Malaria is caused by a parasite that is passed from one human to another by the bite of infected Anopheles mosquitoes.

After infection, the parasites (called sporozoites) travel through the bloodstream to the liver, where they mature and release another form, the merozoites. The parasites enter the bloodstream and infect red blood cells.

The parasites multiply inside the red blood cells, which then break open within 48 to 72 hours, infecting more red blood cells. The first symptoms usually occur 10 days to 4 weeks after infection, though they can appear as early as 8 days or as long as a year after infection. The symptoms occur in cycles of 48 to 72 hours.

 Most

symptoms are caused by:

The release of merozoites into the

bloodstream Anemia resulting from the destruction of the red blood cells Large amounts of free hemoglobin being released into circulation after red blood cells break open

Malaria can also be transmitted from a mother to her unborn baby (congenitally) and by blood transfusions. Malaria can be carried by mosquitoes in temperate climates, but the parasite disappears over the winter.

There are four types of common malaria parasites.

Quartan malaria; Falciparum malaria- , affects more red blood

cells than the other types and is much more serious. Biduoterian fever; Blackwater fever; Tertian malaria;

Recently, a fifth type, Plasmodium knowlesi, has been causing malaria in Malaysia and areas of southeast Asia.

 Anemia Bloody Chills Coma Convulsion Fever

Headache Jaundice Muscle

stools

pain Nausea Sweating Vomiting

a physical examination, the doctor may find an enlarged liver or enlarged spleen. Malaria blood smears taken at 6 to 12 hour intervals confirm the diagnosis. A complete blood count (CBC) will identify anemia if it is present.
During

 Malaria,

especially Falciparum malaria, is a medical emergency that requires a hospital stay. Chloroquine is often used as an antimalarial medication. However, chloroquine-resistant infections are common in some parts of the world.

Possible treatments for chloroquineresistant infections include:

The combination of quinidine

or quinine plus doxycycline, tetracycline, or clindamycin Atovaquone plus proguanil (Malarone) Mefloquine or artesunate The combination of pyrimethamine and sulfadoxine (Fansidar)

Medical care, including fluids through a vein (IV) and other medications and breathing (respiratory) support may be needed.

Brain infection (cerebritis) Destruction of blood cells (hemolytic anemia) Kidney failure Liver failure Meningitis Respiratory failure from fluid in the lungs (pulmonary edema) Rupture of the spleen leading to massive internal bleeding (hemorrhage)

Most people who live in areas where malaria is common have gotten some immunity to the disease. Visitors will not have immunity, and should take preventive medications. It is important to see your health care provider well before your trip, because treatment may need to begin as long as 2 weeks before travel to the area, and continue for a month after you leave the area. In 2006, the CDC reported that most travelers from the U.S. who contracted malaria failed to take the right precautions.

The types of anti-malarial medications prescribed will depend on the area you visit. According to the CDC, travelers to South America, Africa, the Indian subcontinent, Asia, and the South Pacific should take one of the following drugs:

mefloquine, doxycycline, chloroquine, hydroxychloroquine, or Malarone.

Even pregnant women should take preventive medications because the risk to the fetus from the medication is less than the risk of catching this infection.

Avoid mosquito bites by wearing protective clothing over the arms and legs, using screens on windows, and using insect repellent. malaria.FLV

 Measles

is a very contagious (easily spread) illness caused by a virus.

 The

infection is spread by contact with droplets from the nose, mouth, or throat of an infected person. Sneezing and coughing can put contaminated droplets into the air.

Symptoms usually begin 8 - 12 days after you are exposed to the virus. This is called the incubation period. Symptoms may include: Bloodshot eyes Cough Fever Light sensitivity (photophobia) Muscle pain

Rash
Usually appears 3 - 5

days after the first signs of being sick May last 4 - 7 days Usually starts on the head and spreads to other areas, moving down the body Rash may appear as flat, discolored areas (macules) and solid, red, raised areas (papules) that later join together Itchy

Redness and irritation of the eyes (conjunctivitis) Runny nose Sore throat Tiny white spots inside the mouth (Koplik's spots)

 Measles

serology Viral culture (rarely done)

 There

is no specific treatment for the measles. The following may relieve symptoms:
Acetaminophen (Tylenol) Bed rest Humidified air

Some children may need vitamin A supplements. Vitamin A reduces the risk of death and complications in children in less developed countries, where children may not be getting enough vitamin A. People who don't get enough vitamin A are more likely to get infections, including measles.

 Complications

of measles infection may include:

Bronchitis Encephalitis Ear infection (otitis media) Pneumonia

Routine immunization is highly effective for preventing measles. People who are not immunized, or who have not received the full immunization are at high risk for catching the disease. Taking serum immune globulin 6 days after being exposed to the virus can reduce the risk of developing measles, or can make the disease less severe. measles.FLV

 Mumps

is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food and helps you chew and swallow.

The mumps are caused by a virus. The virus is spread from person-to-person by respiratory droplets (for example, when you sneeze) or by direct contact with items that have been contaminated with infected saliva. Mumps most commonly occurs in children ages 2 - 12 who have not been vaccinated against the disease. However, the infection can occur at any age. The time between being exposed to the virus and getting sick (incubation period) is usually 12 - 24 days.

 Mumps

may also infect the:

Central nervous system Pancreas Testes

Face pain Fever Headache Sore throat Swelling of the parotid glands (the largest salivary glands, located between the ear and the jaw) Swelling of the temples or jaw (temporomandibular area)

Other symptoms of this disease that can occur in males:

Testicle lump Testicle pain Scrotal swelling

physical examination confirms the presence of the swollen glands. No testing is usually required.

 There

is no specific treatment for mumps. Ice or heat packs applied to the neck area and acetaminophen (Tylenol) may help relieve pain. Do not give aspirin to children with a viral illness because of the risk of Reye syndrome.

 You

can also relieve symptoms with:

Extra fluids Soft foods Warm salt water gargles

Infection

of other organs may occur, including orchitis.

 MMR

immunization (vaccine) protects against measles, mumps, and rubella. It should be given to children 12 - 15 months old. The vaccine is given again between ages 4 - 6, or between ages 11 - 12, if it wasn't given before.

 Meningitis

is a bacterial infection of the membranes covering the brain and spinal cord (meninges).

 The

most common causes of meningitis are viral infections that usually get better without treatment. However, bacterial meningitis infections are extremely serious, and may result in death or brain damage, even if treated.

 Meningitis

may also be caused by:

Chemical irritation Drug allergies Fungi Tumors

Symptoms usually come on quickly, and may include:

Fever and chills Mental status

Other symptoms that can occur with this disease:

Agitation Bulging fontanelles Decreased

changes Nausea and vomiting Sensitivity to light (photophobia) Severe headache Stiff neck (meningismus)

consciousness Poor feeding or irritability in children Rapid breathing Unusual posture, with the head and neck arched backwards (opisthotonos)

 Physical

examination will usually

show:
Fast heart rate Fever Mental status changes Stiff neck

For any patient who is suspected of having meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing. Tests that may be done include:

Blood culture Chest x-ray CSF examination for cell count, glucose, and

protein CT scan of the head Gram stain, other special stains, and culture of CSF

Doctors prescribe antibiotics for bacterial meningitis. Antibiotics are not effective in viral meningitis. Other medications and intravenous fluids will be used to treat symptoms such as brain swelling, shock, and seizures. Some people may need to stay in the hospital, depending on the severity of the illness and the treatment needed.

 Brain

damage Buildup of fluid between the skull and brain (subdural effusion) Hearing loss Hydrocephalus Seizures

Haemophilus vaccine (HiB vaccine) in children will help prevent one type of meningitis. The pneumococcal conjugate vaccine is now a routine childhood immunization and is very effective at preventing pneumococcal meningitis. Household members and others in close contact with people who have meningococcal meningitis should receive preventive antibiotics to avoid becoming infected themselves.

The meningococcal vaccination is recommended for:

Adolescents ages 11 - 12 and adolescents

entering high school (about age 15) who have not already received the vaccination. All college freshmen who have not been vaccinated and are living in dorms. Children age 2 and older who do not have their spleen or who have other problems with their immune system. Those traveling to countries where diseases caused by meningococcus are very common (ask your doctor). meningitis.FLV