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Malaria

Fever - Fever in Thailand

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A fever occurs when your temperature rises above its normal range. What's normal for you may be a little higher or lower than the average temperature of  37 C. That's why it's hard to say just what a fever is. But a "significant" fever is usually defined as an oral or ear temperature of 38 C or a rectal temperature of 39 C. If you're an adult, a fever may be uncomfortable, but it usually isn't dangerous unless it rises above 39 C. For very young children and infants, however, even slightly elevated temperatures may indicate a serious infection. In newborns, a subnormal temperature - rather than a fever - may be a sign of serious illness.

COMPLICATIONS

Most people who develop dengue fever recover completely within 2 weeks. Some, however, may go through several weeks to months of feeling tired and/or depressed. Others develop severe bleeding problems. This complication, dengue hemorrhagic fever, is a very serious illness which can lead to shock (very low blood pressure) and is sometimes fatal, especially in children and young adults.

Malaria is a serious and sometimes fatal disease which is widespread in many tropical and subtropical countries. It is caught by being bitten by an infected mosquito that is carrying the malaria parasites in its saliva.

  • Parasites
  • The malaria parasite is a microscopic organism called a Plasmodium and it belongs to the group of tiny organisms known as protozoans. There are four types of plasmodium: P. falciparum (the most dangerous), P. vivax, P. ovale and P. malariae. The species of mosquito that carries the malaria parasites is the Anopheles mosquito.

    Malariacyle
    These parasites enter the host's bloodstream when bitten by an infected mosquito and then migrate to the liver where they multiply before returning back into the bloodstream to invade the red blood cells. The parasites continue to multiply inside the red cells until they burst releasing large numbers of free parasites into the blood plasma causing the characteristic fever associated with the disease. This phase of the disease occurs in cycles of approximately 48 hours.

    The free parasites are then able to infect any mosquito that feeds on the host's blood during this phase. The cycle then continues as the parasites multiply inside the mosquito and eventually invade its salivary glands. (see the plasmodium life cycle below).

    Malaria occurs in over 100 countries and more than 40% of the people in the world are at risk. Large areas of Central and South America, Hispaniola (Haiti and the Dominican Republic), Africa, the Middle East, the Indian subcontinent, Southeast Asia, and Oceania are considered malaria-risk areas.

    Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Infection with one type of malaria, P. falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.

    For most people, symptoms begin 10 days to 4 weeks after infection, although a person may feel ill as early as 8 days or up to 1 year later. Two kinds of malaria, P. vivax and P. ovale, can relapse; some parasites can rest in the liver for several months up to 4 years after a person is bitten by an infected mosquito . When these parasites come out of hibernation and begin invading red blood cells, the person will become sick.

  • Headache
  • Nausea
  • Parasites
  • vomiting
  • Any traveller who becomes ill with a fever or flu-like illness while traveling and up to one year after returning home should immediately seek professional medical care. You should tell your GP that you have been traveling in a malaria-risk area.

    Malaria can be cured with prescription drugs. The type of drugs and length of treatment depend on which kind of malaria is diagnosed, where the patient was infected, the age of the patient, and how severely ill the patient was at start of treatment.

    Anybody travelling to an area where malaria is endemic is at risk of catching the disease. Lately there has been an increase in the cases of malaria reported in the UK - in 1993 there were 1922 reported cases in the UK, including five deaths. All caught the disease abroad and almost all cases could have been prevented.

    Be aware of the fact that adventure travelers are usually more exposed to malaria than ordinary travelers due to the nature of their activities and the fact that they travel to the more remote locations.

    The Malaria Cycle (Plasmodium life cycle)

    Malariacyle

    Malariacell

    Ruptured blood cells release free parasites (gametocytes) into the
    host's bloodstream.

  • Parasites
  • The human host shows the classic malaria symptoms at this stage.

    The gametocytes are sucked up by a feeding mosquito and the cycle begins again.

    Malaria > 1 > 2 > 3 > 4

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