Often, the last thing we want to think about is our health while we are on holiday – but falling ill while abroad can be a traumatic and stressful time for the patient and their family alike.
Traveling to a mosquito-infested area is not something to be dismissed lightly. Not only are mosquitoes the deadliest creature on the planet, thought to be responsible for more deaths than all the wars (in history and currently ongoing) put together, malaria is a debilitating illness. A dark joke about how awful the disease makes you feel runs along the lines of, 'First you worry that you're dying – then you worry that you are not.'
Countries, where you might be at risk of contracting the disease, include much of the Indian subcontinent, a broad swathe across the top of South America and much of Africa, from just above the equator down to the tip of the Cape. Many of the Pacific islands, too, are infested with the parasite. All these countries are hot and humid, offering perfect breeding conditions for the flying pests.
Malaria is not so much an infection as a parasite. Simply put, when the female Anopheles mosquito feeds on a person, she releases parasite sporozoites into the blood stream. These sporozoites travel around the body and mature, becoming fully-fledged parasites in their own right. It is these parasites that make the patient feel so very ill.
Symptoms often start with the patient feeling chilled, even icy cold, for long periods of time, even in blazing sunshine. Flu-like symptoms rapidly occur: aching fuzzy head, painful joints and abdomen, general debility and feeling very, very ill. Often the patient will be unable to keep any food down – even liquids, including water, in extreme cases. This, combined with another occasional symptom, that of diarrhoea, can result in the patient quickly becoming dehydrated on top of their malarial symptoms. Untreated or undiagnosed, it can lead to more severe issues, including liver failure and jaundice, shock, pulmonary oedema, and respiratory problems. Death results in a significant number of cases.
Malaria can be prevented and treated, however, and if caught early and there are no other health issues, a good recovery can be expected with reasonable confidence. Diagnosis is made through a simple blood test – the parasite is visible in the blood, under a microscope, especially if a Giemsa stain, or similar, is used to make it stand out. Treatment is a course of medication, which can be administered intravenously if the patient is still vomiting.
However, prevention is always better!
Prevention is usually a course of antimalarial medication, along with advice to use mosquito nets while sleeping, and insect repellent whenever at risk of exposure to the insects. It is the antimalarial tablets that work best to prevent the onset of the illness, repellent, and nets being more for comfort than anything else. Essentially, they suppress the reproductive cycle of the parasite, preventing them from maturing and reproducing. This is why it is absolutely vital that the course of antimalarial tablets is taken in full – stopping taking them too soon means that the sporozoites just begin to mature later, and the disease presents a week or two after it would have normally done. This can cause diagnosis issues, as usually the parasites reproduction cycle is very regular and doctors may not think of the right diagnosis if it seems that the patient has not been in a problem area at the right time.
Holidays are to be enjoyed and remembered with happiness: avoiding illness is nothing more than a sensible precaution!
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