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The symptoms appear after 7-15 days of an infected bite. Typical malarial illness is characterized by shaking chills, followed by high grade fever and sweating (Cold stage, Hot stage and Sweating stage), usually occurring during mid-day. This recurs in 48-72 hour cycles. But many patients may have atypical illness characterised by atypical fever, head ache and body ache, weakness, prostration, easy fatiguability, Vomiting, diarrhoea, cough etc. With complicated malaria, patients can develop breathlessness, chest pain, abdominal pain, altered behaviour, altered sensorium, convulsions, coma etc.

Diagnosis

Diagnosis of malaria is confirmed by examination of the blood for malarial parasite, either by a peripheral smear examination or the new QBC fluorescent technique. Now, non-microscopic rapid tests are also available.

Treatment

Chloroquine is the most widely used drug for treating P. vivax malaria. With wide spread resistance to chloroquine in P. falciparum malaria, combinations of drugs like artimisinin derivatives, sulfadoxine/pyrimethamine, doxycycline, lumefantrine, atovaquone and proguanil etc., are being used for the treatment of P. falciparum infection.

Prevention

Malaria vaccine has not yet become a reality and therefore, prevention of individual is essentially protection from the vector mosquitoes.

Unless breeding sites (most of which are man-made and temporary) are taken care of, it is impossible to control mosquito breeding and hence mosquito-borne diseases. And it is impossible to achieve this without the participation of the general public. Education of the people is thus very important for any meaningful action. The following measures are called for to minimize mosquito breeding and these measures require only a trifle of human efforts:

• Do not throw utensils, vessels, buckets, tyres, bottles, tender coconut shells etc. in the open. They should be either destroyed or buried or at least kept inverted so that water cannot collect in them. All such things should be cleared during the rainy season
• All tanks should be kept tightly closed. A black plastic sheet can be used for the purpose. Also, all tanks should be emptied, cleaned and allowed to dry for at least half an hour, once every week
• Terraces and roofs should ideally have a slope, particularly in places where monsoon tends to be heavy. All such roofs/terraces should have adequate drainage for water. Any collection of water on these surfaces should be cleared at least once a week
• At construction sites, all the care should be taken to avoid collection of water at one place for more than a week. The layer of water on the surface of the concrete, used for concrete curing, should be cleared at least once a week and allowed to dry for half an hour. All other puddles should be cleared regularly. Collections of water in the toilets and closets under construction should also be cleared. All tanks should be kept snugly closed
• All unused wells and tanks should be closed or destroyed. Engine oil or kerosene has been used as a larvicidal on these collections. Another method to prevent egg laying on unused wells is by adding EPS polystyrene beads onto the surface of water. These beads are non-toxic, cheap and long lasting. They coat the water surface and prevent the mosquito from laying eggs
• Wells that are being used and ornamental tanks can be treated with biological larvicides that do not harm the quality of drinking water. Also, these wells should be covered with either mosquito-proof nets or with plastic sheets