Malaria is found typically in tropical and subtropical areas; there is no malaria in Europe. The majority of infections occur in Africa, in the area from south of the Sahara to north of South Africa. According to WHO estimates, there are up to 500 million people infected with malaria each year.

Female anopheles mosquitoes cause the spread of malaria in the human body by biting and infecting humans with the protozoan parasite of the Plasmodium species. Other methods by which the disease is spread are so rare, they are not worth mentioning.

Types of Malaria

There are four types of malaria, which in turn cause three different types of malaria fever that differ in terms of disease severity. The problem arises because the Plasmodium spends part of its life cycle in the mosquito and the other part (hopefully, from their point of view) in people. It is dependent on mosquitoes and humans for its survival.

Plasmodium-infected mosquitoes pass the agents into the bloodstream of humans. They migrate to the liver where, depending on the type, they evolve over five to 18 days. At the end of this stage they burst the infected liver cells and malaria pathogens are back into the bloodstream. There, they attach to red blood cells (erythrocytes) and multiply.

Overall, incubation takes seven to 40 days before the first symptoms occur – fever, headaches, limb pain and a general “feeling sick.” These non-specific complaints are often diagnosed as other maladies if your doctor does not know you have been to an infected area.

Symptoms

How intense the complaints are depends on the degree of immunity of those infected. The average healthy adult acquires a so-called semi-immunity, which avoids particularly serious illness. Non-immune people are most at risk, especially infants and the elderly; it is not a good idea to go to a high-risk area with very young children, or if you have an immunity problem.

Once infected, malaria attacks occur in cycles; some varieties every 48 hours, some every 72 hours. Attacks show up in the late afternoon as chills and a fever rapidly rising to 40°C; these will last for three or four hours, and then stop. The symptom cycles disappear in six to eight weeks, even without treatment.

Malaria tropica, if untreated, is the most dangerous form of malaria; but still, it only carries a 20% risk of death in infected people. There is no rhythm of fever with this malaria. It instead attacks the liver or spleen and causes very serious diarrhea.

Treatment and vaccines

If treated, there is practically no chance of death. However, malaria pathogens can rest for two to five years, or even after 40 years in the tropica variety. For westerners at least, it is rarely the deadly disease people imagine; but it is incredibly unpleasant and should be avoided at all costs.

Unfortunately, there currently is no vaccine against malaria. In order to protect against malaria pathogens, you either can take measures in order not to be bitten by mosquitoes or take a precautionary medication, chemoprophylaxis, which kills pathogens that have entered your body.

How to avoid exposure to Malaria

You can take the following measures to avoid contact, which is the best way to avoid exposure:

– Keep mosquito screens on windows closed day and night.
– Sleep under mosquito nets in areas where they are provided.
– Wear mosquito-proof clothing, such as long pants, socks, long sleeved blouses or shirts.
– Take oral anti-malarial medication.
– Use insect repellents (mosquito defence sprays).

The disease takes time to mature, so it is unlikely you will get sick on holiday, but rather when you return home. Medications therefore need to be taken for several weeks before and after your trip to make sure you do not come into contact with the disease.

Please note

The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this guide cannot and should not be used as a basis for diagnosis or choice of treatment. In other words contact your doctor for more information.