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November 25, 2009
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Travel Medicine (cont.)

Malaria

Malaria is an infection caused by a tiny organism called a protozoa. It enters red blood cells and multiplies until the cells burst open. The broken cells release the young protozoa into the bloodstream where they infect more red blood cells. This release of young protozoa causes high fevers that can last for several hours. The fever of malaria often comes and goes in a defined pattern, coinciding with when the infected red cells burst open. With some types of malaria, the protozoa can hide in the liver and cause episodes of fever over many years. In serious cases, malaria can cause the kidneys to shut down, can infect the brain, or cause death.

Malaria is spread to people by mosquitoes. The mosquitoes bite between dusk and dawn. Malaria occurs in many tropical areas and a few areas that have a milder climate. Travelers to sub-Saharan Africa, South America, and Asia may be at risk for the disease. Some countries in Central America and the Caribbean also have malaria. Not every area of a country will be infected. A doctor can evaluate your itinerary to see if you might be exposed to malaria. The Centers for Disease Control and Prevention (CDC) has a Web page that tells where malaria occurs (http://wwwn.cdc.gov/travel/).

Malaria can be prevented by avoiding mosquito bites (see the section on insect precautions) and by taking preventive medications. Travelers who will be exposed to malaria should take medications starting before travel to the area and continuing for a time after they leave the area. Several different medicines are available. Some are taken only once a week, and others are taken daily. In some countries, malaria has become resistant to older medicines. Your physician will choose which medicine to use based on what countries you are visiting.



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