P. falciparum:

Typical incubation time: 7 to 30 days.

If a person is taking chloroquine and if the parasite is partially resistant, there may be temporary suppression of a malaria attack. The fever is generally irregular. If the attack is not treated, after a few weeks a regular fever pattern will develop with peaks every 2 days (tertian malaria, so called because the fever reappears on the third day). This is rare in everyday clinical practice, however. At the beginning of the attack the symptoms are similar to influenza: general malaise, tiredness, muscle pain, headache but in general without respiratory tract problems or runny nose. These symptoms are not very specific. After a while the muscle pain and headache become worse. Sometimes there is also abdominal pain and diarrhoea. Rarely there is a classic attack: this lasts for approximately 12 hours and occurs every 48 hours. At first cold shivers with high fever occur, followed by an intense feeling of heat and fever, leading to a sweating stage with a drop in fever. Most falciparum attacks do not follow this classic pattern, however. So what is referred to as a classic attack is paradoxically not the general rule.

Category: Medicine Notes