Malaria

Malaria is a disease passed through the blood. It is caused by a parasite. The parasite is typically passed to humans through the bite of an infected mosquito.

Malaria is caused by one of the following four types of parasites:

• Plasmodium falciparum
• Plasmodium malariae
• Plasmodium ovale
• Plasmodium vivax

An Anopheles mosquito becomes infected when it bites someone with malaria. Another bite will pass the malaria to a new person.

Malaria can be passed from a mother to her unborn child. It can also be passed through a blood transfusion from an infected donor.

Plasmodium falciparum is by far the most dangerous form of malaria. In most areas, it is also the most common form.

Risk factors that increase your chance of malaria include:

• Geography: Africa, Asia, and Latin America:
  • Malaria occurs regularly among tourists who fail to follow recommended precautions.
  • The majority of fatal cases of malaria seem to be acquired by tourists visiting game parks and other rural areas in east Africa.
• Living in or traveling to hot, humid climates where Anopheles mosquitoes are prevalent
• Failing to use DEET-containing insect repellents when outdoors
• Failing to use medicines to prevent malaria infection
• Failing to use mosquito netting (especially netting treated with permethrin) while sleeping

Once inside the bloodstream, parasites travel to the liver. There they multiply (hepatic phase). During this phase, the infected person has no symptoms.

After several days, the parasites' offspring are released into the bloodstream. The parasites infect red blood cells. Within 48 hours, the infected red blood cells burst. The parasites infect more red blood cells. This process leads to:

• Anemia
• Chills
• Diarrhea
• Headaches
• Jaundice (yellow coloring of the skin or eyes)
• Muscles aches
• Nausea and/or vomiting
• Recurrent fevers (as high as 106°F)

Without treatment, the cycle of red blood cell destruction and fever will continue. This can lead to death.

Symptoms usually begin within 10 days to four weeks after being bitten by an infected mosquito. P. malariae may not produce symptoms for a year or more. P. falciparum infections tend to cause more severe symptoms with higher death rates.

The doctor will ask about your symptoms, medical history, and travel history. A physical exam will be done. You will have blood tests done.

Prescription drugs are used to treat malaria. They kill the parasites. The choice of an antimalarial agent depends on:

• Severity and stage of infection
• Type of parasite

The following medications are used alone or in combination:

• Combination of pyrimethamine and sulfadoxine ( Fansidar )
• Artemisinin
• Chloroquine —In many parts of the world, P. falciparum is resistant to this drug.
• Clindamycin
• Doxycycline
• Malarone
• Mefloquine
• Primaquine (for hepatic phase of P. vivax and P. ovale )
• Quinidine
• Quinine

Many of these medicines are used to treat resistant strains of P. falciparum .

To reduce your chance of getting malaria when in an area where malaria is prevalent:

• Avoid being outdoors from dusk to dawn. This is when mosquitoes are most prevalent.
• Do not rely on electronic mosquito repellents, which are supposed to repel mosquitoes by emitting a sound. These devices do not prevent mosquito bites.
• Seek medical care right away for any illness with high fever.
• Take antimalaria medicine prior to, during, and after travel. Follow your doctor's instructions.
• Use DEET insect repellent when outside. It should be at least 30%-35%.
• Use flying insect spray in non air-conditioned rooms while sleeping.
• Use proper mosquito netting at night.
• Wear clothing that covers as much skin as possible.