Malaria (patient information)
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Malaria |
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Malaria On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, MBBS [2]
Overview
Malaria is a parasitic disease that involves high fevers, shaking chills, flu-like symptoms, and anemia.
What are the symptoms of Malaria?
Symptoms of malaria may be divided in two categories, depending on the stage of the disease:
Uncomplicated Malaria
Symptoms of uncomplicated malaria include:
- General malaise
The classic progression of the disease which however, is rarely observed, is as follows:
- Cold stage - whee the patients experiences a sensation of cold and shivering
- Hot stage - characterized by fever, headaches, and children may experience seizures
- Sweating stage - characterized by sweats and return to normal temperature with a feeling of tiredness
Following the infective bite by the Anopheles mosquito, a period of time (the "incubation period") goes by before the first symptoms appear. The incubation period in most cases varies from 7 to 30 days.
What causes Malaria?
Malaria is caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. The disease may be transmitted from one human to another by the bite of infected Anopheles mosquitoes.
Four kinds of malaria parasites have long been known to infect humans:
- Plasmodium falciparum
- P. vivax
- P. ovale
- P. malariae.
- P. knowlesi - a recently recognized type of malaria that naturally infects macaques in Southeast Asia, that also infects humans, causing malaria that is transmitted from animal to human ("zoonotic" malaria).
Falciparum malaria, one of four different types of malaria, affects a greater proportion of the red blood cells than the other types and is much more serious. It can be fatal within a few hours of the first symptoms.
Malaria can also be transmitted from a mother to her unborn baby (congenitally) and by blood transfusions.
Malaria can be carried by mosquitoes in temperate climates, but the parasite disappears over the winter.
In some areas of the world, mosquitoes that carry malaria have developed resistance to insecticides. In addition, the parasites have developed resistance to some antibiotics. This has led to difficulty in controlling both the rate of infection and spread of this disease.
Who is at highest risk?
- Anyone is at risk to get malaria.
- Most cases occur in people who live in countries where malaria is endemic.
- People who live in countries where malaria is not endemic, may also get the disease when they travel to such countries, or through blood transfusions.
- Malaria may also be transmitted from an infected mother to her infant before or during delivery.
When to seek urgent medical care?
Call your health care provider if you develop fever and headache after visiting the tropics.
Diagnosis
During a physical examination, the doctor may identify an enlarged liver or an enlarged spleen. Malaria blood smears taken at 6 to 12 hour intervals confirm the diagnosis.
Treatment options
Malaria, especially Falciparum malaria, is a medical emergency requiring hospitalization. Chloroquine is a frequently used anti-malarial medication, but quinidine or quinine plus doxycycline, tetracycline, or clindamycin; or atovaquone plus proguanil (Malarone); or mefloquine or artesunate; or the combination of pyrimethamine and sulfadoxine, are given for chloroquine-resistant infections. The choice of medication depends in part on where you were when you were infected. Aggressive supportive medical care, including intravenous (IV) fluids and other medications and breathing (respiratory) support may be needed.
Where to find medical care for Malaria?
Directions to Hospitals Treating Malaria
Prevention
Most people living in areas where malaria is common have acquired some immunity to the disease. Visitors will not have immunity, and should take preventive medications. It is important to see your health care provider well before your trip, because treatment may begin is long as 2 weeks before travel to the area, and continue for a month after you leave the area. The types of anti-malarial medications prescribed will depend on the area you visit. According to the CDC, travelers to South America, Africa, the Indian subcontinent, Asia, and the South Pacific should take one of the following drugs: mefloquine, doxycycline, choroquine, hydroxychoroquine, or Malarone. Even pregnant women should take preventive medications because the risk to the fetus from the medication is less than the risk of acquiring a congenital infection. People on anti-malarial medications may still become infected. Avoid mosquito bites by wearing protective clothing over the arms and legs, using screens on windows, and using insect repellent. Chloroquine has been the drug of choice for protection from malaria. But because of resistance, it is now only suggested for use in areas where Plasmodium vivax, P. oval, and P. malariae are present. Falciparum malaria is becoming increasingly resistant to anti-malarial medications. For travelers going to areas where Falciparum malaria is known to occur, there are several options for malaria prevention, including mefloquine, atovaquone/Proguanil (Malarone), and doxycycline. Travelers can call the CDC for information on types of malaria in a given geographical area, preventive drugs, and times of the year to avoid travel. See: www.cdc.gov
What to expect (Outlook/Prognosis)?
The outcome is expected to be good in most cases of malaria with treatment, but poor in Falciparum infection with complications. Possible Complications
- Destruction of blood cells (hemolytic anemia)
- Liver failure and kidney failure
- Meningitis
- Respiratory failure from fluid in the lungs (pulmonary edema)
- Rupture of the spleen leading to massive internal bleeding (hemorrhage)
Possible complications
It can lead to infection of brain and brain coverings if not properly and timely treated.
Alternative Names
Quartan malaria; Falciparum malaria; Biduoterian fever; Blackwater fever; Tertian malaria; Plasmodium
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000621.htm Template:WSTemplate:WH