Who would think that a simple bite from a mosquito could send you to your grave in a short period of time? It’s true – and the threat is very real in many places around the world. I’ve just now entered into the Malaria Zone of Africa, and have been doing extensive research into prevention, treatment, and its origins. I’d like to share some of my findings and discuss how I’m approaching the issue.

Malaria has actually been around before humans were walking on the earth evolving in prehistoric times millions of years ago. It’s been causing death and sickness to humans for most of their time on earth and continues to this day affecting 250 million people annually, and causing 1 million annual deaths. That’s a huge number – and to imagine throughout all this time we’ve never been able to develop an effective vaccine for the disease. Scary Stuff.

What is it?

Malaria is caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases progressing to coma or death. Five species of Plasmodium can infect and be transmitted by humans. Severe disease is largely caused by Plasmodium falciparum while the disease caused by Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae is generally a milder disease that is rarely fatal. Plasmodium knowlesi is a zoonosis that causes malaria in macaques but can also infect humans. While P. vivax is responsible for the largest number of malaria infections worldwide, infections by P. falciparum account for about 90% of the deaths from malaria.

^{How does one get it?}

Mosquitoes are the primary source for transmitting the disease, while blood transfusions also serve an infection mechanism. A young mosquito becomes infected with the parasite by sampling blood from another human, creating a cyst that ruptures inside the mosquito releasing spores that migrate from the gut to the salivary glands which pass into the humans body when the mosquito is having a meal. Malaria occurs in over 100 countries and more than 40% of the people in the world are at risk. Large areas of Central and South America, Hispaniola (Haiti and the Dominican Republic), Africa, the Middle East, the Indian subcontinent, Southeast Asia, and Oceania are considered malaria-risk areas.

How do you know you have it?

It’s not instantaneous – Malaria’s effects start affecting the human body 6-14 days after infection. Symptoms of some types of malaria introduce cold sweats, headache, and fever that lasts up to 6 hours every 2 days. Other types of malaria can reoccur every 36-48 hours with a high fever. At the same time, it cause cognitive impairments resulting in brain damage. If it has started to affect your brain (Cerebral Malaria) one can tell by the whitening of their eyes retina. The most dangerous cases of malaria can place a victim into a coma or even death if untreated promptly. A severe headache, enlarged liver, and hemoglobin from red blood cells leaking into the humans urine can cause death within hours.

How do you treat it?

if you have mild case of malaria – Quinine Sulphate taken 600mg every 12 hours will in most cases treat the infected human in one week. It has been shown that persons infected with Malaria can suffer a relapse due to a release of latent parasites from the liver, and resurface many years later.  If one is to be treated for severe malaria, it involves could involve fluid replacement, intravenous delivery of drugs, . Recovery from Malaria is often weeks to recover, sometimes years in severe cases.

Better yet, how do I avoid it?

It’s likely best to maintain a preventative role with this disease using multiple mechanisms. Oral medication such as Mefloquine is available, which has been shown to prevent infections of the disease or reduce the strength of malaria if infected. While this has been used for over 40 years, it has been known to cause serious health issues to those who take it, such as psychotic breaks, hallucinations, and abnormalities with the heart rhythm. Other medication is available taken once per week as opposed to daily, and an antibiotic Doxycycline has also shown to be successful in prevention. Unfortunately with Antibiotics there is only a limited time one can take the medication before it loses its potency, while also causing other side effects such as photosensitivity, headaches, and esophegal ulceration. Over time the prevention drugs have changed due to the disease evolving and becoming resistant to the drugs. One must also focus energies on preventing the mosquitos from landing on the body in the first place. Infection can only occur at night from dusk till dawn – so during these times it’s best to keep the body covered with long sleeved clothing, utilize spray that contains DEET, and other natural remedies such as eating cloves of garlic and use netting. One can also utilize devices such as ‘foggers’ to remove mosquitoes from the area, and make sure that there is no standing water nearby, as that is where mosquito larvae reside. Still, with many preventative measures taken these crafty insects can make their way into your personal space and snack on your body.

This poses a huge problem for long term bicycle tourists who are often sleeping in tents at night outdoors, sweaty and smelly attracting these insects to their space. Not to mention that many of the areas which are classified as Malaria Zones are in the tropics, so prevention using oral medication can cause severe side effects with long term exposure of the sun, some lasting long after utilization of the medication. It’s also been said that those taking antibiotics can mask the symptoms, allowing it to multiply in ones body and cause damage without the human knowing. Test Kits are available that can be used on the road to see if you have been infected, but it’s likely best that you are prepared to treat the disease yourself if you are in remote places by carrying Quinine Sulphite and then proceed to a hospital immediately once you enter into a populated area.

How I’m trying to deal with it..

I have some serious issues with long term usage of drugs to combat the disease, not wanting to limit my ability to use the drug in the future for other infections or treatments, and struggle with the fact that my skin will burn during usage and sit day by day wondering if I should be starting preventative treatment with drugs. I’m still unsure if I am prepared to alter my internal bodies flora at this time when I’ve had issues in the past with other drugs. I’m careful with making sure that I am in my tent by dusk, eat cloves of garlic and do my best to keep myself clean. Still I find 5 or so mosquitos each morning in my tent, and once killed I’m left with blood on my hands – knowing it came from me sometime throughout the night. I’m not going to carry a test kit with me, but instead carry  Quinine for instant self treatment, before seeking help (no, this doesn’t mean riding to the next town – it means stopping at the side of the road and flagging down any driver I see in a car) and rushing to a hospital. The longest stretch of path I have mapped out for the next few months is no more than 3 days between villages and towns where medical services exist which means only a few short hours by car to the next one. I’d like to hear your thoughts on this approach – your stories of infection, treatment and other sage advice – as I realize that sometimes my thinking may not be the most rational. Although it does seem logical to me. I would hope that one would see a doctor before making up their own mind what they’d like to do if traveling through a Malaria-Zone, as this post is not advice, purely an informational piece detailing my own actions.

You can find out more information about Malaria at the World Health Organizations Website where an area is dedicated to the disease.