Malaria and Seizures

QUESTION

Is it possible to contract malaria early in life and have a seizure 20 years later?

ANSWER

I think it is highly unlikely. There are only two types of malaria that can reoccur long after the initial infection (Plasmodium vivax and Plasmodium ovale) and neither of these usually results in seizure or other cerebral effects. Looking through the literature, I can only find one case of P. vivax infection which had cerebral involvement (Beg et al., 2002, ‘Cerebral involvement in benign tertian malaria’, published in the American Journal of Tropical Medicine and Hygiene, volume 67, issue 3, pages 230-232).

Symptoms of Malaria

QUESTION

What are the symptoms of malaria?

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

 

Timing of Malaria Microscopy

QUESTION

Contrary to our past beliefs we came to know that malaria slides should be taken during afebrile periods when RBCs remain intact, enabling easier diagnosis of malarial parasites. Is this true?

ANSWER

That is a very interesting question, which I passed on to a diagnostic expert who serves as an advisor to Malaria.com. His response is as follows:

Blood films should be collected from someone who is sick with a febrile illness after they have been in an area where malaria transmission occurs.  That does not mean that the smears need to be collected during particular times during the fever cycle.  If the first set of films is negative they should be repeated every 12-24 hours for a total of 3 sets.  During that time period, in general, the parasitemia if present will be rising—increasing the likelihood of detection.

It is worth noting that blood films are of little to no value as a screening test of asymptomatic travelers.

Blood Test After Child’s Malaria Exposure

QUESTION

Our 2 year old son was exposed and bitten about 10 times on Friday, 21st of Ocober in Malindi, Kenya. This was our last day in Kenya after 3 days on the coast preceded by 4 in Masai Mara. On October 28, our son started vomiting. This lasted a day. He did not have a fever at the time. The doctor diagnosed him with rota virus. Our 2 year old took his last dose of Malarone on the same day the vomiting started.

We believe he did not keep it down. Since the doctor visit our son has developed a cough and has had a low constant 38 C fever for a day and a half. Given the risk of a small child to malaria, is there any reason we should not request a blood test for Malaria?

ANSWER

Generally speaking, coughing is not a common symptom of malaria, and fever more usually comes in cycles, so the clinical presentation suggests that your son may be suffering from another illness.

However, as you say, small children are particularly at risk from malaria, so I would say it is worth getting a blood test for malaria, to be on the safe side. It only requires fingerprick blood, and the results can be available very quickly.

It is also important to remember that Malarone (including Malarone Paediatric, the version marketing for children over 11kg in weight) should be taken for 7 days AFTER leaving a malarial area, to prevent latent stages of malaria developing into a full infection.

With small children, other preventative measures are also especially important, such as sleeping under an insecticide-treated bednet, wearing long sleeved clothing in the evenings and early mornings and using insect repellent on exposed skin.