About one thousand malaria diseases are reported to health authorities in Germany every year. According to the discharge statistics of hospitals, there could be twice as many cases. This makes malaria the world's most important and most dangerous tropical disease. The most dangerous type of malaria, the malaria tropica, causes a completely irregular or even a continuous fever. As many patients also have head, limb or back pain, some also have diarrhea or cough, many sufferers think of flu or traveler's diarrhea.
Can German mosquitoes transmit malaria?
Like the tropical physicians around Prof. Dr. med. Thomas Löscher of the TU Munich report that most diseases in the tropics are acquired through the bite of an infected Anopheles mosquito. Very rarely, the mosquitoes can stab in Germany, for example, if they have come by plane or in the luggage. A rarity is the transmission by native mosquitoes. You must first have acquired the malaria parasite in an infected person. Two such cases were described in 1997, which are absolute exceptions.
Malaria sometimes misjudged as a flu
Usually, patients become infected in Central Africa or other malaria areas. Often they only get ill after returning home. The fevers all three (Malaria tertiana) or four days (Malaria quartana) occurring are by no means typical. The most dangerous form of malaria, the malaria tropica, causes a completely irregular or even a continuous fever, Löscher and coworkers report. As many patients also have head, limb or back pain, some also have diarrhea or cough, many sufferers think of flu or traveler's diarrhea.
Early diagnosis is important
But experts like Löscher warn: "Any unclear fever after stay in malaria areas is malaria-suspicious." Unknown, malaria can quickly progress to complications with kidney failure, shock lung or brain attack. Untreated, a tropica ends up 20 percent, almost always deadly in a brain attack. These patients must therefore be treated in an intensive care unit.
The timely diagnosis is important: a few hours decide on life and death. Quite often, therefore, blood samples must be transported by taxi or messenger to the nearest tropical hospital. There, the diagnosis is made under the microscope: By detection of the pathogen in a dried drop of blood ("thick drop"). According to Löscher and co-workers, this method is often more reliable than modern gene tests.
Malaria tropica requires hospitalization
Malaria tertiana and quartana can be treated on an outpatient basis. Patients always have to go to the hospital for the Tropica, but in complicated cases they are sent to the intensive care unit for monitoring. Doctors are increasingly confronted with resistant pathogens. With mefloquine, atovaquone / proguanil or artemether / lumefantrine, however, effective drugs for the treatment of uncomplicated Tropica are available. In complicated cases, an infusion treatment with quinine takes place. Because of the increased resistance many malaria patients are transferred to the wards of the tropical institutes.