Malaria

Malaria occurs mainly in the tropical areas of the world, including Africa, Asia, and Central and South America. Humans acquire malaria through the bite of a mosquito. There are 4 species of Plasmodium that cause infection.

When an infected mosquito bites a person, the parasite travels through the bloodstream to the liver. The parasite multiplies in the liver. Then it goes back into the bloodstream and attacks the red blood cells. As the red blood cells are destroyed, symptoms begin in the body.

Common symptoms of malaria are as follows:

• fever, which may recur every 48 to 72 hours
• shaking chills
• excessive sweating
• headache
• nausea and vomiting
• diarrhea

The Plasmodium parasite causes malaria. The bite of the Anopheles mosquito transmits the parasite from person to person.

When a mosquito bites a person who has malaria, the parasite multiplies in the mosquito. If the mosquito then bites another person, it can inject the parasite into another person.

The infection can also be spread from an infected pregnant woman to her unborn child across the placenta.

People who travel to an area where malaria exists should take antimalarial medications. The exact medication depends on the area and the type of Plasmodium there.

Travelers can also help prevent mosquito bites by doing the following:

• wearing protective clothing
• avoiding the outdoors from dusk until dawn
• using mosquito netting while sleeping
• using insect repellents

A healthcare professional may suspect malaria after examining the person. The parasite causing the malaria can be determined by examining a blood smear under a microscope. The best time to obtain these blood samples is during a fever. A complete blood count, or CBC, will be ordered to look for low numbers of red blood cells and signs of infection.

Long-term effects that may result if malaria is untreated are as follows:

• very low blood count and bleeding
• respiratory failure (rare in children)
• kidney failure
• jaundice, or yellowing of the skin
• low blood glucose

Infection in the central nervous system may cause the following:

• confusion
• decreased consciousness (coma)
• seizures
• possibly death

Some types of Plasmodium can cause chronic infection in the liver. This can cause a relapse many years after the first infection.

Malaria is not spread directly from person to person. But if a mosquito bites an infected person, the mosquito can spread the disease to the next person it bites. Malaria may pass through the placenta of a pregnant woman and infect her unborn child.

Antimalarial medications are used to treat malaria. The choice of medication depends on the following factors:

• the species of malaria, and whether it is likely to be resistant to medications
• the age of the infected person
• the extent of symptoms

Medications commonly used to treat malaria include:

• quinine sulfate (usually combined with another antimicrobial)
• quinidine
• chloroquine (i.e., Aralen)
• primaquine
• a combination of atovaquone and proguanil (i.e., Malarone)
• mefloquine (i.e., Lariam)

Hospitalization and intravenous medications may also be necessary.

Medications used to treat malaria may cause stomach upset or allergic reactions.

For mild symptoms, bed rest, adequate nutrition, and medications may be enough. Recovery from more serious complications of malaria may take more time.

Any new or worsening symptoms should be reported to the healthcare professional.