Dengue and Typhoid Co-infection- Study from a Government Hospital in North Delhi

Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for the treating physician. The symptoms of dengue may mimic other diseases such as leptospirosis, influenza A, Salmonella Typhi, Japanese encephalitis, chikungunya and malaria. There is paucity of data regarding dengue and typhoid co- infection both in the developed and developing countries. This study attempts to find the current co- infection rates in North Delhi.

This retrospective study was done between August and November 2013. Medical records of 659 patients exhibiting febrile illness who visited Kasturba Hospital were studied. Dengue specific IgM antibodies were detected by Dengue IgM antibody capture ELISA test. Serodiagnosis of Salmonella infection was conducted by Widal test in the hospital.

Of the 659 febrile sera samples tested here, 141 (21.39%) tested positive for dengue. Of these 91 were females and 50 males. Of the dengue cases, eleven were co-infected with enteric fever (11/141= 7.8%). Maximum number of dengue positive cases seen in age group 0-10 y. Case Fatality Rate (CFR) was zero. Age groups of patients co-infected with dengue and typhoid were as follows: 0-10 y: 5, 11-20 y: 3, 21-30 y: 2, >60 y: 1.

Co-infection should always be kept in mind while dealing with cases of dengue or enteric fever with or without atypical features. In order to reduce the burden of disease, along with improvement of sanitation and personal hygiene, emphasis should be given on vaccination against typhoid.