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Malaria
Malaria refers to either a chronic or acute infection caused by a parasitewhich grows within red blood cells. This organism is referred to as a parasite because it needs the red blood cell to complete its reproductive cycle.Infection occurs with the bite from an infected mosquito which carries the disease. The destruction of red blood cells brings about the characteristic symptoms of malaria. The incubation period is anywhere from 3 days to several weeks before the onset of symptoms. Annually, over 200 million persons develop malaria and 1.5 million persons die from this disease. The incidence of malaria has been increasing in recent years despite aggressive attempts worldwide to control this disease. Not only is the mosquito carrier becoming less susceptible to insecticides, but Plasmodium falciparum (the parasite responsible for the most deadly form of malaria) is becoming increasingly resistant to antimalarial medications. Malaria transmission occurs in large areas of Central and South America, the Caribbean, sub-Saharan Africa, the Indian subcontinent, Southeast Asia, the Middle East, and Oceania. The occurrence of malaria in the U.S. is essentially secondary to travel to endemic areas. There were 546 total cases reported in the U.S. in 1988. Common symptoms include: "attacks" of high fever, chills, sweats, and body aches.
Evaluation includes analyzing a blood smear (microscopically) to determine the presence of parasites. Treatment is with medications (chloroquine) which kill the parasite and interrupt its reproductive cycle. Malaria prophylaxis (pyrimethamine) is given to travelers into areas where malaria is endemic. Remember, this infection is quite rare in the continental United States and most cases in the U.S. occur in people who have traveled to endemic areas outside the United States. Prevention begins with the avoidance of being bitten by the infected mosquito. Wearing long sleeved shirts and pants in high risk areas is important. Avoid going out at dusk and night, when the likelihood of being bitten is the greatest. Any insectacide spray containing N,N-diethylmetatoluamide (DEENT) is recommended for application to exposed skin. A pyrethrum containing insect spray should be used during evening hours and before retiring to bed. Permethrin can be sprayed on clothing for additional protection. Most of these insecticides can be found at camping and outdoor sporting goods stores. Centers for Disease Control (CDC) Malaria Hotline: (404) 332-4555
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