Introduction
Malaria is a mosquito-borne illness. It is endemic to Africa,
most of Southeast Asia, Central America, and Northern South
America. Worldwide there are approximately 300 million cases
a year. There have been cases reported in California, New
York, and Florida. However, this is usually the result of
a person having been abroad and diagnosed upon their return
to the States. The incubation period of malaria is approximately
one or more weeks after being exposed to a Malaria-infested
mosquito.
Malaria Symptoms
Signs and symptoms include periodic chills, fevers, headaches
and backaches. There is a fluctuation of chills and fever.
The fever can rise to 105-106 degrees. There may be a thready,
rapid pulse. However, it is not uncommon to find a pulse/fever
paradox; with each degree of fever, the pulse rate usually
increases by ten beats per minute, although it is not uncommon
in Malaria for an individual to have a 103-104 fever with
a normal pulse. This can be a clue to aid in the diagnosis;
however, the most important consideration if malaria is suspected
is taking a good history and finding out where the individual
has traveled in the last month.
Malaria Prophylaxis
Prophylaxis should begin one to two weeks before traveling
and continue for four weeks after returning from a possibly
endemic area. Although the most common medication is Chloroquine,
Doxycycline, can be taken as an alternative. Mefloquine is
recommended when individuals travel to Chloroquine-resistant
areas. The Center for Disease Control (CDC) usually has updates
for which areas are resistant to Chloroquine. If you are planning
to travel abroad, Survive Outdoors strongly recommends checking
with your healthcare provider, as well as the CDC, regarding
which areas in the world are resistant to Chloroquine. Malaria
is a very serious illness, and should be taken very seriously.
I have personally treated one individual with malaria. She
was working as a missionary in Africa, and thought that using
an insect repellent with Deet as well as mosquito coils, and
putting them in her tent, would be more than enough safeguard.
Unfortunately, she was wrong. She recovered within a few weeks
after treatment but was quite miserable during that time.
If one is traveling to an endemic area, taking the medication
is extremely important and definitely reduces the risk tremendously.
Mosquito nets should always be used when sleeping in unscreened
rooms and Permethrin is a great chemical that can be used
on the clothes.
References
1. Paul S. Auerbach, Wilderness
Medicine
2. Mark H. Beers, The Merck Manual
