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Malaria Symptoms

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West Nile Fever: Common Symptoms Of Mosquito-borne Illness; How Is It Different From Malaria?

A 47-year-old man from Kerala's Thrissur district, died of West Nile fever on Sunday after which the health department of the state is taking measures to control mosquito breeding. West Nile virus is spread by mosquitoes much like Malaria and is often seen in later summer. It mostly causes milk, flu-like symptoms and but can turn life threatening in few cases. (Also read: World Malaria Day 2022: Lesser-known symptoms of malaria to watch out for)

Dr. Kavita Prabhakar Pai, Consultant Endocrinology & Internal Medicine, Masina Hospital, Mumbai in an interview with HT Digital shared details about symptoms, causes, its differences and similarities with Malaria and more.

What is the West Nile virus?

The West Nile virus (WNV) is spread by mosquitoes. The WNV can infect not just humans, but also birds, mosquitoes, horses, and other mammals. The virus very rarely, can spread through transfused blood, a transplanted organ, or the placenta to a fetus.

It is often seen during late summer. It can also occur year-round in dry, hot-semi arid climates. Most often, the West Nile virus causes mild, flu-like symptoms. But, the virus can cause life-threatening illnesses, such as:

· Encephalitis (inflammation of the brain)

· Meningitis (inflammation of the lining of the brain and spinal cord)

· Meningoencephalitis (inflammation of the brain and its surrounding membrane)

What causes West Nile virus?

West Nile virus is spread to humans through the bite of an infected female mosquito. The mosquitoes get the virus when they bite an infected bird. Crows are the most common birds linked to the virus. But other bird species also have the virus.

It isn't spread between humans. However, in a few cases it has spread through organ transplant. Health officials think the organ donor acquired the virus through a blood transfusion. All blood is screened for the virus.

What are the symptoms of West Nile virus?

Most people infected with WNV have only mild, flu-like symptoms that last a few days. Symptoms usually appear within 3 to 14 days of infection.

About 20% of the people who become infected will develop West Nile fever. These are the most common symptoms of West Nile fever:

· Fever

· Headache

· Body aches

· Skin rash on trunk of body

· Swollen lymph glands

The more severe form of the WNV affects mostly older adults. It occurs when the virus crosses the blood-brain barrier and can cause:

· Headache

· High fever

· Neck stiffness

· Stupor (a state of impaired consciousness, extreme lethargy, and reduced reactivity to outside stimuli)

· Disorientation

· Coma

· Tremors

· Convulsions

· Muscle weakness

· Paralysis

How is West Nile fever different from Malaria?

The key difference between Malaria and West Nile virus is that Malaria is a mosquito-borne disease caused by Plasmodium parasites while West Nile virus is a single-stranded RNA virus which causes West Nile fever. Female Anophyles mosquito is the insect vector of Malaria while Culex mosquitoes are the insect vectors of West Nile fever.

Many infectious diseases are transmitted by insect vectors such as mosquitoes, lice, fleas, etc. Malaria and West Nile fever are two diseases transmitted by mosquitoes to human. When a mosquito bites a human, infectious agents enter the human body and cause the disease.

- Malaria is a disease caused by a parasite, while West Nile fever is a disease caused by a virus.

- Both diseases are life threatening since there are no vaccines for them.

- Moreover, the symptoms of Malaria are evident immediately, while the symptoms of the West Nile virus do not always immediately become evident.

Can West Nile virus be prevented?

At this time, there's no vaccine available to prevent West Nile virus. There are recommendations to take the following steps to avoid mosquito bites and WNV:

· Apply insect repellent containing DEET (N,N-diethyl-meta-toluamide) when you're outdoors. (If you spray your clothing, there's no need to spray repellent containing DEET on the skin under your clothing.)

· When possible, wear long-sleeved shirts and long pants treated with repellents containing permethrin or DEET since mosquitoes may bite through thin clothing. (Don't directly apply repellents containing permethrin to exposed skin.)

· Consider staying indoors at dawn, dusk, and in the early evening. These are peak hours for mosquito bites, especially those mosquitoes that carry the West Nile virus.

· Limit the number of places for mosquitoes to lay their eggs by getting rid of standing water sources from around your home.

Treatment

There's no specific treatment for West Nile virus-related diseases. If a person gets the more severe form of the disease, West Nile encephalitis or meningitis, treatment may include intensive supportive therapy, such as:

· Hospitalization

· Intravenous (IV) fluids

· Breathing support (ventilator)

· Prevention of other infections (such as pneumonia or urinary tract infections)

· Nursing care

Malaria on the other hand is treated with prescription drugs to kill the parasite.

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Malaria

Overview

Malaria is a disease caused by a parasite. The parasite is spread to humans through the bites of infected mosquitoes. People who have malaria usually feel very sick with a high fever and shaking chills.

While the disease is uncommon in temperate climates, malaria is still common in tropical and subtropical countries. Each year nearly 290 million people are infected with malaria, and more than 400,000 people die of the disease.

To reduce malaria infections, world health programs distribute preventive drugs and insecticide-treated bed nets to protect people from mosquito bites. The World Health Organization has recommended a malaria vaccine for use in children who live in countries with high numbers of malaria cases.

Protective clothing, bed nets and insecticides can protect you while traveling. You also can take preventive medicine before, during and after a trip to a high-risk area. Many malaria parasites have developed resistance to common drugs used to treat the disease.

Symptoms

Signs and symptoms of malaria may include:

Fever

Chills

General feeling of discomfort

Headache

Nausea and vomiting

Diarrhea

Abdominal pain

Muscle or joint pain

Fatigue

Rapid breathing

Rapid heart rate

Cough

Some people who have malaria experience cycles of malaria "attacks." An attack usually starts with shivering and chills, followed by a high fever, followed by sweating and a return to normal temperature.

Malaria signs and symptoms typically begin within a few weeks after being bitten by an infected mosquito. However, some types of malaria parasites can lie dormant in your body for up to a year.

When to see a doctor

Talk to your doctor if you experience a fever while living in or after traveling to a high-risk malaria region. If you have severe symptoms, seek emergency medical attention.

Causes

Malaria is caused by a single-celled parasite of the genus plasmodium. The parasite is transmitted to humans most commonly through mosquito bites.

Mosquito transmission cycle

Uninfected mosquito. A mosquito becomes infected by feeding on a person who has malaria.

Transmission of parasite. If this mosquito bites you in the future, it can transmit malaria parasites to you.

In the liver. Once the parasites enter your body, they travel to your liver -- where some types can lie dormant for as long as a year.

Into the bloodstream. When the parasites mature, they leave the liver and infect your red blood cells. This is when people typically develop malaria symptoms.

On to the next person. If an uninfected mosquito bites you at this point in the cycle, it will become infected with your malaria parasites and can spread them to the other people it bites.

Other modes of transmission

Because the parasites that cause malaria affect red blood cells, people can also catch malaria from exposure to infected blood, including:

From mother to unborn child

Through blood transfusions

By sharing needles used to inject drugs

The greatest risk factor for developing malaria is to live in or to visit areas where the disease is common. These include the tropical and subtropical regions of:

Sub-Saharan Africa

South and Southeast Asia

Pacific Islands

Central America and northern South America

The degree of risk depends on local malaria control, seasonal changes in malaria rates and the precautions you take to prevent mosquito bites.

Risks of more-severe disease

People at increased risk of serious disease include:

Young children and infants

Older adults

Travelers coming from areas with no malaria

Pregnant women and their unborn children

In many countries with high malaria rates, the problem is worsened by lack of access to preventive measures, medical care and information.

Immunity can wane

Residents of a malaria region may be exposed to the disease enough to acquire a partial immunity, which can lessen the severity of malaria symptoms. However, this partial immunity can disappear if you move to a place where you're no longer frequently exposed to the parasite.

Complications

Malaria can be fatal, particularly when caused by the plasmodium species common in Africa. The World Health Organization estimates that about 94% of all malaria deaths occur in Africa -- most commonly in children under the age of 5.

Malaria deaths are usually related to one or more serious complications, including:

Cerebral malaria. If parasite-filled blood cells block small blood vessels to your brain (cerebral malaria), swelling of your brain or brain damage may occur. Cerebral malaria may cause seizures and coma.

Breathing problems. Accumulated fluid in your lungs (pulmonary edema) can make it difficult to breathe.

Organ failure. Malaria can damage the kidneys or liver or cause the spleen to rupture. Any of these conditions can be life-threatening.

Anemia. Malaria may result in not having enough red blood cells for an adequate supply of oxygen to your body's tissues (anemia).

Low blood sugar. Severe forms of malaria can cause low blood sugar (hypoglycemia), as can quinine -- a common medication used to combat malaria. Very low blood sugar can result in coma or death.

Malaria may recur

Some varieties of the malaria parasite, which typically cause milder forms of the disease, can persist for years and cause relapses.

Prevention

If you live in or are traveling to an area where malaria is common, take steps to avoid mosquito bites. Mosquitoes are most active between dusk and dawn. To protect yourself from mosquito bites, you should:

Cover your skin. Wear pants and long-sleeved shirts. Tuck in your shirt, and tuck pant legs into socks.

Apply insect repellent to skin. Use an insect repellent registered with the Environmental Protection Agency on any exposed skin. These include repellents that contain DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-3,8-diol (PMD) or 2-undecanone. Do not use a spray directly on your face. Do not use products with OLE or PMD on children under age 3.

Apply repellent to clothing. Sprays containing permethrin are safe to apply to clothing.

Sleep under a net. Bed nets, particularly those treated with insecticides, such as permethrin, help prevent mosquito bites while you are sleeping.

Preventive medicine

If you'll be traveling to a location where malaria is common, talk to your doctor a few months ahead of time about whether you should take drugs before, during and after your trip to help protect you from malaria parasites.

In general, the drugs taken to prevent malaria are the same drugs used to treat the disease. What drug you take depends on where and how long you are traveling and your own health.

Vaccine

The World Health Organization has recommended a malaria vaccine for use in children who live in countries with high numbers of malaria cases.

Researchers are continuing to develop and study malaria vaccines to prevent infection.

Diagnosis

To diagnose malaria, your doctor will likely review your medical history and recent travel, conduct a physical exam, and order blood tests. Blood tests can indicate:

The presence of the parasite in the blood, to confirm that you have malaria

Which type of malaria parasite is causing your symptoms

If your infection is caused by a parasite resistant to certain drugs

Whether the disease is causing any serious complications

Some blood tests can take several days to complete, while others can produce results in less than 15 minutes. Depending on your symptoms, your doctor may order additional diagnostic tests to assess possible complications.

Treatment

Malaria is treated with prescription drugs to kill the parasite. The types of drugs and the length of treatment will vary, depending on:

Which type of malaria parasite you have

The severity of your symptoms

Your age

Whether you're pregnant

Medications

The most common antimalarial drugs include:

Chloroquine phosphate. Chloroquine is the preferred treatment for any parasite that is sensitive to the drug. But in many parts of the world, parasites are resistant to chloroquine, and the drug is no longer an effective treatment.

Artemisinin-based combination therapies (ACTs). ACT is a combination of two or more drugs that work against the malaria parasite in different ways. This is usually the preferred treatment for chloroquine-resistant malaria. Examples include artemether-lumefantrine (Coartem) and artesunate-mefloquine.

Other common antimalarial drugs include:

Atovaquone-proguanil (Malarone)

Quinine sulfate (Qualaquin) with doxycycline (Oracea, Vibramycin, others)

Primaquine phosphate

Preparing for an appointment

If you suspect you have malaria or that you've been exposed, you're likely to start by seeing your family doctor. However, in some cases when you call to set up an appointment, you may be referred to an infectious disease specialist. If you have severe symptoms -- especially during or after travel in an area where malaria is common -- seek emergency medical attention.

What you can do

Before your appointment, you might want to write down answers to the following questions:

What are your symptoms, and when did they start?

Where have you traveled recently?

How long did you travel and when did you return?

Did you take any preventive drugs related to your travel?

What other medications do you take, including dietary supplements and herbal remedies?

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