Dengue, typhoid or viral? Reading the fever pattern

Every monsoon, fever clinics fill up with the same question: is this an ordinary viral fever, or is it dengue or typhoid? You cannot diagnose the cause from the fever alone — a blood test confirms it — but the pattern of the fever and the symptoms around it give useful clues about what to watch for and when to test.

Viral fever

The most common cause. Fever comes on quickly with body aches, a blocked or running nose, sore throat and a cough. It usually rises and falls through the day and settles within 3–5 days. It spreads easily at home and in schools. Most viral fevers need only rest, fluids and paracetamol — not antibiotics, which do nothing against viruses.

Dengue

Spread by day-biting Aedes mosquitoes that breed in clean, stored water. Dengue brings a sudden high fever with severe body and joint aches (the old name is "breakbone fever"), pain behind the eyes, headache and often a rash after a few days. The dangerous phase can begin as the fever falls around days 4–6, so this is exactly when to watch most closely, not relax. A NS1 antigen test helps early; IgM and a platelet count are checked from around day 4–5.

Typhoid

Caused by bacteria from contaminated food or water. The fever climbs step by step over several days, often peaking in the evenings, with a poor appetite, abdominal discomfort, constipation or loose motions and marked tiredness. Unlike viral fever, typhoid does not settle on its own — it needs a doctor-prescribed antibiotic. A blood culture is the most reliable test; the older Widal test is less dependable on its own.

Malaria is also worth ruling out in the monsoon if the fever comes with chills and shivering in a clear cycle — a simple blood smear or rapid test settles it.