What is Malaria
Malaria is a mosquito-borne disease that is endemic in Sub-Saharan Africa, parts of Asia and South America, as well as in other scattered locations around the world. The disease is transmitted when an infected mosquito bites a human or animal. Microscopic parasites in the mosquito’s saliva enter the victim’s bloodstream and make their way to the liver. They then mature and reproduce, causing potentially life-threatening illness. Although malaria can be successfully treated, the rapid onset of severe cases can cause death before treatment becomes available.
The symptoms of malaria may include painful fever, tiredness, vomiting and headaches. In severe cases it can cause jaundice, seizures, coma and death. The World Health Organisation estimates that in 2015 there were 214 million new cases of malaria resulting in 438,000 deaths. A single mosquito bite can potentially prove fatal and it is important to protect yourself it you are travelling to a malarial region (these include many popular holiday locations). There are a variety of preventative medications that you can take to avoid malaria. Your online GP will advise you, based on your own health situation and the potential risk that you face.
Causes of Malaria
Malaria is caused by tiny parasites that enter the bloodstream through bites from infected mosquitoes. The malarial parasites are present in the mosquito’s saliva and cross over to the bloodstream where they move to the liver. The symptoms of malaria usually begin around two weeks after being infected. Malaria is present in most parts of the world bordering the equator, and is endemic in Sub-Saharan Africa and areas of Asia and South America. If you are travelling to any of these locations, or even just passing through them, you are at risk of contracting malaria. You do not have to visit the jungle, or be near a swamp or a mosquito infested area to catch malaria. Infected mosquitoes can be found in developed cities, including in modern hotels, offices, and resorts (although the risk is usually lower).
A single bite from an infected mosquito may prove fatal. Even a less severe attack of malaria can cause considerable discomfort and the symptoms may recur unexpectedly months or years later. If you are travelling to a malarial region it is important to take full precautions against infection. These include taking prophylactic medication, using mosquito repellent, wearing long trousers and long sleeves (especially in the evening) and sleeping with full mosquito nets.
Symptoms of Malaria
The symptoms of malaria usually begin about ten to fifteen days after being bitten by an infected mosquito, but they can occur weeks or even months later. It is possible to visit a malarial region and develop malaria after you’ve returned to Britain. In 2015 there were 1,400 cases of malaria (with six deaths) reported in the UK. The onset of symptoms can be very sudden and will often take patients by surprise. Initially, malaria may feel like a bout of bad flu and can be confused with sepsis, gastroenteritis, or various viral infections. If you have been to a malarial region, and you experience any of the following symptoms it is important that you mention the possibility of malaria to your doctor.
- Symptoms of malaria may include:
- Muscle pains
- Paroxysm (a cycle of coldness, shivering, fever and sweating)
- Yellow skin (jaundice related symptoms in around 2.58% of cases)
- Seizures (fits)
The symptoms of malaria can be debilitating and can cause long term health problems. You should seek urgent medical assistance if you suspect that you have malaria. Serious cases of the disease may end in death. There is also a possibility of brain damage if you suffer from cerebral malaria. Other complications may include anemia, respiratory problems and pneumonia, and pulmonary oedema.
Diagnosis of malaria
The symptoms of malaria vary in intensity and number according to individual circumstances. They can also be confused with other diseases or viral infections, including sepsis, gastroenteritis, and various fevers. If you are consulting a doctor in a region where malaria is endemic, the health professionals may have a high level of practical experience and local knowledge to help with the diagnosis. Even so, the only reliable way to confirm a diagnosis of malaria is with a blood test. This may also be used to identify the particular type of malarial parasite that has caused your illness. Doctors will need to know whether you are suffering from a simple (uncomplicated) form of malaria, or a severe (complicated) form of the disease. Severe or complicated malaria is a medical emergency that requires hospitalisation and specialist treatment. Simple malaria can usually be treated at home with prescription medications.
If you have visited a malarial location during the previous year and you develop a recurring fever that alternates between chills and hot sweats, or you have unexplained flu- like symptoms with muscle pains and bad headaches, you should immediately alert your doctor to your travel history.
How to prevent malaria
There are two combined strategies for preventing malaria. The first is to take a preventative medication such as Doxycycline or Malarone. The second strategy is to limit your exposure to mosquitoes and prevent bites.
Preventative medicine for malaria (Chemoprophylaxis)
Preventative medicines for malaria work on the assumption that you will be bitten by infected mosquitoes and that malarial parasites will enter your bloodstream. The active ingredients in the medications can either disrupt or suppress parasites, or do both simultaneously.
- Disruptive prophylaxis involves preventing the malarial parasites from bonding to your red blood cells.
- Suppressive prophylaxis like chloroquine, proguanil, mefloquine, and doxycycline work to kill the parasites after they have passed through your liver.
- Causal prophylaxis like Malarone and primaquine use a combined effect to kill malarial parasites.
If you are prescribed either Doxycycline or Malarone, your online GP will give you precise advice about how to take the medication. This will include how many days before your trip you need to begin preventative treatment and how long you must continue to take the medication after you return.
Prevention of malaria
There are two combined strategies for preventing malaria. The first is to take preventative medication such as Doxycycline or Malarone. The second strategy is to limit your exposure to mosquitoes and prevent bites.
Avoiding mosquito bites
You can actively limit your risk of contracting malaria by avoiding mosquitoes and taking steps to prevent bites.
- Wear light coloured clothing that covers your body, especially in the evening.
- Use mosquito repellents on clothes and exposed skin
- Use a protective head net if you are in an area with a lot of mosquitoes.
- Try to stay in accommodation that has protective screens on doors and windows.
- Sleep under full mosquito netting
- Use residual sprays
- If you are sitting in one place, try to use fans or other means to create a disruptive airflow.
Consistently taking these simple precautions will reduce your chances of being bitten by infected mosquitoes.