How to Recognize Malaria Symptoms

Two Parts:Recognizing the Symptoms of MalariaUnderstanding the Risk Factors

Malaria is a blood-born disease caused by a parasite, which is transmitted via the bite of infected mosquitoes.[1] While malaria is uncommon in developed countries and temperate climates in general, it's still prevalent and often deadly in developing tropical and subtropical countries. For example, despite prevention efforts, malaria still kills an estimated 660,000 people each year. Americans put themselves at risk when they travel to tropical destinations. Recognizing the symptoms of malaria is important in order to get appropriate treatment, as the infection is life threatening if left untreated.

Part 1
Recognizing the Symptoms of Malaria

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    Watch for a high fever. One of the primary symptoms that is so common with a malarial infection is a high fever, at least 102°F.[2] It's also one of the first symptoms to appear after at least 7 days (although usually between 10-15 days) from getting bitten from an infected mosquito. Your body develops a fever in efforts to stop the parasite from reproducing in your liver and then spreading around your body via the bloodstream. As such, reducing the fever with medication is usually not a good idea.
    • There are at least five types of Plasmodium parasites that infect people, although P. falciparum (mainly in Africa) and P. vivax (mainly in Latin America and Asia) are the most common and deadly.
    • The fever and other initial symptoms may be mild and mimic less serious viral infections, such as the common cold and influenza.
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    Take notice of severe shaking chills. The other primary symptom of malaria is severe shaking chills with intermittent periods of sweating.[3] Again, shaking chills are typical of many other types of infections, but they are usually more pronounced and severe with malaria. They can cause teeth to chatter and even prevent sleep. When they're severe, the shaking can be mistaken for seizures. The chills from malaria are usually not remedied by blanket cover or by wearing warmer clothes.
    • Although the primary symptoms of malaria typically begin within a few weeks of being bitten by an infected mosquito, some types of malarial parasites can lie dormant in the body for up to a year or more.[4]
    • Malarial symptoms are caused by the bites from female Anopheles mosquitoes, which injects the parasite into the hosts bloodstream. The parasites then migrate to the liver where they lay dormant for a week or two before causing symptoms.
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    Look out for headaches and muscle pains. Secondary and less specific symptoms of malaria are moderate-to-severe headaches, often combined with mild muscle aches.[5] These secondary symptoms often occur a short while after the above-mentioned primary symptoms as the parasite needs a little more time to proliferate in the liver and spread around the body in the bloodstream. Headaches and muscle aches are also very common with most other infections, as well as from the bites of other insects and spiders.
    • The bites from female Anopheles mosquitoes are not very noticeable (a small red itchy bump), unlike the bites of some other insects and spiders that can cause similar symptoms.
    • The initial headaches of malaria are typically dull in nature (like a tension headache), but as the parasites start to infect and destroy red blood cells, they can become pounding in nature (more like a migraine).
    • The achy pain is usually most noticeable in the leg and back muscles because they are larger, more active and get more of the infected blood.
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    Be suspicious of vomiting with diarrhea. Other non-specific secondary symptoms of malaria are vomiting and diarrhea, multiple times per day.[6] They often occur in combination with each other, which mimics the initial symptoms of food poisoning and other bacterial infections. The main difference is that the vomiting / diarrhea caused by food poisoning fades away within a few days, whereas it can remain for a few weeks with malaria (depending on treatment).
    • Unlike the explosive and bloody diarrhea of some bacteria infections, particularly shigella, there's usually no blood or severe cramping with malaria.
    • Once the primary and secondary symptoms become noticeable, the malaria-causing parasites can be seen under a microscope from a drop of infected blood — especially if the specimen is stained with Giemsa stain.[7]
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    Recognize the advanced symptoms. If the advancing primary and secondary symptoms don't prompt the infected person to seek medical attention and get treatment (which may not be possible in the developing world), then symptoms begin to appear that signify serious injury / damage to the body.[8] When these advanced symptoms of malaria appear, the risk of health complications and death significantly increase.
    • Confusion, multiple convulsions, coma and neurological impairment indicate brain swelling and injury.
    • Severe anemia, abnormal bleeding, deep labored breathing and respiratory distress indicate advanced blood infection and lung involvement.
    • Jaundice (yellowish skin and eyes) is evidence of liver damage and dysfunction.

Part 2
Understanding the Risk Factors

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    Be very cautious of underdeveloped tropical areas. The biggest risk factor for coming down with malaria is either living in or traveling to tropical countries where the infection is common.[9] Impoverished and underdeveloped countries in the tropics are particularly risky because they don't have the money to spend on spraying mosquitoes or taking other safety precautions against malaria.
    • The most risky areas are African countries south of the Sahara Desert, most of the Asian subcontinent, Haiti, Solomon Islands and Papua New Guinea.[10]
    • The Centers for Disease Control and Prevention (CDC) estimate that 90% of all malaria deaths occur in Africa — mostly in kids younger than 5 years.
    • Approximately 1,500 cases of malaria are diagnosed in the U.S. each year, mostly in returned travelers.[11]
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    Be particularly careful if your immune system is weak. People with immature or weakened immune systems are especially susceptible of getting infected by Plasmodium parasites and developing malaria. This group includes infants, children younger than 5 years, pregnant women, the elderly and patients with HIV/AIDS.[12] As such, don't travel to high-risk countries if you are in this group and/or don't bring young children with you.
    • Strong immune systems can fight off malarial infections, which means the majority of people bitten by infected mosquitoes either don't get the disease or develop only mild short-term symptoms.
    • Supplements that can boost your immune system include: vitamins A, C and D, zinc, selenium, echinacea, olive leaf extract and astragalus root.[13]
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    Avoid contaminated blood. The Plasmodium parasites that cause malaria primarily infect the liver, but also the red blood cells within blood. Consequently, people can also catch malaria by being exposed to contaminated (infected) blood.[14] Common modes of transmission due to contaminated blood include blood transfusions, sharing needles to inject illicit drugs and childbirth (from an infected mother to her unborn child).
    • Hemophiliacs and people who lose lots of blood from injuries are at higher risk of malaria from blood transfusions, particularly if they life in Africa or Asia.
    • Malaria is not considered an STD (sexually transmitted disease), although there is a small chance of contracting it via sexual practices if the blood from one partner enters the bloodstream of another.


  • Doctors in western countries are not used to seeing malaria and might confuse the symptoms with that of another disease.
  • Drugs used for malaria work by killing the parasite in the blood. Examples include chloroquine, atovaquone-proguanil (Malarone), artemether-lumefantrine (Coartem), mefloquine (Lariam), quinine, quinidine, doxycycline, clindamycin and artesunate (not currently licensed in the U.S.).
  • When traveling abroad to tropical countries, avoid mosquito bites by applying insect repellents to your skin and using insecticide treated bed nets.
  • Scientists around the world are working to develop a vaccine to prevent malaria, although it's not available yet.
  • Many malaria parasites have become immune to the most common drugs used to treat the infection.[15]


  • Malaria should always be considered a potentially deadly disease. If you suspect that you have malaria, contact your doctor immediately.
  • The leading cause of death in malaria patients in the U.S. is delay in proper diagnosis and treatment.

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Categories: Insect Borne Diseases