According to the Centers for Disease Control and Prevention (CDC.gov, 2017), malaria is contracted from the bite from a specific type of mosquito. A dangerous and sometimes fatal disease, symptoms of mild malaria include chills, high fever, and other signs similar to the flu; severe malaria results in organ failure and is a medical emergency. Even though malaria is a serious threat, it is treatable and preventable.
There are approximately 1500 cases of malaria diagnosed annually in the United States. Most of the cases originate in people traveling from countries where malaria is present, such as South Asia and sub-Saharan Africa. There were 214 million reported cases in 2015 resulting in 438,000 deaths, most of which were children in Africa.
Originally called “bad air”, malaria or a form of it was noted 4000 years ago in China, Greece, and Rome. One Chinese remedy was Qinghao, derivatives of which are still used for treating the disease today. Spanish Jesuit missionaries traveling to the New World were taught the use of a medicinal bark for the associated fevers by Indian tribes. The bark was called Peruvian bark, and the tree producing the bark was later named Cinchona after the countess whose life was saved by its ingestion. The bark was later used to create quinine, one of the most effective medications currently used in malaria treatment.
The incubation period for malaria after receiving an infected bite may vary from shorter than a week to longer than a month, particularly if the traveler has taken drugs for malaria prevention. When a patient is seen by healthcare providers with a fever, a travel history should be taken in order to determine if there has been travel to an area where malaria is present. Diagnostic tests for the disease will provide a reliable diagnosis. Malaria is identified by the presence of microscopic parasites in the blood. The CDC has services available for diagnostic and technical assistance. The most effective medication depends on the severity of the infection, the type of mosquito carrier, and the geography where the disease was contracted.
The parasites present in malaria infection thrive in humans and the female Anaopheles mosquito. The parasitic infection in humans begins in the cells of the liver, and then the red blood cells after the liver cells lyse, releasing the parasites into the bloodstream. The infected blood cells cause the visible symptoms of the disease. The mosquito may become infected biting a human who is carrying malarial parasites, and humans become infected from the bite of a mosquito carrying the same parasites in its saliva.
There are a number of cautions recommended from the CDC in relation to the risk of contracting malaria. First, when traveling to a foreign country, check with local health agencies or use the CDC’s Malaria Map to determine if there is malaria present in the region. The Malaria Information by Country Table also offers information on the types of malaria present in the area to be visited, if resistance to medications exists, and what medications are recommended. Next, avoid the bites of potentially infected mosquitoes through the use of repellents. There are also medications for prevention if bitten that should be purchased before traveling to insure quality. Preventative drugs include atovaquone-proguanil, chloroquine, doxycycline, mefloquine, and primaquine. If travelers become ill within one year of entering an area of high-risk for malaria, they should seek medical help immediately.
References
CDC.gov. (2017). CDC - Malaria. Cdc.gov. Retrieved 18 January 2017, from https://www.cdc.gov/malaria/
