Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.
Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).
Malaria Symptoms
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. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.
How soon will a person feel sick after being bitten by an infected mosquito?
For most people, symptoms begin 10 days to 4 weeks after infection, although a person may feel ill as early as 7 days or as late as 1 year later. Two kinds of malaria, P. vivax and P. ovale, can occur again (relapsing malaria). In P. vivax and P. ovale infections, some parasites can remain dormant in the liver for several months up to about 4 years after a person is bitten by an infected mosquito. When these parasites come out of hibernation and begin invading red blood cells (“relapse”), the person will become sick.
Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. Malaria disease can be categorized as uncomplicated or severe (complicated) . In general, malaria is a curable disease if diagnosed and treated promptly and correctly.
Malaria Incubation Period
Following the infective bite by the Anopheles mosquito, a period of time (the “incubation period”) goes by before the first symptoms appear. The incubation period in most cases varies from 7 to 30 days. The shorter periods are observed most frequently with P. falciparum and the longer ones with P. malariae.
Antimalarial drugs taken for prophylaxis by travelers can delay the appearance of malaria symptoms by weeks or months, long after the traveler has left the malaria-endemic area. (This can happen particularly with P. vivax and P. ovale, both of which can produce dormant liver stage parasites; the liver stages may reactivate and cause disease months after the infective mosquito bite.)
Such long delays between exposure and development of symptoms can result in misdiagnosis or delayed diagnosis because of reduced clinical suspicion by the health-care provider. Returned travelers should always remind their health-care providers of any travel in malaria-risk areas during the past 12 months.
Uncomplicated Malaria
The classical (but rarely observed) malaria attack lasts 6-10 hours. It consists of:
- a cold stage (sensation of cold, shivering)
- a hot stage (fever, headaches, vomiting; seizures in young children)
- and finally a sweating stage (sweats, return to normal temperature, tiredness)
Classically (but infrequently observed) the attacks occur every second day with the “tertian” parasites (P. falciparum, P. vivax, and P. ovale) and every third day with the “quartan” parasite (P. malariae).
More commonly, the patient presents with a combination of the following symptoms:
- Fever
- Chills
- Sweats
- Headaches
- Nausea and vomiting
- Body aches
- General malaise.
In countries where cases of malaria are infrequent, these symptoms may be attributed to influenza, a cold, or other common infections, especially if malaria is not suspected. Conversely, in countries where malaria is frequent, residents often recognize the symptoms as malaria and treat themselves without seeking diagnostic confirmation (“presumptive treatment”).
Physical findings may include:
- Elevated temperature
- Perspiration
- Weakness
- Enlarged spleen.
In P. falciparum malaria, additional findings may include:
- Mild jaundice
- Enlargement of the liver
- Increased respiratory rate.
Diagnosis of malaria depends on the demonstration of parasites on a blood smear examined under a microscope. In P. falciparum malaria, additional laboratory findings may include mild anemia, mild decrease in blood platelets (thrombocytopenia), elevation of bilirubin, elevation of aminotransferases, albuminuria, and the presence of abnormal bodies in the urine (urinary “casts”).
Severe Malaria
Severe malaria occurs when P. falciparum infections are complicated by serious organ failures or abnormalities in the patient’s blood or metabolism. The manifestations of severe malaria include:
- Cerebral malaria, with abnormal behavior, impairment of consciousness, seizures, coma, or other neurologic abnormalities
- Severe anemia due to hemolysis (destruction of the red blood cells)
- Hemoglobinuria (hemoglobin in the urine) due to hemolysis
- Pulmonary edema (fluid buildup in the lungs) or acute respiratory distress syndrome (ARDS), which may occur even after the parasite counts have decreased in response to treatment
- Abnormalities in blood coagulation and thrombocytopenia (decrease in blood platelets)
- Cardiovascular collapse and shock
Other manifestations that should raise concern are:
- Acute kidney failure
- Hyperparasitemia, where more than 5% of the red blood cells are infected by malaria parasites
- Metabolic acidosis (excessive acidity in the blood and tissue fluids), often in association with hypoglycemia
- Hypoglycemia (low blood glucose). Hypoglycaemia may also occur in pregnant women with uncomplicated malaria, or after treatment with quinine.
Severe malaria occurs most often in persons who have no immunity to malaria or whose immunity has decreased. These include all residents of areas with low or no malaria transmission, and young children and pregnant women in areas with high transmission.
In all areas, severe malaria is a medical emergency and should be treated urgently and aggressively.
Malaria Relapses
In P. vivax and P. ovale infections, patients having recovered from the first episode of illness may suffer several additional attacks (“relapses”) after months or even years without symptoms. Relapses occur because P. vivax and P. ovale have dormant liver stage parasites (“hypnozoites”) that may reactivate. Treatment to reduce the chance of such relapses is available and should follow treatment of the first attack.
Other Manifestations of Malaria
- Neurologic defects may occasionally persist following cerebral malaria, especially in children. Such defects include troubles with movements (ataxia), palsies, speech difficulties, deafness, and blindness.
- Recurrent infections with P. falciparum may result in severe anemia. This occurs especially in young children in tropical Africa with frequent infections that are inadequately treated.
- Malaria during pregnancy (especially P. falciparum) may cause severe disease in the mother, and may lead to premature delivery or delivery of a low-birth-weight baby.
- On rare occasions, P. vivax malaria can cause rupture of the spleen or acute respiratory distress syndrome (ARDS).
- Nephrotic syndrome (a chronic, severe kidney disease) can result from chronic or repeated infections with P. malariae.
- Hyperreactive malarial splenomegaly (also called “tropical splenomegaly syndrome”) occurs infrequently and is attributed to an abnormal immune response to repeated malarial infections. The disease is marked by a very enlarged spleen and liver, abnormal immunologic findings, anemia, and a susceptibility to other infections (such as skin or respiratory infections).
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Here are some further comments on malaria re-occurrence, courtesy of Dr Etty Villanueva, an MD from the Netherlands:
The re-occurrence of malaria needs some precision: A ‘relapse’ is a renewed manifestation of clinical symptoms (caused by parasitaemia, which means parasites in the blood) of a malarial infection, and comprises of two types: ‘recrudescence’ and ‘recurrence’, the latter of which is considered a true relapse.
A recrudescence is a renewed manifestation of symptoms due to an increase in the surviving population of erythrocytic forms; in other words, infection in the blood persists. In P. malariae a small number of parasites in the blood stream can cause a recrudescence after up to 50 years. In P. falciparum the parasites persist in the blood for a much shorter period and recrudescences cause renewed bouts of fever for up to one or two years in persons in whom the infection is not completely eradicated.
A recurrence/true relapse is a renewed manifestation due to multiplication of the parasites in the blood from an exo-erythrocytic (which means outside the blood cells) source, and most commonly from the liver cells. Dormant forms of the parasite, called hypnozoites, can become activated by some kind of trigger to resume growth and burst into circulation, invade red blood cells and cause a relapse. This ‘latency’ is only existent in P. vivax. It is absent in P. falciparum. Thus, although P. falciparum is much more dangerous than P. vivax, it is more easily cured by drugs, except where drug resistance has appeared.
On the subject of donating blood: Transmission of malaria by blood transfusion is frequently due to P. vivax or P. falciparum, but P. malariae accounts for many cases and is of special importance because of its chronicity in blood donors and the difficulty in detecting it. That is the reason that most countries refuse donors who have had malaria or have been exposed frequently to malaria when traveling. Dried plasma prepared from malarial blood is safe. In the Netherlands if you are refused as a donor because of the aforementioned reason you are accepted to donate plasma.
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Hi Lexi,
Thanks for your question! Malaria certainly is a serious disease which messes up your body while you are infected with the parasite. Problems can include complications with the liver, spleen and kidneys, particularly if you have a serious case of P. falciparum malaria. P. falciparum is also known for affecting the brain, leading to impaired consciousness, coma and even death. However, most of these complications are reversible once the infection has been cured, which is usually easily achieved through oral medication (or intravenous drugs if the disease has already progressed to a severe state). Other than that, long term consequences of malaria infection are usually limited to effects such as reduced growth in children that have been severely affected by malaria, or enlarged liver and spleen in people who live in highly endemic areas or who may have latent infection, for example with P. vivax or P. ovale. Hope that was helpful!
Cheers, Claire
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Hi Clair
I have been travelling in South America for over 7 months – including the Amazon jungle.
About 3 months ago I got very badly bitten in the Colombian jungle by mosquitos and until now I still have one bite that doesn’t seem to heal. I haven’t taken malaria pills during my trip as I was told the areas were safe.
However the bite has a hard centre and it itches all the time.
And I am wondering whether this is a potential malaria bite?
Thank you for your comment in advance
Kindest
Krisztina
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Hi Krisztina,
Mosquito bites usually go away in less than two weeks, so what you have is probably something else. Also, bites which cause malaria are no different from other mosquito bites, and if you haven’t had any symptoms such as fever or chills, I doubt you have malaria. Instead, it could be some other kind of bite, such as a spider or sandfly, or you could have gotten something underneath your skin (like a tiny splinter) which has now become infected. Some flies in South America also lay eggs beneath the skin, which hatch into larvae and can cause painful and itchy welts. Since you’ve had it for so long, I would recommend getting it checked out by a doctor!
Hope that helps.
Claire
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I caught malaria when I went to Angola, Africa working offshore. The doctors told me that I had 1
parasite and that it was under control because I have been taking my medication everyday. What I
need 2 know when I return back to the states can malaria come back. My wife ask me if she was
to have a baby can I pass it to the unborn child. Will I have to continue taken my malaria meds
when I return to the states to keep the parasite under control.
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Hi Keith, the quick answer is no, you can’t pass the parasite on to your child, but yes, in some cases the malaria can come back. The chances of this occurring depend on the type of malaria you had; when the doctor said you had “1 parasite”, that could either mean one species or strain (there are four different types that commonly infect people, and all have different subtleties to how they should be treated) or a very low parasite burden – either way, you should talk to your doctor about the type of malaria you have and what sort of treatment that implies. It was definitely good that you were taking your preventative medicine while you were in Angola; that certainly prevented a much worse infection, but it doesn’t mean that it will go away by itself, so you should consult a physician about receiving proper additional treatment.
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I work in Papua New Guinea and have had malaria (both kinds) several times. What I was told by ex-patriot doctors there upon leaving was to take what is called an eradication treatment using primaquine. You have to have a blood test first for a particular condition found in some people. It is called the G-6-PD. If normal you can take the primaquine to eradicate the parasites. When I have done it, I haven’t had a recurrence of malaria until I am back in a malaria area and have been bitten again. The treatment takes several weeks. Ask your doctor or a travel medicine doctor about it. People I know who work in Papua New Guinea do this quite often when leaving so as not to have attacks several months or years later.
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Hi Clif,
Thanks so much for this comment – you are absolutely right, and it’s a really important thing for people to know about the use of primaquine for preventing relapse of malaria. The information on G6PD testing is correct as well – this deficiency tends to run in families and populations so your doctor should know if you present a high risk case, and will test accordingly.
Thanks again!
- C
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I don’t think you’re ever completely the same again Tom. I’ve had P. Falciparum twice and P. Vivax three times all during my work travels in Africa. I’ve lost part of my hearing and have a permanent balance problem due to an overdose of intravenous quinine sulphate.
I hear you with the blood donorship issue they won’t accept my blood either!
Good luck to you.
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Did You Know That……….
Malaria kills more African children than any other disease.
Children who survive episodes of severe malaria may develop learning impairments and brain damage.
35 countries, 30 in which are in Africa, account for 98% of worldwide malaria deaths.
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Hi Bryce,
Thanks for your comment! Malaria certainly is the most deadly single disease for African children. However, it is important to note that according to the World Health Organisation, the leading cause of all deaths for infants and children under five in Africa is problems occurring immediately after birth, collectively known as ‘neonatal death’. 29% of fatalities in under-fives in Africa are due to these varied conditions, which include birth asphyxia and trauma, prematurity and low birth weight and neonatal infections.
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Hi my twin sister is in nigiria on a 5 month missions trip. She has just been diagnosed with Malaria, they believe she got it a year ago in El Savador and that it has been dormant in her system, she has week kidneys and has chronic high blood pressure due to childhood illnesses she has had her whole life. She is in the Northern part of Nigiria and the hospitals there are no real help, my questions is…. in your opinion should come home now to recover?? I am sure the type of Malaria she has, I have been doing lots of research and I am extremely concerned for her health. She has always had health issues and I am wondering if the malaria will be even worse for her given her pre existing health conditions. It is very hard to reach her so I am not able to ask her many questions, I know she is in pain, can’t keep food down and currently is not being treated in a hospital. Any thoughts or recommendations would be appreciated!!! ASAP Please!
Thank You!
Tasha Stewart
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Hi Tasha,
Sorry for the slow reply, I’ve been travelling. It sounds like your sister really needs urgent medical attention, and is not receiving that where she is in northern Nigeria. If possible, I would try to encourage her to seek further medical help, either in the area she is in or, if she is able to travel, in one of the major cities. If they have accurately diagnosed the type of malaria she has (which is presumably how they suspected she was infected in El Salvador, since it is likely not a species of malaria that is commonly found in Africa), it will be straightforward to give her treatment, but any physicians she sees must be made aware of her existing health conditions. If she has Plasmodium vivax, which is often found in Central America, she should also look into taking a course of drugs (called primaquine) which will prevent further recurrence of the disease at a later date. Hope this has been of some help and that she is on the road to recovery already.
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In addition to the above, I have just received some advice from a medical doctor who is involved with our website:
If she contracted it in El Salvador, then Plasmodium vivax most likely and not a particularly resistant strain (generally chloroquine sensitive west of Panama Canal). I think this could be easily treated in Nigeria so long as the diagnosis is clear and there are drugs available – almost any standard regimen would be effective. Did she have anything with her for prophylaxis or stand-by treatment? Chloroquine/mefloquine/Malarone shouldn’t need much adjustment for her kidneys, but it would help to know what her renal function is (GFR/Creatine). The pain and nausea/vomiting present a problem in keeping the medication down, however, even IV hydration is an option if she is becoming dehydrated from the illness. In general, more details are needed, as worsening kidney problems from hydration or gall bladder problems from not eating could complicate the picture, even if the malaria is treated. I don’t know where home is, but she should at least get to a town where basic blood work can be obtained, and anti-nausea medication/IV fluids are available.
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Thank you…this article was helpful!
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Hi,
I just wanted to know what symptoms a malaria
Infected person shows before it becoming life
Threatning? I too have malaria and my one
Eye has gone blurry and its blood red and in
The same day it cleared up.
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Hi Jen,
Malaria symptoms are much more like having a bad cold or the flu – fevers, chills, nausea, headache, etc. There are not usually any symptoms which are associated specifically with the eyes. If you think you might have malaria otherwise, you should go to your doctor or the hospital to get tested – they can then advise you on the best course of treatment for the particular type of malaria you have. Hope that helps!
-Claire
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Hi Claire,
I have already been tested and I do have malaria,
I have been on meds for 6 days now but it doesn’t seem to
Be going away. Do you perhaps know what symptoms
You get in order to know when it is life threatning?
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Hi Jen,
Life-threatening malaria usually progresses incredibly quickly (within two or three days), and you feel very very sick. While normal, so-called “uncomplicated” malaria usually still makes you feel pretty bad, the symptoms tend to be quite general, such as a high fever (cycles of fever are characteristic of malaria infections, usually every 2 or 3 days), chills, nausea etc. Clinical markers associated with severe, life-threatening malaria include convulsions/seizures, coma, impaired consciousness, hypoglycemia, respiratory distress, very rapid pulse and hyperlactatemia (elevated plasma lactate). The chances of developing severe malaria while on appropriate malaria medication are low.
You should always complete the full course of malaria medication, even if it doesn’t seem like the symptoms are going away. If you are still feeling sick after the full course of drugs, you should go back to your doctor. There are a number of reasons for treatment failure, such as resistance in the parasite (many types of P. falciparum malaria are resistant to chloroquine, for example) or counterfeit drugs, so it is important you get tested again to see if the malaria really is still there, and if so, you should take a different kind of medication to try to cure it. Your doctor might also want to test you for some other common diseases, such as bacterial infections, viral infections or even other parasites; the symptoms of malaria are quite non-specific and similar to lots of other infections, so if you tested positive for malaria your doctor might have focused on treating that and not looked for other potential co-infections.
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My husband was in Vietnam 1966-67. A few years ago he developed seizure disorder. Knowing this can happen we had him tested for Malaria and he did test positive to P. falciparum with the blood test. They did not make and recommendations as to a followup –. He has had 30+ years of now and then develope flu like symptoms and would feel poor , lay in bed well covered, and then in two or three days have a total body sweat, and once again feel okay. He does not recall having Malaria in Vietnam, however they were in the field most of the time and it is my understanding from many articles if the fever didn’t get higher than 102 they were not shipped out.
His records do not indicate any illnesses. He did have a fungal or parasitic infection of the leg, (not in his medical records either, where he was visited by a medic three times daily to dress the wound that seemed to go right through his leg. He has a scar on the front and on the back of his leg about boot high. Could this cause a positive to Malaria? Should we ask for more followup with these issues at the Veterans Hospital.
Thank you.
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Hi Joanne, this is a bit of a puzzling one, because Plasmodium falciparum infection is usually very severe at the time of infection but once it clears, it is not capable of recurring years later. So, your husband would probably have had to be treated (P. falciparum malaria can kill within a few days if left untreated) while he was in Vietnam, which would show up on his records. Relapses of infection are much more associated with infection with a different species of malaria, called Plasmodium vivax, which is also found in Vietnam. It is usually not as immediately severe as P. falciparum (though still can be deadly and so requires treatment), but can form stages which lie dormant in the liver for months or even years, causing relapses of disease later on. I would certainly encourage you to follow-up with the diagnosis of P. falciparum, and perhaps ask for confirmation that his infection is definitely not P. vivax – if it is P. vivas, there is a drug called primaquine which can kill the liver stages and prevent further relapses. If it is not P. vivax, then I think there are probably other health factors which are causing the recurring episodes of illness, and you should also talk to a physician about possible causes.
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We will be seeing the DR, and I will indeed follow-up on this P Vivax information. The blood test was for all four types of Malaria and the positive was 0.55 with a refeernce 0.00 – range 1.00 and she stated he did test positive to P. falciparum, He has developed Complex partial seizure disorder. He was tested for all four—perhaps we misunderstood ,or she did, on what was a positive test. Could one test pos. to all types- ie, and would one have to have had the disese to test post. another question was the range high enough to just mean exposure and not have had the actual disease. P falciparum seems to be the only one they can end up with brain disorder, or am I misunderstanding what I am reading. Thank you so much for your reply–these sights are so important to people such as myself. Thank you I will will continue to follow this site. Joanne
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Hi Joanne,
Thanks for following up with us. You’re right in thinking that P. falciparum is usually the only type of malaria associated with brain/cerebral complications. One test can be used for all types of malaria, since each type looks subtly different under the microscope, and rapid blood tests can often also distinguish between different types, though usually not all four (often they just distinguish P. falciparum versus non-P. falciparum malaria). It is extremely unlikely that one person would be infected with all four kinds simultaneously (not least because all four do not occur in the same parts of the world!). I’m afraid without more information about the type of test used it is impossible to say whether the reference value for the test indicates exposure or infection; this would certainly be worth clarifying with a doctor if symptoms persist. I’m glad you found the site useful! Thanks again for your inquiry. – Claire
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i caught malaria a few days back,it’s been a week now. doctors said it was a mild case. how long does a mild case of malaria take to recover completely?..i am feeling way better now. do i need to do another blood test just to ensure that the virus is longer there?
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Hi there, I presume the doctor gave you some medication to take, once you were diagnosed? If so, it certainly sounds like the parasite (malaria is caused by a single-celled parasite, not a virus!) has responded well to the treatment, which is great. Recovery times vary a lot, but especially in mild cases, it shouldn’t take longer than a week or two to feel back to normal. I do think it’s usually a good idea to get a second blood test, just to make sure that all the parasites in your blood have been killed – if they haven’t, once you stop the medication the infection can come back (this is called recrudescence). You should also check with your doctor that the kind of malaria you have isn’t capable of causing relapsing infection: two kinds of malaria, Plasmodium vivax and Plasmodium ovale, are capable of hiding in the liver and producing new infections weeks or months after you think you’ve been cured. However, you can take another medication, called primaquine, which kills these liver stages, so you should ask your doctor whether this might be a useful option for you.
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Sir, my son is getting fever for last 3 days and my doctor has been treating with viral fever symptoms and today after the blood report it’s found that he has Falciparum traces in his blood. He gets chills and high fever… It’s night time and tomorrow morning we will go to doctor. My son is 2.5 years old. Can you please tell me what the curable time for malaria? Do we need to panic or try to control temperature till morning? Thanking you…
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I would recommend going to the hospital or your doctor straight away – children are at high risk for malaria, and Plasmodium falciparum in particular is known to cause severe disease very rapidly. In its early stages, it can be treated very effectively with oral medication, preferably artemisinin-based combination therapies (ACTs), such as Coartem, but if left untreated it can progress such that intravenous quinine is required as a first-line treatment. Moreover, P. falciparum is prone to causing cerebral malaria if left untreated, whereby the parasite affects blood cells in the brain, causing convulsions, impaired consciousness and even coma. Some of these neurological effects may be irreversible. As such, it is crucial that you seek treatment for your son as soon as possible.
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Hello,
My mom is being treated for cerebral malaria at this moment. All the symtoms showed that and doctor confirmed after all the tests. Currently she is being treated in ICU with aggressive medication in one of the good hospitals. Her Platelet count was reduced to almost 18,000 and doctors have given her blood to increase the same.
She had semi conciousness before being admitted to hosptials. This is her 5th day since the decease occured and she was admitted on the fourth day. (Initially we thought it was common fever). unfortunately this is tough time for us. She was never hospitalised this way and it was really heartbreaking to see her speaking in semi conciousness.
Has there been any similar cases in the past where people have recovered from such condition and been normal. I know there are answers on this before, all I am looking for some words of confidence and hope that she recovers soon…
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Hi Manohar,
I can understand it must be very hard for you to see your mother like that. While malaria is a dangerous disease, treatment is usually effective and successful, and so if a patient is able to be seen by a doctor and given appropriate medication, the prognosis is often positive. I hope your mother has by now recovered.
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Sir, I had maleria 5 days before. I had taken treatment and it was cured. But after 2 days I again had fever and weekness.Then I again went to doctor, then doctor did blood test and no malerial parasites were seen. Doctor also did blood tests to see RBC & WBC cound and it was in normal range.
Could you please let me know why I am still having fever and weekness.
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Malaria is a serious illness and can weaken the body significantly. I would suspect that weakness and maybe a slight fever after the main infection has been treated could just be your immune system getting back on track. Many people feel nauseous while suffering from malaria and unable to ingest sufficient foods and liquids, leaving them depleted of energy and dehydrated immediately after recovery. As such, I would recommend resting and making sure you take in plenty of fluids while recovering from malaria – if weakness and fever persist more than a week after your treatment finishes, then it may be worth talking to a doctor about other diagnoses.
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Hi there
I contracted both faliciparum and ovale malaria at the same time on a trip to Ghana six years ago. After a week of seemingly successful treatment in a western hospital I was sent home. In the several months after leaving the hospital I continued to feel extremely fatigued and although it improved somewhat, my energy levels never returned to what they were before the malaria. A few of the many symptoms I’ve felt over that time have been pain throughout my body that I can’t attribute to any cause, going to bed cold and waking up in a sweat and memory loss. The symptoms forced me to switch to a less demanding job several years ago and recently forced me to take an indefinite medical leave. My doctors are having a lot of trouble figuring out what’s wrong with me. Could my current symptoms be side effects from the malaria or the drugs (quinine, doxyclycline and primaquine) I was given to treat it? Any feedback would be appreciated.
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Hi Yvonne,
I’ve had malaria a number of times including P. Falcipurum twice. I have not been the same since and feel that it has definitely changed my life. I have partial deafness and balance loss. I agree with you regarding the muscle pain and sweating at night because I get the same thing.
Unfortunately I don’t think there’s not much to do about it.
Chin up though.
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Hi, My mum and I have travelled to India and she is feeling really cold (even though it is hot here), feels like vomitting, has a headache, a reaaly bad and painful stomach and is feeling very weak. Does she have malaria?
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Hi there. It could well be malaria – it is important to visit a physician or clinic for a diagnosis, as they will then be able to recommend appropriate treatment.
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Hi – I travel to Gambia 3 times a year just for 7 or 14 days on holiday and take doxycycline before and during our stay then on the morning of the day we leave we go to the local clinic where they do a malaria test. We then leave and go to the airport for our flight home and stop taking medication as the test shows negative. The man in the clinic assures us that even if we had been bitten the night before the test by a malaria carrying mosquito it would show the following day. I just wanted this confirmed please as if there is any chance at all that the test might not have detected malaria that quick we will continue with doxycylcine but don’t want to take it unneccessarily. many thanks
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Hi there,
You MUST continue to take doxycycline after you leave a malarial area – indeed, you need to continue taking it for a full 4 weeks after returning home (other anti-malarials require a different amount of time). This is because malaria has what is called a pre-patent stage: when you are first bitten, the malaria parasites take some time to develop before signs of disease can be detected. The length of this pre-patent stage varies depending on a number of factors, including the type of malaria and whether you have been taking anti-malaria medication. Doxycycline and other anti-malarials prevent the parasite from developing into the stage that causes disease, hence why it important to continue taking the medication even after you have left a malarial area. Similarly, most blood tests for malaria CANNOT detect the pre-patent stage of malaria, as at this point the parasites are hidden in the liver and are not visible in the blood. Even tests that look for antibodies to malaria, which begin to be produced early in infection, may only work once the parasite has entered the blood stage. Therefore, even if the clinic you use in Ghana assures you they can detect very early stages of malaria (which they probably cannot), it is important to continue to take anti-malarial doxycycline after you return home. Hope that was helpful for your future trips!
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I travelled to a national park in Kenya and got bites which i suspect must have been from a mosquito, can mosquitoes bite and leave big painful pimples that have fluid or n are very itchy or are these other insects?
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Hi Stella, those could be mosquito bites, but depending on which part of Kenya you were in, they could also be bites from tsetse flies. These flies are more like European or North American horseflies – the initial bite hurts, and the site of the puncture can get very red and swollen.
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Hi, I contracted malaria (Plasmodium Vivax) about 14 months ago, initially it was diagnosed with a blood test and treated with a three day course of Chloroquine and I recovered fully. However, since first episode, I get a relapse every two months with the same symptoms and is cured by same three day course of Chloroquine. My doctor advised a G-6-PD test to see if a Primaquine course can be given to eradicate the parasite from liver, I took the test but unfortunately I showed deficiency and can not be treated with Primaquine. It now seems a regular feature to get a relapse every two months, is there something I can do to avoid these relapses?
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There is dispute over what causes malaria relapse – some evidence shows that there is variation based on the geographical origin of the parasite, with longer relapse periods associated with higher latitudes and shorter relapse times more predominant in the tropics. Other studies show that mosquito bites can trigger relapse, as can infection with a different form of malaria (such as Plasmodium falciparum). In some cases, different treatment drugs may affect the length of time between relapses, but cannot prevent them entirely. While your doctor was correct to test you for deficiency for G6PD, in some cases of low levels of deficiency the drug can still be given as an intermittent therapy to prevent relapse. However, if you live in a malaria endemic area this therapy may not be suitable.
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HI………
If I get high fever and headache in night and morning is it normal (Its happening for 5days)……Is that a symptom of MALARIA?? please reply……….
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Hi there,
Fever can be a symptom of malaria, but fever is also associated with a lot of other infections and diseases. With malaria, the fever normally cycles, with a peak every 2 or 3 days, depending on the type of malaria, with periods of normal temperature and even chills in between. As such, what you are describing doesn’t sound like typical malaria infection, but it is still important to get diagnosed by a doctor or at a clinic, since sometimes malaria can manifest itself in different ways. The quicker you receive a good, accurate diagnosis, the quicker you can receive appropriate and effective treatment, regardless of whether you have malaria or something else.
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Hello there!
I’m currently writing magazine article for our school’s literacy project and I’m writing about Malaria. This website has been really helpful to me and also you guy’s comments has been real helpful.
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Hi i just came back from the dominican republic, puerto plata.
i have been getting a slight fever, chills, a headace, muscle pains,
and a cough. my fever and chills are gone now but now my
headace and my cough has gotten worse. It hurts my head so much
when i cough. I feel a lot of pressure on my head, can you please
tell me the reason why my head hurts so much. Is this malaria?
Thanks a lot hope to hear from you guys soon.
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Hi, I think you just wrote to the Q&A forum as well? If so, I replied to that post a few minutes ago. Hope the answer is helpful!
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sorry Claire Standley but i canot find your post
on the Q&A forum, can you please respond on here.
it would be greatly appreciated thank you and
sorry for the inconvenience
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Hi Nathan,
Here is the Q&A response: http://www.malaria.com/questions/malaria-dominican-republic
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Hello,
I live in Seattle, Washington, USA & have recently been getting cyclical sicknesses that led me to get a malaria test which came back positive. I have been exhausted & had chills/sweats for years, but attributed it to my thyroid condition ~ it is only in the last 6 months that I have had severe enough symptoms to seek medical treatment. It is impossible to tell whether this is a new condition contracted in the US somehow or if this was contracted 7+ years ago on my travels. I don’t remember my sicknesses from the past, so can’t say whether or not I got sick after one of my travels.
I don’t know what type of malaria I have yet & it is very hard to guess where in the world I contracted the parasite: I was in Mexico in 2000 & 2004, the Canary Islands in 2000, Tunisia in 1997, all over Central America in 1996 & Morocco in 1991. The only places I’ve traveled outside of the US in the past 7 years are Canada, England & Ireland.
Have you heard of cases contracted in the United States? If so, what type of malaria are they usually?
Have you heard of cases that don’t cause debilitating sickness for years?
How worried should I be about the drugs that treat malaria (I don’t tolerate drugs at the best of times)?
Lastly, I have an autoimmune disease, plus thyroid disease & urticaria/angiodema ~ can this cause any complications that I should know of before starting treatment?
Thank you very much!
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Hi SK,
Thanks for your question. I’m going to ask one of our medical advisors for his comments regarding complications that might arise with treatment, given your medical history. Hopefully I’ll be able to post his response soon!
In the meantime, I can make a few comments on the possible origin of your malaria. I think it is highly unlikely you contracted it in the United States – malaria transmission in the US is very rare, and limited to the south-eastern States, and then only at the height of summer, and very infrequently. Given the duration of your illness (i.e. many months), plus the length of time since you travelled in malarial regions, it sounds like you have either Plasmodium vivax or Plasmodium ovale (the former is much more common). These are the two that are known to cause relapses, months or even years after the initial infection. However, I suppose it is also possible that you have Plasmodium malariae, which is known to stay at sub-clinical levels for long periods of time, though never actually enters a dormant stage (technically, it “recrudesces”, whereas P. vivax and P. ovale are said to “relapse”). If your infection turns out to be P. malariae, then treatment will be a simple course of chloroquine. With P. vivax and P. ovale, you will need to take something like chloroquine to control the current infection in the blood, followed by primaquine to kill the latent liver stages. This drug may be contraindicated in people with G6DP deficiency, so you should be tested for that prior to getting a prescription.
Hopefully that helped!
- Claire
PS I’ve now heard back from our medical advisor – he says there are no contraindications for treatment of malaria. Any treatment regime that your doctor prescribes can be tailored so that it does not interact with your existing medications. So make sure your doctor treats you!
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Hi, i am also suffering from the same symptoms in malaria. I had fever, chills, headache and cold. But the test didn’t show if i have malaria.But still i have the symptoms.After recovering from fever i am having severe headache and cold. Can you tell me if i have malaria?
Thanking you
Mahima
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If the test was negative for malaria, but you are experiencing symptoms, then you probably don’t have malaria, but some other illness. The symptoms of malaria are very general, and can easily be confused with a number of different diseases, even influenza. Given that your fever has gone away, you are probably on the road to recovery – if you still feel ill in a few days then it may be worth talking to a pharmacist or doctor about your remaining symptoms.
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Hi Claire
I believe I contracted malaria in Kenya in the 1980′s and was diagnosed some four years later by a Doctor in the then Zaire. I now live in Australia. For the first eight years or so I used to have recurring bouts every Christmas but spent some time in the Northern hemisphere where it seemed to abate. I have now been in Aus for three years and the last two Christmases I have experienced the usual malarial symptoms. The last one, yesterday, was one of the worst with painful kidneys (lower back) and the old “blackwater” when I urinated.
Reading ont he web it appears that there are “cures” for this recurring malaria…..Is this so? and is this “annually recurring” malaria real or just co-incidence. I personally believe it is malaria every year and usually take leave during this time as I expect it with some confidence. I have never been to a doctor as I thought there was little point. My “attacks” usually last little more than a couple of days so have got used to putting up with it. Any advice you can offer is greatly appreciated.
Regards
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Hi Jon, thanks for the question. There is indeed a cure for recurring malaria – primaquine appears to kill the latent liver forms of the two species of malaria that are known to cause relapses (Plasmodium vivax and P. ovale). The drug needs to be taken every day for 14 days to be effective, and may not be appropriate if you have G6DP deficiency – you should be tested for this before being prescribed the drug. Since your last relapse was quite recent, you might also want to try to have a blood test to check for antibodies against Plasmodium species, and specifically the two mentioned above. While your doctor might still be happy to prescribe you primaquine, given your clinical history, double checking is always best! The test is very simple and uses only a droplet of blood – you can even buy self-testing rapid diagnostic tests (RDTs) online or in some pharmacies (depending on where you are in Australia – malaria products tend to be more common in northern Queensland and NT), some of which can distinguish between P. vivax and other forms of malaria.
The reasons for the varying periodicity of malaria relapses aren’t fully understood, but some theories have been put forward based on field observations. For example, it seems that the forms of malaria from the tropics tend to relapse more frequently than forms from the sub-tropics, where transmission is seasonal. This makes sense from the evolutionary perspective of the parasite – it wants to maximise its chance of being transmitted, and so should reoccur when conditions are appropriate for transmission (i.e. when mosquitoes are around). This theory is supported by the observation that relapse may be triggered by mosquito bites, again suggesting that enhanced transmission might be the key to relapse timing. This matches your own observations of relapses around Christmas, in the Antipodean summer, when mosquitoes abound and you may have been bitten. Hope this helped! Good luck getting treated. – Claire
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Many thanks Claire for giving me such hope. I understand that Primaquine is no longer available in Australia but I have a year to go to get the tests done and to find some. After suffering this for so many years your comments are fantastic news to me. Before finding this site I was sure that there was no treatment for recurring malaria and I would have gone the rest of my life suffering each year. Again, many thanks.
Jon
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Hi,
I got malaria in 2002 while working in Tanzania. I got it in the 6th week I was there working in the village and I guess the symptoms developed after being bitten in training 2 weeks before. I was given Fansidar (spelling?) which cleared it up. I was probably severely ill for about a week, it came on very hard,. significant symptoms but then I was back up and about roughly a week later.
2 weeks before leaving the village I had another dose of malaria which I’m not sure was a recurrence or a separate dose altogether. What I remember is that this time it was much more resistant to go. I was given metakefaline (spelling?) and then finally 10 days later a French drug called Arinate which seemed to finish it off.
In the years immediately after returning I had far more flu type incidents year to year (averaging about 1 a year) compared with pre-Tanzania/malaria. Pre Tanzania I can only remember having flu once and that was at Uni in 1998. In recent years I have had flu type occurences but have always put it down to other things but some of the instances have reminded me very much of malaria, body ache, shakes, chill lasts for a few days then goes rapidly back to normal.
Is there anyway of checking if these occurences over the years have in fact been the malaria returning? Can I get detailed blood tests somewhere to confirm whether I still have any of the parasites lying in the liver?
Thanks very much,
Rob Salter
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Hi Rob,
Thanks for the question. Of the various types of malaria that infect humans, P. vivax and P. ovale are the only ones that can remain dormant and then relapse weeks, months or even years after the initial infection. In places like Tanzania, P. falciparum, which cannot relapse, is the most common and deadly form of malaria, and gets a lot of media attention. However, P. vivax and even P. ovale are both present, and perhaps at higher prevalences than previously realised. Do you know which type you were diagnosed with initially? While experienced technicians can easily tell the different species apart based on their appearance in the blood, most clinics do not diagnose to this level of detail, unfortunately. Given that your later symptoms have felt to you like malaria, with the characteristic chills, fever, etc, then I would say there is definitely a possibility that you have been experiencing relapses, and especially if you were diagnosed initially with P. vivax. As far as I know, no tests are yet available for humans to check for the dormant liver forms; some blood tests can pick up antibodies to past infections, but given that your attacks are not very frequent, these antibodies may have broken down by the time you test yourself. However, I would recommend that as soon as you next experience those symptoms, you should visit a travel health clinic or tropical disease hospital to get tested for malaria. Once you have symptoms, it means that the malaria parasites have exited from the liver and are back in your blood stream, where they can be detected using a blood test, either for antibodies as described above (these are called rapid diagnostic tests, or RDTs) or microscopy of a blood film on a slide. If you test positive, and especially if you have not returned to a malarial country since Tanzania, you can be reasonably confident the source of your infection was the initial disease back in 2002. The good news is that there is a drug, called primaquine, which can be used to kill the liver stages of P. vivax and P. ovale, thus preventing future relapse events. If you test positive for malaria, talk to your doctor about taking this drug – you will need to have a test for G6DP deficiency beforehand. Hope this has helped! Good luck.
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I know someone who is from papua new guinea and was treated in cairns for malaria. They are now blind following the drugs that were given to treat the condition. He can only see shades of light. Would there be any chance of fixing his eye sight?
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Such severe side-effects are very rare from malaria medication alone – is it possible they were also treated for something else at the same time? Some anti-protozoan drugs, to treat diarrhea, can be very potent. In some cases, people who have been given quinine can develop a condition called cinchonism, which is related to the dosage they receive. Cinchonism can result in visual disturbances, which usually return to normal once the person stops taking quinine. Doses that are delivered too quickly or at concentrations above therapeutic level can result in more severe cardiotoxic events, some of which can potentially lead to blindness. Whether your friend’s condition is permanent or not will depend on the exact type of drugs they received, whether it was in combination with anything else, and also what the dosage was.
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I have recently returned from Accra, Ghana and am feeling really unwell. I was bitten on my legs quite badly, first time this has happened as I visit there often. I work for an airline who only issue us with DEET which is deemed adequate for protection.
I don’t have a fever (yet?) but ache all over, am completely exhausted and cannot seem to get warm.
My GP has said the chances of it being Malaria are quite slim and has suggested I call again on Monday if I feel no better.
I have had a slight cold for a couple of weeks and am wondering if the hot weather has just made this worse?
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Hi Kate, if it is indeed malaria, then the symptoms can get worse very quickly, in which case you should go to the emergency room and make sure they are aware of your recent travel history. Alternatively, if you are in the UK and can get to London, you can make an appointment to visit the Hospital of Tropical Diseases in Warren St. They are experts at travel medicine, and can easily, and quickly diagnose malaria if you presenting with any o the symptoms (and chills certainly can be a symptom). They will also be able to provide other suggestions if the test is negative. Of course, the option that it is a cold that got worse from travel or change of climates is not out of the question, but it is certainly better to be on the safe side where malaria is concerned! Keep hydrated and monitor yourself for fever in the meantime. Hope you feel better soon! – Claire
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how early can a person be cured from maleria……………..
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A person can be cured of malaria within a few days of being diagnosed and given the appropriate treatment.
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hi claire,
I’ve been here on tanzania for almost a year. And now i am diagnose of having a malaria (2mps/500WBC), don’t know if its correct, they did not explain the details. I experienced the cold, slight sweat, back pain, and weak joints. But one of my co-worker also have been diagnose but he is not feeling anything. Is this normal?
And also, before coming here I am examined to have fatty liver, Is there a great effect that the parasite is living in the liver? Can you give me an advice what to do?
I am taking “artequin”. I finished the 3rd day of medication. I still feel weak, and this evening my feet feels hot. Can you explain if this is connected on having malaria? How can I be sure that the medicine kills the parasites, should I have another blood examination? Thank you so much. I am really worried with my situation.
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Hi there,
Thanks for your question. Your diagnosis is indicative of a low level malaria infection – what is slightly confusing is that the count is given per number of WBC, which usually stands for white blood cells. If anything, the count should be presented as per number of red blood cells, since these are the cells that are infected by the malaria parasite. More usually, the count is given per microlitre of blood examined. Artequin is a combination therapy consisting of mefloquine and artemisinin, and so is suitable for treatment of all types of malaria. The full course of medication should completely cure the infection, as there is no evidence yet for resistance against this drug in Africa. However, if you want, you could revisit the clinic for another blood test to be sure that there is no trace of the malaria parasite left in your blood (i.e. you are completely cured). If you continue to experience fever and other symptoms, you should ask your doctor for advice on other infections – my experience in some parts of Tanzania is that diagnosis of malaria is sometimes given even when it is not accurate, and other methods of diagnosis show that the patient does not have malaria. I suspect this has happened to your friend, since it is rare to be positive for malaria using microscopy and not experience symptoms (unless your friend grew up in a highly malarial area and experienced many malaria infections in childhood – in this case he might be able to tolerate low levels of malaria without symptoms). Another method of diagnosis you might want to try are self-testing rapid diagnostic kits (RDT), which you should be able to buy either from the clinic or a pharmacy. Using this RDT, you can test yourself at home for malaria, and the test is more sensitive and accurate than the blood microscopy done in most clinics.
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Hello there, I stumbled on this amazing site by chance since I’ve been diagnosed with Lyme disease and it’s two co-infections Bartonell and Babeisa. Babesia is malaria’s ‘cousin’ – hence my quest for some answers. I am under the care of a specialist. My sx are eerily like those above, chills followed by ‘feverish’ sx (land me in bed) every 2-3 days, headache, horrendous fatigue, etc. I’m having difficulty tolerating Mepron/Zithromax, my liver enzymes keep creeping up and I can’t keep starting/stopping tx, I can’t get better that way. I am neg for G6PD. Tried Clindamycin + Biaxin briefly last year, made no difference to my sx. I am at a loss. I have been bed-bound for over a decade (initial dx of ‘CFS’ and ‘FMS’) which kept me sick. I got sick a few weeks after a hiking trip. My illness started with fever, heart palps, sweats, brain fog, horrendosu fatigue, diff swallowing, the list goes on and on. And here I am a decade later trying to unravel this mystery. I realize you can’t give medical advice and I also know there are other meds to try… I also feel many people don’t realize they may have Lyme dx and/or babesiosis which can cause similar sx to malaria. My Hb and ferritin are always on the ‘low’ end of normal, my blood smears have always come back neg (tests for babesia is notoriously inaccurate). I did spend several years in India in the mid-90′s where I was very ill but never dx w/ malaria. I became ill about a5 yrs after that. Just looking for some insight from you and also wanting to relate my own diagnoses w/ others out there. Thanks!!
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Hi there,
Thank you SO much for your post. I hear a lot of stories about people who struggled for years with mysterious symptoms before finally being diagnosed with Lyme’s disease or other blood-borne parasites. As you say, diagnosis is notoriously inaccurate and treatment regimes can be tough – in developing countries in particular, where health infrastructure isn’t good, it can be very easy for clinics and hospitals to assume someone has malaria, give them treatment, and send them on their way, whereas in fact the person is suffering from something else.
In terms of the specifics of your case, were you tested for malaria in India and not found positive, or never tested? There are some very interesting possibilities for research into the dynamics and effects of co-infections of diseases like malaria and Babesia, since, as you say, they are related and both utilise blood as a habitat. I don’t know how much is known about the symptoms of such co-infections, or what the implications for treatment efficacy might be, but it could be worth talking to your doc about this. Another thing to discuss could be possibility of residual malaria infection from your time in India (such as Plasmodium vivax or Plasmodium ovale, which have dormant liver forms) being implicated in your liver’s failure to tolerate your current drug regimen. Since you are G6DP negative, you could be a candidate for primaquine, which is the drug used to kill those dormant liver stages.
Hope that helps, and thank you so much for sharing your story on http://www.malaria.com. I really believe that comments like yours are crucial in raising awareness about rarer blood-borne diseases like Lyme’s and Babesia to people who are suffering from symptoms that are proving difficult to diagnose.
- Claire
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