Malareich and Pregnancy

QUESTION

Hi , am 31 weeks pregnant and had to take Malareich as my Anti malaria drug. I did not take the drug until I felt I had malaria, because I had body pains and headaches. Please advise if I will be ok after taking the malareich.

ANSWER

Malareich is a combination drug comprising of sulfadoxine and pyrimethamine, which is one of the medications recommended for treatment of malaria in pregnant women. However it sounds like you took the medication because you thought you had malaria – it is really important to be diagnosed by a doctor. For example, they will be able to ensure that you get the correct type of treatment for the kind of malaria you have. Malareich, for example, is probably not as effective against P. vivax malaria as P. falciparum malaria, but P. vivax is still susceptible to chloroquine, which is another drug that is suitable for the treatment of malaria in pregnant women.

Ingestion of Malaria Blood

QUESTION

If someone were to eat/ingest the blood of an infected individual would they become infected with malaria? If an infected person’s blood was on their hands and they handled food, would eating the food put others at risk for malaria?

ANSWER

No, you would not get infected with malaria, as the malaria parasites must be transmitted into a person’s blood directly in order for them to be infected. As such, most transmission only occurs via mosquitoes: when a mosquito bites a person infected with malaria, it may pick up some of the malaria parasites while it feeds on the person’s blood. When it then goes to bite another person, after the parasite has replicated and changed inside the mosquito, it can pass the malaria on to the next person, again when it bites them and drinks the person’s blood.

Additionally, in some cases malaria can be transmitted by blood transfusion or organ donation, or from a mother to her unborn baby via the placenta, or through blood passed in childbirth. If you ate/drank malaria-infected blood, the parasites would be broken down and destroyed by your stomach acid.

Malaria Transmission

QUESTION

How is malaria transmitted?

ANSWER

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito. 

Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).

Hereditary Malaria

QUESTION

Can malaria be passed on through heredity?

ANSWER

In the vast majority of cases, malaria is only transmitted via the bite of an infected mosquito.

However, if a pregnant woman becomes infected with malaria, she can pass the parasite to her unborn child via the placenta, or via blood transfer during childbirth. An infection in a newborn child, caused by infection in the mother during pregnancy, is known as “congenital malaria”. Otherwise, a child cannot “inherit” malaria from their parents, apart from the above case of congenital malaria.

Can I Catch Malaria from Someone?

QUESTION

My fiancee contracted malaria a few years ago. It was diagnosed as recurring. Could I contract malaria from the infected person, I have had similar symptoms which last a day or two, recurring with regular two week intervals, of which the most concerning are malaise, fever, stiff neck, headaches and severe pains over abdomen spreading into my mid back. What should I do?

ANSWER

Malaria cannot be directly transmitted between two people—it is almost always transmitted by the bite of an infected mosquito, and cannot survive at low temperatures (under about 17 degrees C). In some very rare cases, malaria can be transmitted through organ transplant, blood transfusion and pregnancy, since it infects red blood cells. Given these restrictions, it is close to impossible that you contracted malaria from your fiancee, and you should talk to your doctor about alternative explanations.

Also, if your girlfriend has recurring malaria, she should talk to her doctor about taking primaquine. While not suitable for everyone (namely people with G6DP deficiency should not take it), it can kill the dormant stages of the malaria parasite and prevent recurrence.

Passing Malaria to Baby

QUESTION

I contracted Malaria 3.5 years ago (either in Uganda or Rwanda). I believe it was the Plasmodium falciparum strain. Upon my diagnosis, I was treated and have been healthy since.

In regards to pregnancy, is it safe for me to have a baby? What are the chances of passing the malaria virus to the baby?

ANSWER

First of all, malaria is caused by a single-celled parasite, not a virus.  Secondly, you probably don’t have to worry—malaria is only very rarely transmitted directly between a mother and her unborn baby, via infected red blood cells passing through the placenta. When I say rare, I mean very rare, especially in developed countries without endemic transmission. There are only 48 cases of this occurring in the United States in the last 60 years, for example. Moreover, this can only occur if you actually have malaria during the pregnancy; if you were successfully treated when you had malaria 3.5 years ago, the parasite should no longer be present at all in your body.

P. falciparum does not lay dormant in the body, unlike some other types of malaria. The only thing to consider is if you plan to travel to malarial areas while you are pregnant – pregnancy makes women more vulnerable to malaria infection, and many forms of malaria preventative medication and treatment have not been thoroughly tested for safety in pregnant women. If you are planning on travelling to malarial areas while pregnant, it would be wise to consult with a specialist travel doctor for the most up-to-date recommendations of malaria prevention when pregnant.