MALARIA

 Basic information

description

Malaria is a serious infection caused by malarial parasites. It is transmitted by a mosquito bite. Most cases of malaria in the United States are in immigrants and travelers returning from malaria-risk areas. A few cases are transmitted by blood transfusion, from mother to fetus during pregnancy, or by mosquito bite that occurred in the United States. Malaria can occur in all age groups.

FREQUENT SIGNS & SYMPTOMS

• Symptoms usually occur about 7 to 30 days after infection (though it can be up to a year or more).
• Shaking chills, with a fever. This is followed by heavy sweating and temperature drops. These may repeat.
• Fatigue and general ill feeling.
• Muscle and joint pain.
• Symptoms may include headache, nausea, vomiting, and diarrhea.

causes

The mosquito becomes infected with malaria after biting a person with the disease. The parasites multiply in the mosquito for a week, then enter the bloodstream of the next person the mosquito bites. Once in a person's bloodstream, the parasites travel to the liver, where they thrive and multiply rapidly. After several days, thousands re-enter the bloodstream and destroy red blood cells. Some parasites remain in the liver, continue to multiply, and are released again at intervals into the bloodstream.

risk increases with

Living in, or travel to, any country where malaria is a risk. It is most prevalent in rural tropical areas such as those found in Latin America, Asia, and Africa.

PREVENTIVE MEASURES

• Take antimalaria drugs before visiting an area where malaria is a risk. Continue to take the drugs after you return. A travel health clinic or your health care provider can give you instructions.
• In mosquito-infested areas, wear long-sleeved shirts and pants, especially from dusk to dawn. Use a DEET insect repellent on exposed skin. Sleep under a bednet that has been dipped in permethrin insecticide.
• Contact Centers for Disease Control (CDC) traveler information about malaria risks and prevention. Toll free voice (877) FYI-TRIP or toll free to get fax information (888) 232-3299, or website: www.cdc.gov/travel.

expected outcomes

Curable with treatment. Symptoms usually improve in about 48 hours and fever is gone in about 4 days. Children, persons with weak immune systems, and pregnant women are more at risk for complications.

possible complications

• Anemia, jaundice, or brain or kidney damage.
• Bleeding, seizures, or coma.
• Severe hypoglycemia (low blood sugar).
• Pulmonary edema (fluid in the lungs).
• Hemoglobinuria (hemoglobin in the urine).
• Enlarged spleen; rupture of the spleen (rare).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and recent travels. Medical tests will include special blood studies. Other tests may be done if complications are a concern.
• Treatment is with drugs. Hospital care may be needed with severe symptoms.
• All cases of malaria are reported to the local health department.

medications

• One or more antimalaria drugs to kill the parasite will be prescribed. It will depend on the type of malaria diagnosed.
• Take nonprescription acetaminophen for fever.

activity

Rest in bed until fever and chills subside. Resume your normal activities gradually as symptoms improve.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of malaria. Symptoms may begin up to one year after returning from travel in a malaria-risk area. During your travels, you should have the name of a medical person or center to contact if symptoms develop.
• After diagnosis, weakness lasts for a prolonged time. This may indicate anemia.
• Symptoms of malaria recur after treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: