Malaria in the United States, Years Later

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QUESTION

For years, I have questioned what sickness I got years ago after a series of bug bites in a bayou in New Orleans. I’ve just read the symptoms described here and they fit everything I was suffering with. I even had problems with my liver, but I was never tested for Malaria because I had immediately left New Orleans for Italy. I never thought of mentioning it. This mysterious illness cropped up in different forms over the years and really I was never the same after it. It has been almost 12 years, and I still suffer from recurring illness which antibiotics help for a while, but it always comes back. Could it be that I have had Malaria in my system all this time?

ANSWER

While malaria was officially eradicated from the US in the 1950s, certainly the swamps and bayous of Louisiana and the rest of the Gulf were a key habitat and a major source of transmission prior to eradication. I just found a news report in the New York Times from October 1883 which reported 16 deaths due to “malarial fever” in the previous week alone!

While these days, virtually all of the 1,500 or so cases of malaria observed in the US every year are attributed to overseas travel, in 2002 a handful of cases of malaria in northern Virginia were believed to be due to local transmission. Prompt treatment, personal protective measures (such as screening houses) and vector control quickly quelled that mini-outbreak.

Given this history along with your symptoms, and particularly your recurrent episodes of fever, I would not rule out malaria, obtained in Louisiana, as a possibility! You should talk to your doctor about the possibility of a serological test for the antibodies against malaria—if positive, you should try to have a blood test done next time you have the recurrence of symptoms. If malaria is confirmed, you should report your case to the Centers for Disease Control (CDC) Domestic Malaria Unit, which monitors all malaria cases in the US.

Malaria After Doxycycline?

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QUESTION

I recently spent a month in Asia. I took doxycycline tablets for malaria. I took them for the month I was away and when I returned. I took the full course and had been fine. Within two days of completing the course I became ill. This has be going on for about a month now with severe headaches, nausea, dizziness, very tired all the time and feeling like I’m going to faint. I have been to the doctor five times, they think this is a virus, I have been tested for malaria and dengue fever. I am only just now starting to feel better. What could this be?

ANSWER

Since you are beginning to feel better, I would go with your doctors’ diagnosis of a viral infection of some kind. It is also possible that you were infected with intestinal amoebas or even worms. A more accurate diagnosis would require faecal sample and possibly blood tests. You did the right thing by getting tested for malaria and making sure you didn’t have dengue.

Fever and Body Aches with Malaria

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QUESTION

Is bad throat and fever with with body ache the symptom of malaria?

ANSWER

While fever and body aches are certainly some of the symptoms associated with malaria, a sore throat is well common, but could be the result of enlarged lymph nodes. It is important to note that these symptoms are also present with many other diseases; in fact, the symptoms of malaria are so general that sometimes it is difficult to diagnose, and a blood test should be performed to confirm that a patient is indeed suffering from malaria before treatment is given.

Blood Test for Malaria

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QUESTION

I would like to know whether the malaria prevention medicine could impact the blood test result for malaria?
For example, if we did a blood test after taking the malaria prevention medicine, will the blood test result could be positive because of that and we are actually not having malaria parasite inside our body?

ANSWER

Malaria preventative medication should not give you a false positive test result – in other words, if you are on malaria medication and take a malaria blood test, if it says you are positive, then you probably have malaria! Anti-malaria medication prevents malaria from establishing in your blood, and it is very effective if taken correctly, but there are instances in which someone taking anti-malarials still gets malaria. In these cases, the anti-malarials will often ensure than the severity of the infection is greatly reduced – it can also delay the onset of symptoms.

If you have taken medications for malaria, please help Malaria.com by taking our Malaria Medication Side-effects Survey: Treatment and Prophylaxis. Thank you!

Child with Fever – Malaria Symptoms?

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QUESTION

Three yrs old boy having fever every 20 days for past 5 times. Remains for 2-3 days. Can it be malaria?
Never got blood tested.

ANSWER

Recurrence of malaria every 20 days is not that common, but could be caused by two different events: (1) true relapse, whereby the boy is infected with either Plasmosium vivax or Plasmodium ovale, and the parasite is disappearing from his blood but re-emerging from dormant forms in the liver (called hypnozoites), or (2) what is known as recrudescence, whereby the parasite never disappears fully from the blood, but reduced enough to stop symptoms from being felt, then flares up again.

Both options can be treated, but require a blood test, to ensure that malaria is the correct diagnosis and also to distinguish between options 1 and 2 above, and different treatment will be required.

A blood test should be performed during a period where the boy is experiencing symptoms, as with both options above, if the infection is not “active” (i.e. few or no parasites are visible in the blood) a blood test may prove negative. Rapid diagnostic tests which look for antibodies might be a good choice in this instance, as they may detect even a non-active infection.

Blood Test After Child’s Malaria Exposure

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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.