Malaria

What is malaria?

Malaria is an infection caused by a group of parasites called Plasmodium. It is passed from person to person by mosquitoes who carry the parasite. There are several types of Plasmodium that can cause malaria. Infants and children under five are most at risk of developing a severe infection. It only takes one bite from a mosquito carrying the parasite to transmit malaria. People can develop malaria more than once and some types of malaria can reactivate months or years after the first infection.

Signs and symptoms of malaria

Malaria symptoms usually appear 10 to 15 days after a mosquito bite but can appear six to 30 days after infection.

The symptoms are initially similar to viral infections and include:

• fever
• chills
• headache
• nausea
• vomiting
• diarrhea
• muscle aches
• pain in the abdomen, back and joints
• coughing

Severe symptoms include:

• extreme tiredness, weakness and fatigue
• confusion
• seizures
• difficulty breathing
• dark or bloody urine
• jaundice (yellowing of the eyes and skin)
• abnormal bleeding or bruising
• coma

Many other diseases share the same signs as malaria. This may delay diagnosis in children.

Malaria is common in some parts of the world

Malaria is common in tropical and sub-tropical regions in Asia, Africa and South America. The risk of contracting malaria may vary from country to country. Updated information from the World Health Organization (WHO) is available here. Children may be infected with malaria when visiting areas in blue on the WHO map. This can happen to children born in the region or who visit the region.

What your child's health-care provider can do

If it is suspected that your child has malaria, they will need a series of blood tests to help with the diagnosis. Blood tests can determine what type of parasite caused the infection and the severity of the infection.

Treatment

Malaria is treated with specific medication. The type and length of treatment depends on:

• the type of parasite
• the severity of the illness
• the age of the child
• the pattern of drug resistance in the area travelled

Your child may need to see a doctor specializing in infectious diseases or tropical medicine. Extreme cases of malaria might require a special type of blood transfusion.

Prevention

If you plan to visit a malarial area, you need to prepare to avoid infection. Anti-malarial medications are the most common way to prevent infection. It is important to take the medication exactly as ordered. It is taken a few days before departure, throughout your trip and then a few weeks after returning home. Taking the correct medication at the correct time interval is very important. Consulting a physician at a travel clinic is recommended prior to travel.

Mosquito avoidance is also extremely important for protecting against malaria. This includes:

• using a bed net treated with insecticide
• using insect repellents
• wearing protective clothing such as long sleeves and pants
• staying indoors from dusk to dawn
• using air conditioners where available, instead of opening windows

Breastfed babies

If your child is being breastfed and you are taking medication for malaria, your baby also still needs medication.

Malaria vaccines

Between 2023 and 2024, 17 countries in Africa began providing malaria vaccination as part of their childhood immunization programs. The number of countries offering malaria vaccination continues to increase. This has led to a significant drop in serious and life-threatening malaria infections and deaths in children. The malaria vaccine is not currently available to children in Canada who are travelling to high-risk regions.

When to seek medical assistance:

See your child's regular health-care provider if your child has returned from travel and:

• they have fever or other symptoms (whether or not they are on anti-malaria medication)

Take your child to the nearest Emergency Department if your child:

• appears confused
• has a high fever that is not brought down by acetaminophen or ibuprofen
• has difficulty breathing
• has severe stomach pains
• is not able to tolerate medication by mouth
• has not passed urine in 8 hours or has very dark urine
• is fainting
• has had a seizure
• is lethargic
• is not looking well
• has abnormal bruising