Is it Malaria?

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QUESTION

I was in Zambia 3-4 weeks ago and had yellow fever shot and malaria pills. A week ago I got a severe headache. I suffer from migraines now and then but it wasn’t one. The headache has not passed. 4 days ago I was feeling really ill. I was extremely tired and disorientated. I am nauseated, but not all the time. Have no appetite. I generally feel ill, like something isn’t right. Exhausted and almost confused. I just don’t have a fever and haven’t had the entire time—that’s why I haven’t been to doc for tests. Is having a fever the main symptom for Malaria? I am not pregnant and am generally a very healthy person.

Not sure if I should go for tests or just wait a few more days?

ANSWER

Fever is certainly a key symptom associated with malaria, due to the way the disease progresses through the human body. However, if you were taking malaria pills, it might be that they suppressed the infection sufficiently to reduce your symptoms. I would certainly recommend having a malaria test, if just for peace of mind. If you test positive you can immediately be treated, and if you are negative and still feeling unwell, you can discuss other possibilities with your doctor. One thought might be worm infections – helminths such as hookworm, roundworm (Ascaris or Strongyloides) or whipworm are very common in Zambia and are associated with symptoms of tiredness, listlessness, headache and nausea. The tests for these diseases are usually easy to perform from either a stool sample or blood test, and treatment is likewise very straightforward, with a single dose of albendazole or mebendazole for Ascaris, whipworm and hookworm, and a series of doses for Strogyloidiasis (this parasite can be harder to get rid of, though it is still very treatable. Ivermectin is another possible drug for this helminth).

Symptoms of Malaria

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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.

 

Malaria with Eye Pain

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QUESTION

I am having malaria with severe eye pains. What is this?

ANSWER

Have you actually been diagnosed with malaria, or do you just think you have malaria based on the symptoms? If the latter, I would suggest you visit the doctor immediately. Eye pain is not usually associated with malaria (beyond the fact that some headaches manifest behind the eyes), whereas eye pain is a common symptom of dengue fever, which is common in many of the same parts of the world as malaria.

The other symptoms of dengue include fever and nausea and are thus similar to the general symptoms of malaria, allowing them to be mistaken for each other in some cases. If the pain worsens with eye movement, this is also characteristic of dengue fever. A key symptom is the presence of a rash, similar to that of measles.

Diagnosis is usually made based on clinical presentation, so it is crucial you see a doctor or visit a clinic. Other tests, such as a tourniquet test or a white blood cell count, can also assist diagnosis. If necessary, there are also laboratory tests, such as cell culture or PCR, which can be used to confirm the infection.

Post Malaria Symptoms

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QUESTION

My girlfriend had malaria in Uganda. It was detected 2nd of October, it was mild form, she felt dizzy, temperature was little higher. She got Artefan, forth day she was in hospital for review, they told her from blood test that its not malaria anymore.

We came home (Slovakia) but week ago she had suddenly the same symptoms like she had had the first time—dizziness, pain in head, temperature. Rapid test showed her she has no malaria. But she is still feeling weak, once in five days she suddenly feels dizzy, sometimes temperature 37,3 Celsius (yesterday last time). Doctors found nothing. Could it be some post-malaria symptom or she might have some other infection? Is it normal?

ANSWER

Rapid tests for malaria are usually quite accurate, especially if the patient is experiencing symptoms. Moreover, the cycles of malaria infection are usually shorter, with patients experiencing fever and dizziness every other day (for Plasmodium falciparum, which is the most common kind in Uganda). I would recommend trying a second rapid test, preferably of a different brand, just to check—make sure it detects ALL kinds of malaria and not just Plasmodium falciparum, as while it is the most common and dangerous kind, there are other types in Uganda, such as P. ovale, which might not show up on a P. falciparum-only test.

If you have access to a travel clinic or hospital that has experience in tropical diseases, you could also see if they could do a blood slide and check for the presence of malaria parasites in your girlfriend’s red blood cells.

If a second rapid diagnostic test is negative, or there is no sign of visible malaria parasites in her blood, then I suspect she has some other infection, as continued symptoms are not usually a side effect of successful malaria treatment.

Do Sporozoites in blood signal the end of prepatent period?

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QUESTION

Will the appearance of sporozoites in blood mark the end of prepatent period in malaria?

ANSWER

Actually, no. The presence of sporozoites indicates the start of the infection. Sporozoites are introduced into the bloodstream via the bite of an infected mosquit0. The sporozoites then have to make their way to the liver and infect hepatocyte cells, where they undergo pre-erythrocytic schizogony. This is where the malaria parasites produce multiple copies of their nucleus without dividing the cytoplasm of the cell; new copies of the cell are produced by budding. These new cells are called merozoites, and they are released back into the blood, where they search for erythrocytes (red blood cells) to infect.

This is the end of the pre-patent period in malaria, as the symptoms of disease will start once the merozoites infect and rupture the host’s red blood cells, and parasitaemia may also be detected at this stage through observation of peripheral blood samples.

Signs of Malaria

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Hello my question is how do I see malaria signs if i haven’t gone to check yet?

 

The key is to recognise whether you have any potential symptoms of malaria, or if you have been bitten a lot by mosquitoes recently and live in an area where malaria is present. Malaria can have many different symptoms, but the initial signs are similar to a flu-like illness, with high fever, chills, headache and muscle soreness or aches. A characteristic sign of malaria is cyclical fever, with peaks of severity every two or three days. Additionally, some people will experience nausea, coughing, vomiting and/or diarrhea.

Because these symptoms are quite generic of a wide variety of illnesses, if you live in a malaria-endemic region, it is crucial to be tested when you develop such symptoms. If you have recently traveled to a malarial area and start to experience these signs of infection, similarly you should inform your doctor of your travel history, as otherwise they might not recognize your symptoms as potentially that of malaria.

If you live in a malarial area, you can always visit a clinic and see if they will do a test to screen you for malaria, even if you don’t have the above symptoms. People who live in malarial areas develop partial immunity to the disease, meaning that new infections do not always present themselves as acutely as when they were children, or in people who are being infected for the first time. As such, some people can have low levels of parasite in their blood and while they may feel tired or a bit under the weather, do not have specific symptoms. This is especially the case for the less severe and deadly forms of malaria, such as Plasmodium vivax, P. ovale and P. malariae, so if you live in an area where any of these three are present, it might be worth getting a malaria test even if you don’t have symptoms.

However, it is very important not to accept treatment unless you are confirmed as having a positive diagnosis for malaria; taking treatment without having the disease can lead to resistance to the medication, and you may also experience side effects, which, though usually mild, are still probably better to avoid!

What is Malaria?

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QUESTION

What is it?

ANSWER

I have copied the below answer from an earlier question also asking what malaria is:

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance.

Symptoms of Malaria

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QUESTION

What are the main symptoms of malaria?

ANSWER

Malaria can have many different symptoms, but the initial signs are similar to a flu-like illness, with high fever, chills, headache and muscle soreness or aches. A characteristic sign of malaria is cyclical fever, with peaks of severity every two or three days. Additionally, some people will experience nausea, coughing, vomiting and/or diarrhea.

Because these symptoms are quite generic of a wide variety of illnesses, if you live in a malaria-endemic region, it is crucial to be tested when you develop such symptoms, rather than assuming it’s just the flu and soldiering on! If you have recently traveled to a malarial area and start to experience these signs of infection, similarly you should inform your doctor of your travel history, as otherwise they might not recognize your symptoms as potentially that of malaria.

If treated rapidly and with the correct medication, malaria is almost always completely treatable; it is only if treatment is delayed that it becomes more serious, with long-lasting and potentially fatal consequences. Similarly, if you take sensible precautions while living or traveling in malarial areas, such as taking prophylaxis (and taking them as per the instructions, for the full required amount of time!), avoiding being bitten by mosquitoes and sleeping under an insecticide-treated bed-net, you vastly reduce your chances of getting infected in the first place.

It’s also worth noting that different species of Plasmodium, the parasite that causes malaria, cause slightly different manifestations of the disease, and also require different forms of treatment. Plasmodium falciparum has a unique way of affecting the red blood cells it infects, which eventually can result in loss of function of internal organs. ‘Cerebral malaria’ is a particularly deadly version of this, whereby the function of the brain is affected. The cycles of fever, mentioned above, are caused by synchronous rupturing of the red blood cells in the body by the malaria parasite; P. falciparum, P. vivax and P. ovale, complete this cycle every 48 hours, resulting in fever cycles of roughly two days (though P. falciparum can be unpredictable); P. malariae, on the other hand, has a cycle lasting 72 hours, so three day cycles of fever are expected. Finally, although many types of malaria can be successfully treated with the drug chloroquine, some strains, and notably of P. falciparum, have become resistant to this treatment. In these cases, artemesinin-based treatment is recommended, usually in combination with other therapies (artemesinin-combination therapy, or ACT). P. vivax, in addition, requires an additional drug, called primaquine, which is used to treat lingering liver stages of the parasite, to prevent recurrence of the infection.

Is it just a cold?

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QUESTION

I came back from a Kenya safari and Mombasa beach holiday 21 days ago.
I took my malaria tablets as prescribed, and only got 5 bites on my last morning.

Since yesterday, I have been feeling hot then cold, though not shivering or overly sweating. A headache which is constantly there. I have also today been sick after eating/drinking. Feeling really tired. Also sore throat and blocked nose which makes me think its more a cold, so don’t want to bother my GP.
Any advice would be appreciated.

ANSWER

Malaria does have an incubation period, which means that the symptoms only show up days or weeks (or in some cases, years) after the patient is bitten by an infected mosquito. Different species of malaria have different incubation times; Plasmodium falciparum, which is the most common form in sub-Saharan Africa, usually has shorter incubation times than P. vivax, a still-acute but less deadly form. P. falciparum incubation is usually between 1 and 3 weeks, although taking anti-malarial medication can extend it. As such, since you began experiencing symptoms within a few weeks of returning, there is definitely a chance it could be malaria, although less likely if you haven’t experienced any fever (this is a key symptom of malaria, and usually goes in cycles of about 48 hours). However, since malaria is a serious issue, and can progress rapidly if not treated, I would suggest you see your GP – if you tell them that you have recently returned from a highly malarial area, they will understand your concern! Alternatively, if you live near London, if you have a fever you can go straight to the A&E department of the Hospital for Tropical Diseases (HTD) in Warren Street, where they have doctors that specialise in traveller’s health and tropical medicine.

Symptoms of Malaria

by

QUESTION

What are the symptoms of malaria?

ANSWER

The 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. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. Since the early symptoms of malaria are very similar to many other conditions, including flu and the common cold, if you live in a malaria area it is important not to ignore these symptoms but to seek medical help and have a blood test to check for malaria early on.