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Malaria - the diseaseThis factsheet is for people who have malaria. For information on how to prevent getting malaria, please see the separate BUPA factsheet:
Malaria is caused by infection with a parasite called Plasmodium that is transmitted by the female of the Anopheles species of mosquito. Malaria is mainly found in tropical areas such as Africa, Central and South America, South East Asia and the Pacific islands. Over 2000 people a year in the UK get infected with malaria whilst abroad. Malaria parasiteYou can get malaria if a female of the Anopheles species of mosquito bites someone carrying the malaria parasite, then bites you, passing it to you. There are four different types of Plasmodium parasite:
Each causes a slightly different type of illness. P. falciparum (the most serious form) and P. vivax are the most common infections. It is possible to get infected with more than one type of Plasmodium parasite and this occurs in five to seven percent of infections. Parasite lifecycleThe malaria parasite passes through your blood into your liver, where it grows and develops. After it has completed its development it travels back into your blood stream, and eventually attacks your red blood cells that are needed to carry oxygen around your body. The symptoms of malaria then appear. Symptoms of malariaThe first symptoms of malaria are like having the flu. You may have:
A day or so later, your temperature may rise and you may have:
Your symptoms can appear any time after you are bitten by a mosquito carrying the malaria parasite. The time it takes your symptoms to appear can vary with the type of parasite that the mosquito was carrying.
If you have an illness with a fever and have travelled to a malarious region within the last year, you should visit your GP. Severe malariaIf you get infected with P. falciparum your malaria can progress to a more severe form and you may have symptoms including:
Severe malaria can also affect your brain and central nervous system and can be fatal. Symptoms of severe malaria can appear within hours or days of your first symptoms of malaria. It is important to seek urgent medical advice if you suspect you have severe malaria. DiagnosisYour doctor will examine you and ask you about your symptoms. He or she will need to know which countries or regions you have recently visited, including any stopovers. Your doctor will usually do a blood test to see if you have malaria. This may need to be repeated as the levels of malaria parasite in your blood can vary. If you have taken antimalarial drugs for example, the levels of parasite may be too low to detect. Repeating the test can help to confirm if you have malaria. TreatmentThere are a number of drug treatments that are effective if you start taking them soon after your symptoms appear. Resistance to certain drugs is a growing problem worldwide, particularly with P. falciparum. Therefore your doctor will ask you which region you have visited and take this into account. Some of the drug treatments for malaria can also help prevent malaria. For more information on preventive antimalarial drugs, please see the separate BUPA factsheet:
If you have taken a preventive antimalarial drug you should not take the same drug to treat malaria. You should tell your doctor about any drug treatments you have recently taken. A common treatment for P. falciparum malaria is artemether with lumefantrine (Riamet). Proguanil hydrochloride with atovaquone (Malarone) is also often used, particularly to treat malaria contracted in sub-Saharan Africa where there is resistance to other antimalarial drugs. Quinine is a safe alternative for pregnant women although you may get side-effects such as nausea and tinnitus (ringing in the ears). Quinine can also be combined with doxycycline for the treatment of P. falciparum malaria. Pyrimethamine with sulfadoxine (Fansidar) can be used with, or following, quinine. Mefloquine (Larium) can treat both P.falciparum and P. vivax malaria. It is now rarely used to treat P. falciparum however, due to resistance. Mefloquine is a prescription-only drug and is not suitable for everybody - ask your doctor or a travel health adviser whether it is appropriate for you. You should not take mefloquine if you are pregnant for example. Primaquine is used to destroy P. vivax and P. ovale parasites in your liver (see Parasite lifecycle above). You may need to take a different type of drug if the first treatment does not improve your symptoms after a couple of days. If your illness is mild you may take medication at home. However, you may need hospital treatment if you develop complications or need medication through an intravenous drip if you are not able to swallow tablets. Further information
References
Reviewed by Dr James Quekett, Bsc.MB Ch.B MRCGP DRCOG DFFP, partner/principal general practitioner at Rowcroft Medical Centre and Dr Martin Wiselka MB, BCh, MA, MD, PhD, FRCP, consultant in general medicine and infectious diseases, Leicester Royal Infirmary and BUPA Hospital Leicester. Published by BUPA's health information team, healthinfo@bupa.com, October 2005
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