What is Malaria?
Malaria is a serious illness caused by a parasite that transmit the infection to humans through a type of mosquito.
It’s found mostly on continents with tropical climates, yet areas in Africa below the Saharan region is where malaria is considered most prevalent.
In fact, it’s thought around 3.2 billion people are exposed to the risk of this condition and it’s children, pregnant woman plus inexperienced travellers who are most susceptible. (1,2,3)
Symptoms
Malaria is a febrile illness. This means it leads the body to respond by causing a very high fever.
However, thankfully not all mosquitoes carry the infection. It’s the female anopheles mosquito which causes all the problems. This is the type which carries the offending parasite, called plasmodium.
The infection is passed onto humans through the bloodstream when they are bitten by the insect.
Where malaria is concerned prevention is key, yet if you are unfortunate to get infected, typical symptoms are as follows: (4)
Chills
It can take up to 18 days for malaria symptoms to take hold of which one of the first signs is the shivers. You can start to experience a chilly feeling throughout the body, similar to the kind experienced when suffering with influenza or the common cold. (5)
Fever
As the illness progresses it will bring on symptoms of a high fever. In fact, it’s not unusual for malarial fevers to force body temperatures up to 41 degrees celsius. This can last for up to 12 hours. (6,7)
Sweating
As the fever begins to subside, excessive sweating will become apparent. This can occur for between 2 to 4 hours, before the cycle repeats.
Headache
During the fever phase those that are infected might also experience headaches as well as dry flushed skin. This is a common symptom and can be caused by complications, such as dehydration.
Nausea, Vomiting and Diarrhea
It’s not uncommon for an infected person to develop nausea, followed by vomiting and also diarrhea during the fever stage.
Jaundice
Jaundice is a dysfunction in the liver, which causes yellowing of the eyes, skin and nails.
It’s also a potential symptom of malaria. It’s caused by certain parasites entering the liver cells whilst they wait to mature.
An infected person can also show jaundice in cases of acute malaria caused by the p.falciparum parasite. In this case it’s classed as an emergency and requires immediate treatment. (8)
Abdominal Pain
Some people can experience pains in the stomach area. If abdominal pain is accompanied by any of the symptoms mentioned above, it could be a telltale sign of malaria.
Anemia
Anemia is when the red blood cells don’t carry enough oxygen for the body.
When the parasites enter the blood cells and start to reproduce it causes blood cells to burst. This can trigger anemia because the oxygen escapes before it reaches its destination. (9)
Seizures
Seizures can indicate what is called cerebral malaria and it’s a severe case of malaria brought on by a strain of the parasite.
Cerebral malaria can lead to seizures and in some cases coma.
It’s not entirely clear how it happens. However, one theory is that it’s caused by infected red blood cells travelling to brain tissue, they burst and contaminate the membranes. (10)
This mostly affects children aged five and under and the mortality rates are high. For those who do survive, it can cause long term neurological issues.
Stages
There are three stages of the malaria infection, which could be described as more of a vicious cycle as opposed to a typical start to finish.
The first two stages take place in the human body whereas the last stage is the transfer back from human to mosquito. (11,12)
It is during the last two stages where the febrile (fever) cycles become apparent.
Stage #1
During this stage a person gets bitten by a female anopheles mosquito, the carrier of the parasite.
At this stage there’s no way to tell if an infection has taken place, this is because of the incubation period. Therefore no symptoms will be displayed.
Stage #2
After a bite from an infected mosquito, parasites enter the bloodstream and make their way to the liver. Here they stay until they’re ready to reproduce, usually about one week.
Once ready, they travel to the bloodstream and settle into red blood cells to reproduce.
During this stage the febrile cycle starts to show along with the other symptoms. The cycles are started when the mature parasites burst during reproduction. (13)
Stage #3
By now the parasites are well established within red blood cells and are now reproducing, it’s also causing them to rupture. The parasites multiply and begin their destructive chain of events, infecting other red blood cells in their path.
The parasites are now fully present in the blood stream, this means when the person gets bitten by another mosquito, the infection then transfers back to the insect.
This means the cycle begins again.
Inside the mosquito the parasite divides, multiplies and then travels to the saliva glands where it gets ready to infect the next victim.
Treatment
Malaria can be life threatening and treatment should be started immediately. However, not all cases require the same treatment. Treatment is based upon: type of parasite, status of the patient, if any other conditions are present and if it’s a case of uncomplicated malaria or severe malaria.
What treatment you need depends on what parasite infected you. The region where you contracted the condition can also help figure out the best course of action.
For example, if you are in a country in Sub-Saharan Africa, you might have an infection by the parasite known as p.falciparum. This bug causes severe malaria and should be treated as fast as possible.
It’s also apparent some strains of the parasite have developed a resistance to certain medication therefore an accurate diagnosis is crucial for recovery.
Pregnant women who carry the illness have a higher chance of miscarriage as well as premature delivery, transmitting the infection to the baby and a higher mortality risk. The newborn baby should also receive further treatment after the birth. (14) However, prevention of malaria is considered one of the best types of treatment.
This is why it’s actively encouraged to: sleep with protective mosquito nets, apply mosquito repellent, cover up any exposed skin areas and use malaria preventative medicines. (15)
There are three cases of malaria which require different treatments:
Uncomplicated Malaria
This can be treated with typical antimalarial drugs. Such as chloroquine, artemisinin, quinine, mefloquine, to name a few.
The best treatment for malaria is the artemisinin-based combination therapy (ACT) This has shown to be the most effective treatment, even in cases of severe malaria. (16)
If the person is treated correctly it can cure the infection. (17)
Severe Malaria
Doctors will treat this type of malaria with an aggressive antimalarial therapy for at least 24 hours. (18)
When the patient is able to take oral medication the above mentioned drugs will be applied as needed.
Malaria in Pregnancy
It is very important to treat malaria in pregnant women, this is because they can transmit the illness to their baby during childbirth. Furthermore, the chance of illness causing complications such as premature birth or miscarriage increases during pregnancy.
Pregnant women won’t be treated with certain antimalarial medicines, except in the case of severe malaria. (19)
FAQ
What is malaria? Malaria is a serious illness transmitted to humans by an infected mosquito, mostly seen in warmer subtropical climates.
What are the signs of malaria? Since malaria is a febrile illness, signs are flu-like symptoms, such as high fever, chills, headaches and nausea. Some people will develop jaundice and anemia. In severe cases, seizures can occur.
How do you develop malaria? People get infected with malaria while being bitten by a mosquito carrying the parasite. When the insect draws blood to feed the parasite is injected into the bloodstream.
How are you diagnosed for malaria? Malaria is diagnosed using parasite-based diagnostic tests where a blood sample is examined for the presence of any parasite related to malaria with either a thin blood smear or thick blood smear. (20)
What is the best treatment for malaria? The best treatment for malaria is artemisinin-based combination therapy (ACT) or prevention. (21)
What are the long term complications of malaria? For people who survive malaria there are no long term complications. However, if the person was infected with certain strains of the parasite it could cause a relapse. In the case of cerebral malaria long term complications could be brain damage.
Is malaria considered a disability? Malaria is not considered a disability, however in the case of cerebral malaria, it can lead to a disability.
Is there a cure for malaria? Yes, if the right treatment is provided swiftly and accurately in most cases it can be cured. (22)
Is malaria life threatening? Yes, if it isn’t treated correctly it can be fatal. Not all the parasites need the same treatment, therefore the right diagnosis is vital.
Summary
Malaria is a disease caused by a species of the plasmodium parasite. These can transmit to humans through a mosquito when it feeds on human blood. The only mosquito who can carry the parasite is a female anopheles.
Malaria causes high fever with chills and excessive sweating, along with jaundice, stomach pain and anemia. If it remains untreated it can be fatal.
Malaria is not contagious, however it can transmit from human to human during childbirth, blood transfusions or even transplants.
For these reasons, if you are travelling to a country where the risk of malaria is great, it is vital to take preventative measures to ensure you don’t get infected.