Malaria is a parasitic infection of the red blood cells. It is acquired via the bite of female Anopheles mosquitoes. The ecology of the disease is complex, depending on factors such as altitude, climate, mosquito breeding sites and human behaviour for successful transmission of the disease in an area.
There are four types of parasites namely Plasmodium vivax, malariae, ovale and falciparum. Vivax, malariae and ovale can cause serious illness but seldom cause death in otherwise healthy patients. P. Falciparum on the other hand can cause cerebral malaria and ultimately death in a relatively short period of time if left untreated. Anopheles mosquitoes can be found in most African countries.
For those travelling to many of the warmer regions of our world there may be a risk of contracting malaria. Each year this parasitic disease causes many deaths both in the tropics and among travellers returning to their home countries. Most of the transmission occurs in tropical Africa (approx. 95%) with the rest in Asia and Central & South America.
In the majority of cases the disease is transmitted to humans through the bite of an infected Anopheles mosquito. The parasite enters the blood and passes very rapidly into the liver cells. After an incubation period (usually 1 to 4 weeks) the parasite breaks out of the liver and back into the blood stream. At this stage the infected red blood cell begins to break down and only then does the patient start to develop symptoms.
All age groups are at risk of being infected by malaria.
Common symptoms include:
- Generalised flu symptoms
- Muscle aches
- Diarrhoea and vomiting
Although it is possible to test yourself for Malaria with a rapid finger prick test (Supplied by your Travel clinic) one should bear in mind that finger prick test are NOT 100% accurate. This implies that a test might return a negative result, when you do in fact have Malaria. It is therefore important to continue testing every 24 hours if you continue to feel ill, or to seek medical attention if you continue to feel ill.
Ultimately the only certain way of confirming a malaria diagnosis is by confirming the parasite’s presence on examination of a patient’s blood under a microscope. One negative smear or rapid test does not exclude malaria. A patient with fever should be tested repeatedly until the smear becomes negative or until a different diagnosis is made.
It is essential that all travellers recognize that none of the malaria prophylactic tablets is 100% effective. Avoiding mosquito bites remains the cornerstone of protection against malaria. At certain times (between dusk and dawn) it is essential that travellers cover up well and use adequate insect repellent. [Insect Bites]
Various drugs are used to protect against malaria. These drugs are used to kill the malaria parasite before the traveller becomes ill. They are commenced before entering the malaria area to ensure that protective levels are reached and that the drugs are tolerated. They need to be continued for 4 weeks after leaving the malaria area. [Malaria Prophylaxis]
It is essential that all travellers realize that malaria is a very serious disease. It can kill a patient very rapidly and as yet we have no vaccine against the disease. The primary responsibility for protection against the disease rests firmly with the individual traveller. The prescribed drugs may assist but they do not provide complete protection.
Remember that patients may develop malaria despite having taken all reasonable care with both personal protection against mosquito bites and prophylactic drugs. The disease may present many weeks or months after exposure.
If you feel you may have malaria it is essential that you attend for detailed medical examination as soon as possible. Ensure that the medical staff realize your history of international travel to a risk region, either just recently or in the distant past.
If you return from overseas and experience fevers, sweating, shivering, aches and pains and other flu like symptoms you should seek medical advice as soon as possible. Malaria can be a serious disease if left untreated. It is wiser to assume you have malaria until proven otherwise.