| Infection
caused by a parasite that is transmitted through the bite
of an infected Mosquitoes.
Malaria
enters the body through the blood stream, once in the blood
stream parasites travel to the liver and destroy red blood
cells. Other complications include anemia caused by blood
cell destruction, and clumping of blood cells that may cause
brain and kidney damage.
They
carry malarial parasites, (plasmodium falciparum, vivax, oval,
or malaria), which are four different species.
Anopheles mosquitoes are sometimes identifiable by the way
they bite (head downward when biting), compared with culex
mosquitoes that stand parallel.
Female
mosquitoes of Anopheles type bite at night or twilight.
Urbanization
may create areas where mosquitoes may breed close to people
(stagnant water).
Mosquitoes usually don't travel more than two miles from where
they are bred.
Weird
exceptions are airport malaria acquired by passengers being
bitten by mosquitoes indoors during stopovers.
Wind
could also blow mosquitoes further away.
Only
female mosquitoes drain blood. Males eat nectars and fluids.
Malaria is caused by a parasite transmitted by certain species
of mosquito.
Once
a mosquito bites a parasite, a gamocyte enters the mosquito
and breeds internally creating oocytes and then sporocites,
which travel to the salivary glands of the mosquito.
These
sporocites can penetrate the liver of an infected human within
45 minutes.
Within
9-16 days the sporocites differentiate into merozites, which
invade red blood and liver cells.
Blood
cells rupture, releases gametocytes and merozites, which cause
the cycle of fevers and chills.
Different
malarial species have different severity of diseases all of
which are bad.
Sometimes
malaria may be easy to recognize, but also sometimes difficult.
Symptoms of malaria may be very subtle - flu like attack,
fever and chills which may lead to multi-organ failure and
death.
Important to note that malaria medication will lessen symptoms
of malaria but does not guarantee immunity. Malaria chemoproplylaxis
helps prevent life threatening malaria that will kill people
before seeking medical attention.
Any
symptoms should be investigated with thick and thin malarial
smear.
This
can still lead to misdiagnosis, as a smear may not "catch"
parasites on microscopic analysis.
If
malaria is suspected, one normal smear does not rule it out.
It
is generally assumed that any returning traveler with fever
has malaria until proven otherwise.
Many
other infectious diseases may also manifest as flu like symptoms
but malaria is the one diagnosis not to miss.
Many other mosquitoes co-exist with the Anopheles mosquito-Aedes
aegypti, Culex, Haemogogus, Sabethes, and Masonia, which cause
other diseases like yellow fever, filariasis, viral encephalitis,
dengue and other hemorrhagic fevers.
Other
insects (tse-tse flies, black flies, deerflies, sand flies,
lice, ticks and mites) cause a variety of illnesses many of
which have no known vaccine or medication to prevent illness
as well as no good treatment.
General
recommendations are to avoid all insects similarly to malarial
mosquitoes.
Prevention is best accomplished by avoiding being bitten.
Wear
long sleeved shirts and long pants.
Use
insect repellent, sleep under a mosquito net, use mosquito
coils, don't sleep on ground, and check for ticks and insect
bites daily.
Be
knowledgeable of the signs and symptoms of the disease you
may likely encounter where you are traveling.
Malaria
Medication
Types of medication to prevent malaria (chemoproplylaxis)
include
Chloroquine: (Aralen): Cheap, well tolerated but bitter
taste, can upset stomach and blur vision. There are many areas
resistant to chloroquine. Medication is started one week prior
to travel, and taken weekly during and for four weeks after
trip.
Mefloquine: (larium): More expensive, but 2-5% of people
reported side effects (anxiety, nausea, hair loss, poor sleep,
irritation). It is used where chloroquine resistance. Medication
is also weekly, starting one week before, during trip and
for four weeks after trip.
Doxycycline: Daily medication used where mefloquine
resistance or as alternative to above. Side effects include
stomach irritation and photosensitivity. It is started four
days prior to trip, and continues for four weeks after leaving
area.
Chloroquine, mefloquine and doxycycline should be taken for
4 additional weeks after leaving the malarious area because
they are only effective for malaria in the blood. Since the
parasite may be in the liver for 4 weeks, they must also be
taken for that long. Long- term use should be monitored for
adverse effects but has been used for years in expatriates
Malarone: (Atoraquine/Proquinil): Is new, but expensive and
can cause nausea and vomiting. This drug may be started 1-2
days before the trip. It is taken daily and then discontinued
7 days after the trip. It is discontinued sooner than mefloquine
because it is effective at killing malaria in the liver. So
there is no need to take this medication as long as mefloquine,
chloroquine or doxycycline.
Malaria
Self Treatment
Self-treat malaria kits are available. Many travelers would
do self-testing and then treat themselves. Also large doses
of malaria drugs in a sick person are not without side effects.
Self-treatment is not recommended. Instead preventative measures
are best and to seek medical attention if ill. 90% of travelers
with malaria do not become ill until after they return home.
This illusion of good health may foster urban myths among
travelers on laxity of mosquito precautions. Taking medications
to prevent malaria is not a perfect solution but is still
the over all best way to prevent malaria. All the malaria
medications have some type of side effects but the benefits
of them preventing malaria far outweigh these effects.
Summary of Signs & Symptoms of malaria
1. Headaches
2. Shakes and chills caused by fever
3. Fatigue
4. Rapid breathing
5. Nausea
6. Extremes sweating with a drop in temperature
Prevention of malaria:
1. Anti-malarial drugs
2. While in mosquito infested areas use mosquito netting
3. Avoid crowded or unsanitary conditions
4. Wear long pants and long sleeved shirts
Treatment:
Anti-malarial drugs are needed to kill the parasites
References: See our separate section
on malaria this website
Malaria Foundation International http://www.malaria.org/
WHO http://www.who.int/health_topics/malaria/en/
CDC http://www.cdc.gov/travel/malinfo.htm
Royal Perth Hospital http://www.rph.wa.gov.au/labs/haem/malaria/
Malaria Journal http://www.malariajournal.com/home/
Malaria Vaccine Initiative http://www.malariavaccine.org/
Global Fund to fight Aids, Tuberculosis and Malaria http://www.theglobalfund.org/en/
Malaria Homepage (French and English) http://www.chez.com/malaria/
Malaria and Health http://www.malariaandhealth.com/
Malaria Site http://www.malariasite.com/
WHO roll back malaria http://www.rbm.who.int/
For your
reference a downloadable version of this text can be found at these links.
Front
Page - Back
Page
|
