Malaria is responsible for more deaths and economic devastation worldwide than AIDS and TB combined. It has been with mankind throughout history. When symptoms first start, it can be hard to differentiate from other ailments such as influenza, Dengue Fever, Lassa Fever, simple gastroenteritis, even Ebola. However, progression of symptoms are classic over a few days, and looking at a blood smear through a microscope along with new rapid diagnostic tests clinches the diagnosis.
Malaria is distributed in tropical regions throughout the world, especially in rural areas but sometimes including cities.
Cause and Dynamic of Malaria
Malaria is caused by a parasite – not a virus or bacteria -- in the blood of genus Plasmodium. Benign forms of malaria which are not life-threatening, but quite debilitating in the moment, are caused by Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae, in different regions. The dangerous malignant form of malaria is caused by Plasmodium falciparum, including the frequently fatal form of cerebral malaria. Often this is called “falciparum malaria.”
Malaria is not contagious by contact between people. It is transmitted by a bite of a female mosquito of the genus Anopheles. Unfortunately, these mosquitoes do not wear name-tags, so it is impossible to identify them by looking. Prevention by mosquito eradication cannot be selective.
There is a distinct and well worked-out life cycle of transmission of Plasmodium.
This may appear complex. The most important point is that they live in the liver and periodically break out to flood the blood stream. This is the time when the paroxysm of acute symptoms occurs.
Once bitten, the process is dormant for a week or two before the first crisis occurs.
Symptoms of Malaria
There are basically three versions of malaria. The benign form produces a first crisis that involves strong symptoms but resolves in 24 hours or so. Then these episodes recur every 3 or 4 days with somewhat reduced intensity until some immunity develops. Ultimately, the process settles down to one to three episodes a year for most people if they were not treated with medications.If you leave the area, this immunity diminishes over time; if you return years later, you can develop episodes again just as before.
The malignant form of malaria is much more severe, and is responsible for the highest death rates. Cerebral malaria is the worst version of falciparum malaria.
If you survive an episode of falciparum malaria, no more episodes occur, and immunity lasts for life.
There is another chronicversion which is less common. In this situation, some symptoms go on continuously at a lower intensity leading to chronic liver symptoms and anemia.
With benign malaria, the episode begins with headache and often diarrhea and/or vomiting, plus aching in muscles and perhaps bones. This can be indistinguishable from influenza or dengue fever. With 12-24 hours, strong chills occur and fever follows. There may be shortness of breath at this stage. These fevers and chills tend to happen more at night, while you feel fine during the day. However, after the acute episode of one or two days, you may have considerable weakness that can last for weeks and months. Also, it converts into recurrent episodes every 3 or 4 days for awhile and then settles into one to three episodes in a year.
The malignant form has a similar progression but with greater intensity, higher fever, aching in bones. Liver and spleen become involved with abdominal tenderness, loss of appetite, gastrointestinal disturbances, and great debility.
In cerebral malaria, sometimes called “brain malaria,” the parasites invade the central nervous system. Abnormal postures and movements may occur. Nystagmus (shaking of the eyes back and forth) may happen. Paralysis of eye muscles may cause one eye to not follow the other in movement. A spasm in the neck drawing it strongly backward (“opisthotonos”) may occur. Finally, convulsions and even coma may take over leading to death.
These malignant forms of malaria definitely need to be treated in a medical facility where IVs and medications to relieve symptoms can occur.
eRemedies available at eremedyonline.com/module/14/malaria/ can rapidly relieve benign forms of malaria, and even malignant forms -- although in the latter case medical support should be a top priority.
Diagnosis of Malaria
Other than the obvious encephalopathy involved in cerebral malaria, milder malaria can frequently involve respiratory distress. This can sometimes be due to heart failure backing up into the lungs, but more often it is a primary difficulty in lung tissue itself. This can be especially problematic in children.
Liver and spleen are often involved, leading to tenderness and swellings in the abdomen. There may be lack of appetite as well as other gastrointestinal problems. Some degree of jaundice can happen.
Parasites can break down blood cells, so anemia is a common complication over time.
Treatment of Malaria
There are many medications that have been used historically for malaria. Unfortunately, the rapid growth of organisms leads to high rates of mutations. Because of this, resistance to drugs have become a huge problem throughout the world.
Long ago, a tree bark called Cinchona (or China officinalis) was used to control malaria. It turned out that the active ingredient was a quinine compound. More recently, related chemicals have been used, especiallychloroquine, primaquine, etc.
Another traditional treatment was Sweet Wormwood (Artemisia annua), containing artemisinin.
Nowadays, various combinations of these drugs and their relatives are used. Combinations are more effective, and resistance is more difficult when combinations are used.
Chloroquine-type compounds are effective in some regions still. Their side-effects include yellowing of skin, bloating and digestive problems, and muscle cramps (especially of calves).
Larium is mefloquine, a popular quinine derivative in current use. Side-effects include nausea, vomiting, and diarrhea. In children, esophagitis can be a complication. Insomnia is common. Sometimes hallucinations and psychosis (insanity) does occur, along with encephalopathy (brain disease) and convulsions. In one hospital study, 68% of patients also had cardiac arrhythmias – irregularities of the heart beat.
Another common drug is Doxycycline, an antibiotic. Many people tolerate it, but there can be common side effects. Thinning of the enamel of teeth, and also of bone development can occur. Photosensitivity causes an intensely itchy rash all over the body wherever there is exposure sunlight or sometimes artificial light.
Natural treatments can be tried as well. Neem tincture (Azadrachitaindica) and Sweet Wormwood tincture (Artemisia annua) can be taken in doses of 5 drops 10 times a day. Alternatively, for children these can be administered as tea. Eucalyptus can be taken similarly.
As mentioned earlier, there are eRemedies available at eremedyonline.com/module/14/malaria/ that can provide rapid relief once chosen by an expert system that selects eRemedies according to individual symptoms of the paroxysms.
Mosquito eradication would theoretically be the most effective prevention, but in many regions this cannot be done efficiently enough because of all kinds of socioeconomic factors. Mosquito nets are an inexpensive solution, and can be effective when used in conjunction with insect repellants – pyrethrum being the most popular and effective. These measures must be used with discipline, of course. It takes only one bite of an infected mosquito to cause malaria.
Dengue fever is a very similar disease to malaria and has a similar distribution worldwide. It is common in Africa, India, and more particularly in South America (Northeast Brazil), and the Caribbean. It too is a mosquito-borne disease (a mosquito of the Aedes genus), but is caused by a virus and not a parasite.
Its incubation period is 2-14 days after the bite.
It is also called “bone-break fever” because of the prominence of bone pains. Otherwise symptoms are similar to malaria. It is not relapsing like malaria, fortunately.
The different forms of Plasmodium appear differently in blood stains when viewed through a microscope. There are also rapid-testing methods of distinguishing whether the symptoms are malaria or not, and which type.
One distinction from malaria is a characteristic Dengue sunburn-like rash that comes during the fever.
A further, more serious, complication that happens in a small proportion of cases is a hemorrhagic complication. Platelets drop, and bleeding of internal organs can occur, with dropping of blood pressure with consequent shock. This can be potentially fatal.
Once the acute paroxysm ends, recovery in Dengue can be gradual over days and weeks.
Treatment of Dengue is similar to malaria in terms of supportive care, although standard malaria medications have no effect because this is a virus.
Though a specific Dengue module has not yet been developed, symptom differentials for selecting eRemedies found in eremedyonline.com/module/14/malaria/ can also work for Dengue fever.