Malaria Symptoms
What is Malaria?
Malaria is a serious and deadly disease transmitted by mosquitos. Although it is rare in most of the first world, malaria occurs in plague-like proportions in many countries. In 2000, nearly 1 million people died from malaria. In recent years, that number has decreased, but deaths were still at 781,000 in 2009.
Although malaria is primarily transmitted by mosquitos, the disease is the result of an infection by parasitic protists of the genus Plasmodium. This unicellular microscopic organism inhabits and feeds off red blood cells. More than 100 mosquito species of the genus Anopheles carry and spread Plasmodium protists by drinking infected blood. The parasites are passed on when the mosquitos jump from person-to-person while carrying infected blood.
Malaria is one of the oldest of known diseases. Mentions of it can be found in some of the earliest historical records. The name comes from the Italian mal aria and translates into English as “bad air.” The term was first used in 1740, but it was not contracted into a single word until the beginning of the 20th century.
The first Plasmodium protist to be identified was Plasmodium falciparum, in 1880. It has long been considered one of the deadliest species, but a new species, Plasmodium knowlesi, is nearly as serious. The less serious, but very common, species of malaria-causing protists are P. malariae, P. ovale and P. vivax.
Malaria Hotspots
According to the World Health Organisation (WHO), nearly half the world’s population lives in areas where malaria is transmitted. Most cases of malaria occur around the equator due to favourable environmental conditions for mosquitos, such as temperature and humidity. However, it is also common in certain subtropical regions, especially in Africa and East Asia. The highest concentrations of malaria are in the northern half of South America, Sub-Saharan Africa and India.
Most malaria hotspots have limited zones that are free from the disease. Malaria is very rare at high altitudes, during cold seasons and in the desert. Additionally, some areas have implemented successful malaria control programs that have created safe havens.
Malaria is spread through many other parts of the world on a more limited basis. Additional areas where malaria is transmitted include Mexico, Central America, West Africa, Central Asia, East Asia and the islands north of Australia, including New Guinea, the Philippines and the West Indies.
Malaria Symptoms
Malaria is categorised as an acute febrile disease, and the primary symptoms are severe fever, and headache. After becoming infected with the disease, symptoms can begin anytime from one to three weeks later, with the median range being 10 to 14 days. Some conflicting reports suggest that, in rare instances, symptoms may begin as soon as four days after infection or may incubate for nearly one year.
It is believed that inadequate treatment may be one reason for a prolonged incubation period. Another factor in the appearance and severity of symptoms is the species of Plasmodium protist causing the infection. P. vivax and P. ovale are known to have a longer incubation period. These species are often dormant when they enter the bloodstream, but they collect inside the liver until they become active again.
The classic symptoms of malaria are flu-like, but often occur in cycles. Specific symptoms include the following:
- High fever
- Headache
- Vomiting
- Chills
- Sweating
- Weakness
The preceding symptoms usually occur for one day and subside for one to three days before returning. The frequency of the cycle depends primarily upon the species of the protist. In some cases, the symptoms are constant and do not subside at all. As the disease progresses, it may appear to become less severe for days, weeks or even months before symptoms return. Infections such as this may last for several years
Many species of Plasmodium protist may also cause anaemia and other related complications, such as kidney failure or a ruptured spleen. If left untreated, symptoms may progress to coma and death.
Malaria Treatment
Malaria treatment falls into one of two general types: prophylactic treatment and treatment of an active infection. Prophylactic treatment primarily takes the form of mosquito vector control, whereas treatment of a malaria infection is best accomplished with a combination of drugs.
Malaria prevention is considered one of the best ways to rid problem areas of the disease. Prevention is accomplished by displacing the mosquito population through a process called vector control. Two common forms of vector control are by using insecticidal mosquito nets and indoor residual insecticides.
Insecticidal mosquito nets can cover large urban areas outdoors. They are very cost effective and practical. When used in combination with indoor residual insecticides, malaria can be reduced to practically nil.
Although no vaccine against malaria has been discovered, WHO recommends that anyone travelling in areas prone to malaria take a chemoprophylaxis. This is especially important for pregnant women because malaria can adversely affect foetal development in the second and third trimesters.
Once malaria is contracted, treatment is accomplished through the use of one or more drugs. In mild to moderate cases, drugs can be taken orally, but severe cases require hospitalisation, intravenous drugs and, possibly, intravenous hydration
The drug of choice in treating malaria is chloroquine phosphate, but some strains of Plasmodia are resistant to it. Resistance to a particular malaria drug is usually discovered through trial and error. If one drug is not working, then the next best drug is attempted.
Many doctors recommend patients be treated with a combination of drugs to increase the chances that one of them will be effective. However, since 2009, it has been discovered that particular strains are resistant to the most commonly used and safest combination drug treatment, known as Artemisinin-derived combination therapy (ACT). More effective drug treatments for malaria are currently being researched.
Malaria Prevention
One of the most important things you can do is to follow an effective malaria prevention routine. This can include the use of insect repellents, sleeping under protective nets, covering areas of the body when appropriate and of course the use of a course of anti-malaria tablets.
We have listed below the most widely used treatments for preventing malaria.
Comparison Table for Anti Malaria Tablets (Malaria Prevention)
| Malaria Tablets |
Atovaquone and proguanil hydrochloride(Malarone) |
Doxycycline |
| Dosage | One tablet per day | One tablet per day |
| Tablets required for a 14 day trip | 23 | 44 |
| Tablets required for a 21 day trip | 30 | 51 |
| Tablets required for a 28 day trip | 37 | 58 |
| When do I start taking the medication? | 2 days before entering your destination | 2 days before entering your destination |
| How long after leaving my destination should I continue treatment? | 7 days | 28 Days |
| Are there any side effects? | Usually mild: Headaches, stomach pain, nausea, diarrhoea. Increased sensitivity to sunlight |
Usually mild: Diarrhoea, nausea, sore throat, increased sensitivity to sunlight |
Anti Malaria Medication Online Consultation
Our doctors can provide you and your family with a preventative course of medication if deemed suitable, via a free online consultation.
Your first step however is to visit http://www.fitfortravel.nhs.uk/destinations.aspx
On the Fitfortravel website you will need to select which countries you will be travelling to. The destinations box is at the bottom of the homepage on the left hand side.
Once you select your destination you will be advised of which malaria tablets you need for that location. The information you need will be towards the bottom of the page, along with other advice and warnings.
Repeat the process for each destination you are planning to visit. Remember to make a note of the type of malaria tablets advised.
Our co-operative doctors are all GMC registered and follow strict confidentiality guidelines. Your information is encrypted and kept private through every step of the process.
