Wednesday, September 9, 2009

Malaria




Causative agent

Malaria is a serious and sometimes fatal disease caused by a group of malaria parasites, namely Plasmodium vivax, Plasmodium falciparum, Plasmodium ovale, and Plasmodium malariae. It is commonly found in many parts of tropical and sub-tropical areas where the climate is warm, like Africa, South-East Asia and South America.

Clinical features

Symptoms of malaria include intermittent fever, chills, sweating, headache, tiredness, poor appetite and muscle pain. In typical cases, the fever comes, then subsides for 1-3 days and then comes again in a cyclical pattern. Complications include anaemia, liver and kidney failure, seizures, mental confusion, coma, and death if the disease is not treated promptly.

Mode of transmission

Malaria is a vector-borne communicable disease transmitted by an infected female Anopheline mosquito. When the mosquito bites a malaria patient, the mosquito becomes infected and will pass on the disease when it bites another person. Malaria is not transmitted from person to person. However, malaria can be transmitted through contaminated blood or blood product transfusion, organ transplant, or shared needles or syringes. Malaria may also be transmitted from a mother to her foetus/newborn baby before or during delivery.

Incubation period

The incubation period varies with different plasmodial species. This usually ranges from 7-30 days but may be up to months or even longer after the bite of an infected Anopheline mosquito.

Management

There are effective drugs against malaria but early diagnosis and prompt treatment are crucial. The doctor would prescribe a course of anti-malarial drugs with other supportive measures. The patient should complete the whole course of medication to ensure clearance of the malaria parasites.

Prevention

Take measures to avoid mosquito bite. There are no vaccines against malaria. If you travel to areas where malaria is common, consult your doctor or the Port Health Office two to three weeks beforehand for preventive measures and obtain anti-malarial drugs for prophylaxis if necessary. You should start taking the drugs before the trip, continue throughout the journey and for four more weeks after leaving the malarious area. During your visit abroad or after coming back to Hong Kong, if you have symptoms of malaria, seek medical advice immediately and inform the doctor of the places you have visited. Urgent blood tests may be performed and prompt treatment is vital. Malaria infection during pregnancy can have adverse effects on both the mother and the foetus. Therefore, pregnant women should not visit malarious areas unless this is absolutely necessary.


General Measures on Preventing Mosquito-borne Diseases

1. Wear long-sleeved clothing and trousers, and apply effective insect repellents containing DEET to exposed parts of the body and clothes. Repeated application may be required. Concentration of DEET should not exceed 35% for adults and 10% for children.

2. Use mosquito screens or nets when the room is not air-conditioned.

3.Apply household pesticide to kill adult mosquitoes with a dosage according to the label instructions. Do not spray the pesticides directly against functioning electrical appliances or flame to avoid explosion.

4. Place mosquito coils or electric mosquito mats / liquids near possible entrances, such as windows, to prevent mosquitoes from entering.

5.Prevent the accumulation of stagnant water Put all used cans and bottles into covered dustbins. Change water for plants at least once a week, leaving no water in the saucers underneath flower pots. Cover tightly all water containers, wells and water storage tanks. Keep all drains free from blockage. Top up all defective ground surfaces to prevent the accumulation of stagnant water.

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