In malaria (synonyms: Febris intermittens in malaria; Corsican fever; Malaria quartana; Malaria recurrens; Malaria tertiana; Malaria tropica; Malarial hepatitis; Malarial relapse; Malarial anemia; Malarial fever; Malarial fever; March fever anemia; Paludal cachexia; Paludal fever; Paludism; Plasmodium falciparum; Plasmodium ovale and Plasmodium vivax; Remittent fever in malaria; ICD-10-GM B54: Malaria, unspecified) is an infectious disease caused by plasmodia (protozoa/ protozoa). These are parasites in which five human pathogenic forms can be distinguished, which in turn cause different forms of malaria:
- Plasmodium falciparum – causative agent of malaria tropica (most dangerous form of malaria); predominantly found in the tropics and subtropics, also South America (Brazil and neighboring countries), South Asia (India and Pakistan), Southeast Asia* * , East Asia, and Africa (West Africa and Kenya).
- Plasmodium ovale and P. vivax* – causative agent of malaria tertiana; predominantly in temperate climates, but also in South Asia (India and Pakistan).
- Plasmodium malariae – causative agent of malaria quartana (rarest form of malaria); focal occurrence in the tropics.
- A new form of malaria with Plasmodium knowlesi, a Plasmodia species that occurs naturally in Javanese monkeys and other macaques in Southeast Asia, especially common in Sarawak and Sabah (Malaysia), leads to a doubling of erythrocytic forms in only about 24 hours. This leads to high parasite densities in the blood being reached very quickly. This form of malaria is as dangerous as malaria tropica.
* Duffy-negative trait carriers are resistant (resistant) to Plasmodium vivax parasites because the altered receptor prevents contact with the host cell. The Duffy factor is both an antigen and a receptor for Plasmodium vivax. Plasmodia from Madagascar and Cambodia have now been detected in which the gene for the “Duffy-binding protein” is present in duplicate, which could facilitate cell invasion by the parasites. However, the loss of Duffy protection could also have other causes. For example, another gene mutation may also be responsible. * * In Southeast Asia (northern and western Cambodia, southern Laos, eastern and central regions of Myanmar, Thailand, and Vietnam), artemisinin-resistant malaria tropica pathogens have been spreading at an alarming rate since 2012! Malaria is the most important tropical disease and the most important imported to Europe. Approximately 75% of cases imported into Germany are malaria tropica. Occurrence: The infection occurs mainly in tropical and subtropical regions (except Australia). Africa is most frequently affected with more than 90 % of the cases. Other endemic areas are: Central and South America, India and Southeast Asia. Isolated occurrence of malaria tertiana in Spain and Greece. Malaria-free areas are: Caribbean (except Haiti and Dominican Republic), Tunisia, some countries in the Middle East, Pacific south and east of Vanuatu. The infected persons reported in Germany are mainly infected in Africa (in 75% of the cases), less frequently in India or Papua New Guinea (approx. 500 imported cases per year). The transmission of the pathogen (infection route) is transmitted by female mosquitoes of the genus Anopheles. They are predominantly nocturnal and crepuscular. Rarely, transmission can occur through blood bags or unsterilized injection equipment. Diaplacental transmission from mother to unborn child can also occur (the incubation period of malaria tropica can be up to several months). Human-to-human transmission: No. The incubation period (time from infection to onset of disease) depends on the form of malaria:
- Malaria tropica – Plasmodium falciparum 7-15-20-(120) days.
- Malaria tertiana – Plasmodium ovale and Plasmodium vivax 12-18-21 days.
- Malaria quartana – Plasmodium malariae 18-40-42 days
- P.- knowlesi malaria – Plasmodium knowlesi 12-x days
It is estimated that up to 500 million people worldwide fall ill each year. Annually, more than two million people die from malaria. In addition, one must delineate rare cases of “airport malaria” or “baggage malaria”. Course and prognosis: Initially, the infection can be latent (hidden) and break out after months or years, for example, triggered by noxious agents (pollutants).Malaria tropica can quickly take a life-threatening course.With timely diagnosis and adequate therapy, the prognosis is good. The lethality (mortality in relation to the total number of people suffering from the disease) is 0.5 to 1 %. The other two forms of malaria usually run a mild course, but over a longer period of time. Malaria quartana can relapse (return) after many years to decades. Vaccination: A British pharmaceutical company has developed “RTS,S” (Mosquirix), the first vaccine against malaria. This vaccine is expected to be licensed in 2015. In Germany, direct or indirect detection of the pathogen is reportable by name under the Infection Protection Act (IfSG) if the evidence indicates acute infection.
