Ways to Keep You and Your Family Safe
Florida's Department of Health recently released a statement that four individuals have become infected with malaria. Malaria is caused by protozoan parasites from the genus Plasmodium: P. falciparum, P. vivax, P. malariae, and P. ovale, and is transmitted by mosquitos of the Anopheles species. It should be noted that malaria was eliminated from Florida in the late 1940s, however in 2012, 65 cases of imported (malaria were reported in Florida. Of the 2012 cases:
69% (45 cases) were P. falciparum
25% (16 cases) were P. vivax
3% (2 cases) were P. ovale
3% (2 cases) were P. malariae
USA Endemic Mosquito Vectors
In Florida, there are eight identifiable Anopheles species that can transmit malaria. The principal mosquito vector is Anopheles quadrimaculatus, which is found in every county in Florida and is most abundant in northern Florida.
Clinical Symptoms
Symptoms may vary depending on the species of malaria contracted but initial symptoms include:
Lasstitude (a state of physical or mental weariness; lack of energy)
Headache
Anorexia
Occasional nausea and vomiting
The fever stage is comprised of:
Cold Stage (shivering and feeling intense cold)
Hot Stage (distressing heat, dryness, burning, intense headache, nausea, and vomiting)
Sweating Stage (profuse sweating)
A typical attack starts in the early afternoon and lasts from 8 to 12 hours.
Malaria and Pregnancy
Uncomplicated malaria in all stages of pregnancy is currently treated with Quinine and Clindamycin, or just Quinine if Clindamycin is unavailable.
Malaria and Children
Early symptoms of malaria in children can include irritability and drowsiness, poor appetite, and trouble sleeping. These symptoms are usually followed by chills, and then a fever with fast breathing. The fever may either gradually rise over 1 to 2 days or spike very suddenly to 105°F (40.6°C) or higher. The same pattern of symptoms (chills, fever, sweating) may repeat every 2 to 3 days depending on which malaria parasite is causing the infection. Please see the links under treatment for weight-based pediatric dosing.
Prevention
Here is a list of varying interventions around your home to prevent mosquito attacks:
Clean out eaves and gutters
Drill holes in or remove old tires
Turn over empty plastic pots and bins
Adjust tarps and equipment on outdoor recreation vehicles to remove standing water
Pump out bilges on boats
Replace bird bath water once a week
Empty water in plant trays and hanging baskets once a week
Remove vegetation and debris from drainage ditches that prevent water flow
Sprinkle shavings of Irish Spring Soap around windows, doors, patios, or other areas you and your family may frequent, you can also place bars of the soap in mason jars around your home and patio
Plant any combination of the following mosquito-repelling plants: Citronella grass/Lemongrass, Mint, Catnip, Sage, Petunias, Marigolds, Rosemary, Lavender, Basil, Bee Balm, Allium.
You can purchase citronella candles and burners
Wall outlet insect repellants
For a list of items I use to protect my family and home from mosquitos click this link.
Treatment
The international gold standard for treating nonsevere, noncomplex malaria is chloroquine and hydroxychloroquine which are FDA-approved drugs used to prevent and treat malaria. They have a long elimination half-life of 30-40 days allowing for weekly dosing when used in the prevention of malaria, and a short 48-hour treatment course when used to treat malaria.
Other medications for treating malaria include:
Oral (pills) Artemether-Lumefantrine (Coartemâ„¢)
Oral (pills) Atovaquone-Proguanil (Malaroneâ„¢)
Oral (pills) Quinine
Oral (pills) Mefloquine
IV (infusion) Artesunate
If you would like to get a prescription for hydroxychloroquine I recommend MyFreeDoctor.Com which is a donation-based telehealth service and is my preference for me and my family when needing primary care services. Hydroxychloroquine can be taken as a prophylaxis for malaria.