Malaria
What are the symptoms of Malaria?
Common symptoms of malaria include:
- General malaise
- Fever
- Chills
- Sweating
- Headache
- Nausea and vomiting
- Body pain
- Jaundice
The classically described progression of the disease, is as follows:
- Cold stage - where the patient experiences a sensation of chills and shivering
- Hot stage - characterized by fever, headaches, and seizures, frequently experienced by children
- Sweating stage - characterized by sweating and exhaustion upon the return to normal temperature
Following an infective bite by the Anopheles mosquito, a period of time (the 'incubation period') passes before the first symptoms manifest. 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 parasite, naturally infecting macaques in Southeast Asia as well as humans, which results in malaria transmission from animal to human ('zoonotic' malaria).
Falciparum malaria, one of the five different types of malaria, affects a greater proportion of the red blood cells than the other types, making it significantly more serious. It can be fatal within a few hours of the manifestation of the primary 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 is inactive over the winter.
In certain areas of the world, mosquitoes that carry malaria have developed resistance to insecticides and some antibiotics. This has led to difficulty in controlling both the rate of infection and subsequent spread of the disease.
Who is at highest risk?
- Anyone is at risk to contract 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.
- Who is at Highest Risk of Dying from Malaria?
- People who are heavily exposed to the bites of mosquitoes infected with P. falciparum (causes severe and life-threatening malaria) are at the highest risk of dying from malaria.
- People who live in African countries south of the Sahara desert, where P. falciparum is common
- People who have little or no immunity to malaria, such as young children, pregnant women, and travelers coming from areas without endemic malaria
- Individuals in poverty who live in rural areas and lack access to health care
When to seek urgent medical care?
Urgent medical care should be sought when:
- Symptoms of malaria manifest while traveling to a country where malaria is endemic
- Travelers who become ill with a fever or flu-like illness, either while traveling in a malaria-risk area, or following their return home (for up to 1 year). For this reason, is essential that individuals report travel history to their health-care provider.
Diagnosis
Health-care providers should always obtain a travel history from febrile patients. The manifestation of fever in individual who recently traveled to a malaria-endemic area should be immediately evaluated using the appropriate diagnostic tests for malaria.
Clinical diagnosis is based on the patient's symptoms and physical findings upon examination. The initial symptoms of malaria often are not specific and are characteristic of other diseases (such as the 'flu' and common viral infections). Likewise, the physical findings are frequently not specific.
In severe malaria clinical findings are more striking, increasing the index of suspicion for malaria. These may include:
- Confusion
- Coma
- Neurological focal signs
- Severe anemia
- Respiratory difficulties
Clinical findings should be confirmed with a laboratory test for malaria. these diagnostic tests may include:
- Microscopic diagnosis
- Antigen detection
- Molecular diagnosis
- Serology
- Drug resistance tests
In addition to ordering the malaria specific diagnostic tests described above, the health-care provider should conduct an initial workup and request:
- Complete blood count
- Routine chemistry panel
In the event that the person does test positive for malaria, additional tests will be useful in determining whether the patient has uncomplicated or severe manifestations of the infection. Specifically, these tests can detect:
- Severe anemia
- Hypoglycemia
- Renal failure
- Hyperbilirubinemia
- Acid-base disturbances
- Treatment options
Malaria can be a severe, potentially fatal disease (especially when caused by Plasmodium falciparum) and treatment should be initiated as rapidly as possible.
Treatment of malaria is dependent on numerous factors including:
Disease severity
- Species of malaria parasite causing the infection
- Part of the world in which the infection was acquired
- These latter two characteristics help determine the probability that the organism is resistant to certain antimalarial drugs. Patients who have severe P. falciparum malaria, or who cannot take oral medications, should be given treatment by continuous intravenous infusion.
What to expect (Outlook/Prognosis)?
In most cases, the prognosis of malaria is positive with prompt and proper treatment.
The prognosis of Falciparum malaria is poor due to the severity of the disease.- Links
- https://en.wikipedia.org/wiki/Malaria
- Relevant Occupations
- Infectious Disease Specialist
