Malaria Causes and Treatment

Symptoms

Malaria (Italian, “bad air”) manifests itself in the following symptoms, which usually appear a few weeks after transmission. The incubation period ranges from a few days to several years:

  • High fever, sometimes with rhythmic attacks of fever, every second or third day. However, the fever may also occur irregularly.
  • Chills, profuse sweating.
  • Headache, muscle and joint pain
  • Feeling sick
  • Vomiting, diarrhea, lack of appetite

Malaria can lead to complications in a severe course and take a fatal outcome. Particularly feared are infections with , which triggers malaria tropica. It is estimated that up to one million people die annually from malaria. Sub-Saharan Africa is mainly affected, but also Asia and South America. Although Switzerland is malaria-free, the disease is important for travel medicine. Every year, between 100 and 300 cases are reported among travelers returning to Switzerland. The vast majority of cases occur within one month of return.

Cause

Malaria is a parasitic infectious disease caused by plasmodia. In humans, the following five pathogens are possible causes: , , , and . Plasmodia enter the bloodstream when bitten by a female mosquito of the genus. They multiply first in the liver and then in the red blood cells, which they thereby destroy (see under Malaria Replication Cylus, animation). Less commonly, plasmodia are also transmitted via blood transfusion, contaminated syringes, or from mother to child. Apart from these, however, direct transmission from person to person is not possible. see also: malaria replication cylus

Diagnosis

Diagnosis is made on the basis of the patient’s history (stay in the malaria area), physical examination, microscopic methods, and other laboratory methods (e.g., PCR).

Nonpharmacologic prevention

Anyone traveling to a malaria area should seek advice in advance from specialists in tropical medicine at a travel medicine center. For prevention, insect bites from mosquitoes should be avoided:

  • The mosquitoes bite mainly between sunset and sunrise.
  • Wear long-sleeved outer clothing and pants, which may be impregnated with insecticides
  • Apply repellents suitable for the tropics, such as DEET
  • Stay in secured rooms
  • Disrupt the flight of insects with a powerful fan
  • Spray insecticides and repellents in the bedroom
  • Use an insecticide-impregnated mosquito net (e.g. permethrin) over the bed in case mosquitoes can enter the sleeping room

Medication prevention

Vaccination is not currently available in many countries. In the so-called chemoprophylaxis (drug prophylaxis), a malaria drug such as atovaquone + proguanil, doxycycline or mefloquine is taken as a preventive measure. This protects the organism from infection. However, the risk does not drop to zero. The choice of drug depends, among other things, on the travel destination.

Reserve medications

If adequate medical care is not available in an area, an antimalarial drug may be taken on the trip as a reserve emergency medication, to be administered at the first sign of malaria or upon diagnosis. However, the traveler should still seek medical treatment as soon as possible.

Drug treatment

Various antimalarial drugs that are causally effective against the plasmodia are used for drug therapy of malaria. Detailed information can be found under the individual agents. The choice depends on various criteria, including the type of pathogen, clinical picture, availability, and existing resistance: