Malaria Alert.

 There has been an alarming rise in malaria cases in the mumbai city over the last few years .Here will take a short view of malaria risk factors and it's prevention .

Malaria is an infectious disease caused by a parasite (plasmodium) which is transmitted from human to human by the bite of infected female Anopheles mosquitoes.

• Description of Malaria  :  Malaria parasite : You can catch malaria if a female of the Anopheles mosquito bites someone carrying the malaria parasite and then bites you, passing the parasite on to you.

There are four different types of Plasmodium parasite.
• Plasmodium falciparum - this is the only parasite that causes malignant malaria. It causes the most severe symptoms and results in the most fatalities.
• Plasmodium vivax - this causes benign malaria with less severe symptoms than P. falciparum. P. vivax can stay in your liver for years and can lead to a relapse.
• Plasmodium ovale - this causes benign malaria and can stay in your blood and liver for many years without causing symptoms.
• Plasmodium malariae - this causes benign malaria and is relatively rare.
Today, the number of cases is rising worldwide. Malarial parasites cause clinical illness in an estimated 300 to 500 million people every year and cause 1.5 to 2.7 million deaths per year.

• Parasite lifecycle : The malaria parasite passes through your blood into your liver, where it grows and develops.

After it has completed its development, it travels back into your bloodstream and eventually attacks your red blood cells, which you need to carry oxygen around your body. You will then get symptoms of malaria.

• Causes and Risk Factors of Malaria : Malaria comes from being bitten by a mosquito carrying the malaria organism. Risk factors include traveling in areas in which such mosquitoes are found or, rarely, being bitten by a mosquito that has previously fed on an "imported" case of malaria (such that the case can occur in an area of the world where malaria is not endemic).
• Symptoms of Malaria :  Malarial attacks present over 4 to 6 hours with shaking chills, high fever, and sweating, and are often associated with fatigue, headache, dizziness, nausea, vomiting, abdominal cramps, dry cough, muscle or joint pain, and back ache. The attacks may occur every other day or every third day.

Cerebral malaria and death can occur, sometimes within 24 hours, if the infection is caused by plasmodium falciparum.
Fever or other symptoms can develop in malaria as early as 8 days or as late as 60 days after exposure or stopping prophylaxis. For plasmodium vivax in temperate areas, the delay may be up to one year.

• Complications of malaria : If you get infected with P. falciparum, your malaria can progress to a more severe form (also called complicated malaria). Complications can affect your brain, kidneys, blood and lungs. They can develop within hours or days of your first malaria symptoms and can be fatal within 24 hours.

* Symptoms of severe malaria can include:

• jaundice - yellow skin and eyeballs
• difficulty breathing
• feeling light-headed or shaky (symptoms of low blood sugar)
• bleeding - eg under the skin (showing as pin pricks or bruises) or from the nose or gums
• pale or blueish skin
• fast heart beat
• fast breathing
• fits
• loss of consciousness

* According to the city’s top cardiologists, the genetic mutation of malaria vivax strain, which earlier was mild in nature, is leading to liver/kidney failure, acute lung injury, and in some cases even heart attacks,this year .

Chest specialist Dr Khusrav Bajan at the Hinduja Hospital stated, "Normally we have malaria vivax-positive patients coming in with high fever and body ache.
“But this time in 2010 , almost 30 per cent patients are coming with heart problems, severe breathlessness and restlessness. Some had suffered heart attacks too. Echo clearly indicated depressed heart functions."


* Diagnosis of Malaria  :  Methods of diagnosis are:
• complete medical history of symptoms and travel
• physical examination
• blood tests, including thick and thin blood films, to identify the plasmodium species responsible for infection

 Treatment of Malaria : 
Medical treatment should be sought immediately.The effectiveness of antimalarial drugs differs with different species of the parasite and with different stages of the parasite's life cycle. Your physician will determine the treatment plan most appropriate for your individual condition.
• Drugs include chloroquine, mefloquine, primaquine, quinine, pyrimethamine-sulfadoxine (Fansidar), and doxycycline. Some plasmodium have developed resistance to certain medications, and therefore, alternative medications will be prescribed for you.


** Special considerations
1) Acquired immunity : If you're born in a malarious area, you may develop immunity to the infection. But this only lasts for six to 12 months after you leave. After this, you will need to take antimalarial medicines if you return to a malarious area.

2) If you're pregnant : Complications of malaria are more likely if you are pregnant. Malaria in pregnancy is also associated with miscarriages or stillbirths.
If you have malaria and are pregnant, you will need to be treated with quinine. Evidence shows that quinine is safe in pregnancy, although it can increase the risk of low blood sugar and can cause labour. Your doctor will monitor you and your baby for any signs of complications. You may need to have your baby early if this is safest for you and your baby.


* Prevention of Malaria : No prophylactic regimen gives complete protection. Speak with your physician or local travel clinic to receive up to date information about the best malaria protection for you. Effectiveness of any given medication varies by the region of the world in which you plan to travel. Effectiveness also varies from year to year, so current information is essential.

** Prevention is based on:
• evaluating the risk of exposure to infection
• preventing mosquito bites by using DEET mosquito repellant, bed nets, and clothing that covers most of the body
• chemoprophylaxis (preventive medications)

• Questions To Ask Your Doctor About Malaria
1) What drugs can be taken as a preventive measure?
2) What is the correct dosage?
3) When should the drug be started and stopped?
4) What other precautions should I take; repellents, clothes, nets?
5) What symptoms should I look for?