Malaria

It is a leading cause of death especially in developing countries. This disease is mostly prevalent in tropical and sub-tropical regions. Malarial parasites Plasmodium falciparum, P. vivax, P. ovale or P. malariae can cause malaria in humans. These parasites that develop in the anopheles mosquito are transmitted to humans. The parasites infect the liver and later enter red blood cells. This results in release and spread of the toxin. Malaria does not spread through casual contact with an infected person. Malaria can be treated and cured if diagnosed early.

High fever and chills are characteristic symptoms of malaria. There are flu-like symptoms. Fever, headache, muscle aches and nausea is associated with many other conditions and therefore diagnosis is delayed. Preventive measures include:

• Antimalarial drugs
  
• Preventing breeding grounds for mosquitoes
  
• Spraying insecticides to repel mosquitoes
  
• Wearing long-sleeved clothing when moving in mosquito-prone areas
  
• Use bed nets

Treatment for malaria is based on the age and health condition of the patient. Preventive treatment of Chloroquine is started a week or so before leaving for a place where malaria is rampant. This can prevent malarial infections. Mefloquine or Doxycycline are other malarial preventives. A person diagnosed with malaria must be immediately treated with antimalarial medicine. Primaquine is given to confirmed cases of malaria.

Antiprozoal medicines

Anti protozoal drugs are prescribed to combat a variety of diseases caused by protozoa. Conditions like amebiasis, malaria etc are caused because of protozoa. Commonly used anti protozoal drugs include Hydroxychloroquine (Plaquenil), Pentamidine (Pentam 300) and Furazolidone (Furoxone). Antiprotozoals are commonly used to treat infections such as trichomoniasis and giardiasis. Metronidazole or tinidazole is often prescribed to treat trichomoniasis and giardiasis. Some persons experience dizziness, light headedness, blurred vision and confusion while on anti protozoal medications. Pregnant women/lactating mothers need to check with the doctor before use of any medicines.

Fever

Fever is an elevation of body temperature and defined as a core temperature higher than 38 C (100.4 F) in infants and higher than 38.3 C (100.9 F) in adults. Normal body temperature range is between 36 and 37.8 degree C (96.8 and 100.4 degree F). If a person has an oral temperature above 98.6 F (37 C), it is considered as fever. In some cases, there is a variation of up to 1 F (0.6 C). Fever is a symptom and not a disease. Fever, by itself is an indicator that the body is building an immune response to an infection. Most viruses and bacteria cannot survive at higher temperatures and fever is the body's fighting mechanism. Any body temperature up to 100 F is considered low grade fever. It is usually noticed along with sore throat, cough, joint pain, chills and nausea. Most fevers of this nature are self-limiting; and medication is given to provide comfort to the patient. Most of the time fever is only a symptom which can be treated symptomatically with antipyretics. Acetaminophen and ibuprofen are prescribed to control fever.

Fever results from the production of prostaglandin E2 (PGE2) in the hypothalamus due to endogenous or exogenous pyrogens. The cause is identified by physical examination and a thorough history - the onset of fever, level, duration, pattern if any and other symptoms.

Normally a person can sustain a body temperature of up to 104 degree F (40 degree C) with relative safety. But when the fever temperature rises above 104 ° it may cause cellular damage to brain, blood and internal organs. To prevent damage from high fever cooling treatments may be of help. Cold compresses, cold packs or sponge baths or ice bags /chemical cold packs are used to bring down the high fever.

Do not swathe a patient with fever in blankets but keep him comfortable. Bath in tepid water can help, but never ice cold water. The patient must be well hydrated. Some immunosuppressed or elderly patients might not exhibit a big rise in temperature in spite of a serious infection. Most often , CBC (complete blood count) is done to look for raised WBC count. Other useful indicators are urine test, gram stains and chest x-ray. If fever is also accompanied by abdominal pain, CT scan of the abdomen is suggested to look for possible appendicitis, diverticulitis and Cholecystitis.

The degree of fever elevation is not an indicator of the severity of the illness. Fever can be due to dengue, chikungunya, chicken pox, measles, malaria or other infections. Metabolic disturbances can cause body temperature to be elevated. In rare cases, fever is due to heart disease, serious illness, AIDS or cancer. Toxic shock, meningitis and peritonitis are other serious causes for high fever.

In some cases, the cause for fever is not easy to diagnose. Fever due to upper respiratory tract infection usually lasts for about 3-5 days.

Do not confuse fever with Hyperthermia, where the body temperature rises due to external sources. Here fever is also accompanied by palpitations, fainting, shivering, aches and confusion or hallucinations. When fever rises, the respiratory rate and heart rate rise. When children below 1 year suffer fever, they should be examined by a healthcare professional. Never use aspirin in children during a viral infection.