue. Most people recover within a week or two with supportive care. Here is what treatment usually involves: ¹²

• Rest and drink plenty of fluids to prevent dehydration.
• Medications like paracetamol to reduce fever and pain.
• Monitoring for warning signs like stomach pain, bleeding, or persistent vomiting that require medical attention.

Hospitals treat severe dengue with IV fluids, electrolyte replacement, and close monitoring to manage bleeding, blood pressure, and oxygen levels. 

Malaria Treatment

Malaria treatment varies based on the type of Plasmodium parasite, region of infection, and whether the infection is uncomplicated or severe. Unlike dengue, malaria requires prompt prescription medication.

Here is how uncomplicated malaria is managed: ¹³

• Doctors generally prescribe medications like Coartem® or Malarone™ for P. falciparum.
• If not available, they may prescribe quinine with antibiotics like doxycycline or clindamycin.
• They may recommend a hospital stay to monitor recovery and parasite levels.
• For P. vivax and P. ovale, you may need extra treatment like primaquine to prevent future relapses.

Severe malaria is a medical emergency. Hospitals usually treat patients with intravenous (IV) antimalarial drugs like artesunate, followed by oral medication once they improve. ¹⁴

When Should You See A Doctor?

See a doctor immediately if you have one or more of these symptoms, especially if you have been to a high-risk area:

• Fever lasting more than 2-3 days
• Severe headache
• Body pain
• Rash or bleeding
• Persistent vomiting
• Diarrhea
• Blood in stool
• Breathlessness
• Confusion

How To Prevent Dengue And Malaria?

Both dengue and malaria are caused by mosquito bites, which are preventable. Here is how you can lower your risk:

• Use mosquito nets and repellents.
• Wear long sleeves and pants.
• Close doors and windows before evening.
• Empty stagnant water from buckets, plant trays, and coolers.
• Cover water storage containers tightly.
• Avoid travelling to high-risk areas during monsoons.

Final Thoughts

Is it dengue or malaria? This is a common confusion during the monsoon season. Both these mosquito-borne diseases start with fever, and both can turn serious if not treated on time. However, the difference between dengue and malaria mainly lies in their causes, symptoms, and treatment options. Recognising the signs of these diseases early can actually save your life. If you are unsure whether it is dengue or malaria behind your unresolving fever, do not panic. Simply opt for LifeCell Diagnostic’s Fever Comprehensive Panel. It can pinpoint the cause quickly and accurately, allowing you to begin the right treatment sooner and speeding up your recovery. Visit www.lifecell.in to learn more or call 1800 266 5533.

FAQs

How Do I Know If My Fever Is Dengue Or Malaria?

You can always look at your symptoms to determine if your fever is dengue or malaria. However, since many of them overlap, the best solution is a diagnostic test.

Can I Have Both Dengue And Malaria At The Same Time?

Yes, you can have both dengue and malaria at the same time. A study found that patients with co-infection were more likely to develop severe symptoms, including deep bleeding, jaundice, and liver enlargement. While rare, this can make the illness more serious. ¹⁶

How Long Does Dengue/Malaria Fever Last?

Dengue fever usually lasts 2-7 days with proper treatment. Malaria fever, on the other hand, may persist for days to weeks if untreated. It follows a distinct pattern of fever cycles, where fever occurs every 48-72 hours. With proper medication, you may take a few days to weeks to recover. 

What Is The Cost Of A Dengue/Malaria Test?

The cost of a dengue/malaria test may vary depending on the lab or city. On average, most tests may range from ₹500-1200. Comprehensive panels available for better diagnosis may cost more.