James Paget University Hospitals. NHS Foundation Trust. Malaria. Patient Information

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1 James Paget University Hospitals NHS Foundation Trust Malaria Patient Information

2 What is malaria? Malaria is a serious and potentially life threatening illness caused by infection with the protozoan parasite, Plasmodium. There are four types of malaria that commonly affect humans: Plasmodium falciparum (which is responsible for the vast majority of malaria deaths), Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. What are the symptoms of malaria and how long do they last? Often the first symptom is a non-specfic flu like illness with fever, sweats and chills. Other symptoms can include malaise, myalgia (muscle pain), headache, diarrhoea and cough. Malaria caused by P.falciparum can progress to become a severe and life threatening illness if not diagnosed and treated promptly, leading to cerebral malaria which can cause coma and death. How long can you have the infection before developing symptoms? The incubation period of malaria (the time from which the parasite enters the body, to the development of symptoms) varies depending on which Plasmodium species is causing the infection. During the incubation period the parasite undergoes an initial period of development in the liver which affects the red blood cells. For P.falciparum, the incubation period is 7-14 days. For P.vivax and P.ovale infection, the incubation period is typically days, but can be longer (months or years in some cases) due to a longer liver stage. How do you get infected with malaria? The malaria parasite is transmitted to humans from the bite of an infected female mosquito. There are roughly 50 species of mosquito that can transmit malaria to humans. The high risk times for transmission happen at dusk and dawn. Malaria is not spread directly from person to person. 2

3 Is it infectious? Anyone who visits a malaria-endemic country is at risk of acquiring malaria if they do not take precautions. Even if you grew up or lived in a country that is malaria-endemic and are now returning to visit friends or family, you will be at risk. No one has full immunity to malaria. Any partial immunity you may have from living in a malaria-endemic country will be quickly lost when you live in countries with no malaria; therefore every individual needs to take precautions. Babies, the elderly and children can get sick very quickly with malaria. It also particularly dangerous for pregnant woman. How do you treat malaria? If you suspect that you may have malaria, you should seek urgent medical treatment. Remember malaria can develop months or years after exposure. There are several treatment options available; the option chosen depends on many factors, including any reported drug resistance in the country visited and type of Plasmodium species causing the infection. P.faciparum infection is considered a medical emergency, requiring hospitalisation to assess symptoms and treatment options. Complicated malaria usually requires admission into high dependency or intensive care ward for intravenous (via a vein) anti-malaria treatment. For non P.falciparum infections it is usual for treatment to be given on an outpatient basis. Treatment with two types of anti-malarial medications may be required to treat the acute infection and to clear any P.ovale or P.vivax from the liver. Will I need to stay off work or school? As malaria cannot be passed from person to person there is no reason for you to stay at home if you are feeling well and having no symptoms. 3

4 Will I have to stay in hospital until malaria has cleared? Depending on your symptoms, how serious your case of malaria is and the causative parasite, you may or may not need to stay in hospital whilst you receive treatment. More guidance will be given on an individual basis should you need it. How will this affect my visitors? Being diagnosed with malaria will not affect you being able to have visitors if you are admitted to hospital. Malaria cannot be passed directly from person to person, so you cannot pass the infection on to your visitors. What happens when I go home? You will be given guidance on your discharge on what you may need to do once you are at home. If you are discharged with treatment, you need to ensure you complete the full course before stopping taking your medication. 4

5 How can I avoid getting infected with malaria in the future? Follow the ABCD of malaria prevention below: Awareness of the risk check your destination to see if malaria is a risk and visit your GP or your usual travel health advisor in plenty of time (6-8 weeks ideally but it is never too late) for travel health advice before you go. Bite prevention use an insect repellent containing DEET, wear cover up clothing especially at night when mosquitoes are most active, sleep under a bed net or in an air conditioned room. More information on bite prevention is available from the National Travel Health Network and Centre (NaTHNaC). Chemoprophylaxis (preventative medication) there are a number of different types of medications. You should speak to your travel health advisor to determine the medication that is most suitable for you and your family. Make sure you understand how and when to take your tablets. You need to start taking them before you go, continue them all the time you are away and for a period of time on your return home. Remember, it is vital that you finish the course of medication when you get home to ensure you are properly protected against malaria. Homoeopathic or herbal remedies do not protect against malaria and must not be used in the place of anti-malarial medications. Effective use of anti-malarial medications will reduce your risk of malaria by approximately 90%. Prompt Diagnosis although malaria prevention methods are highly effective, they do not provide 100% protection. If you or your family has symptoms of a fever or flu-like illnesses after being in a country with malaria you must see a doctor urgently. 5

6 Notes 6

7

8 James Paget University Hospitals NHS Foundation Trust Courtesy and respect A welcoming and positive attitude Polite, friendly and interested in people Value and respect people as individuals So people feel welcome Attentively kind and helpful Look out for dignity, privacy & humanity Attentive, responsive & take time to help Visible presence of staff to provide care So people feel cared for Responsive communication Listen to people & answer their questions Keep people clearly informed Involve people So people feel in control Effective and professional Safe, knowledgeable and reassuring Effective care / services from joined up teams Organised and timely, looking to improve So people feel safe The hospital is able to arrange for an interpreter to assist you in communicating effectively with staff during your stay through INTRAN. If you need an interpreter or a person to sign, please let us know. If you require a large print version of this booklet, please contact PALS on Author: Michelle Turner, IPC Nurse Specialist 8 April 2015 James Paget University Hospitals NHS Foundation Trust Review Date: April 2018 IP 12 version 1

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