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Malaria

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US Army First Aid Manual
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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




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