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Essays > Malaria (October 19, 1999 by Pat Heyman)
The doctor was an elderly man, his queue long and well oiled, his ancient black robes threadbare. His eyes were clear and a few long hairs grew from a wart in his cheek. He had long thin fingers and the backs of his slender hands were blue-veined. "Tai-Pan, this is the best doctor in Tai Ping Shan. We came as fast as we could… He says Mother’s very sick, Tai Pan. That a poison has entered her bloodstream through her lower limbs. This poison has centered in her liver, and the liver is now—maladjusted. Soon there will be fever, bad fever. Then three or four days of time and again fever. And again."
"Malaria? Happy Valley Fever?"
"He says yes."
"Everyone knows it’s the night gases—na poison through the skin, by God. She’s na been there for weeks!"
"I only tell you what he says, Tai-Pan. I’m no doctor. But this doctor I would trust—I think you should trust."
"What’s his cure?"
"He says, Tai-Pan: ‘I have treated some of those who suffered the Happy Valley poison. The successful recoveries were all strong men who took a certain medicine before the third fever attack. But this is a woman, and though in her twenty-first year and strong with a fire spirit, all her strength is going into the child that is six months in her womb. He fears for the Lady and the child." –Tai-Pan, James Clavell (1966)
Malaria is a re-emerging disease that has vast implications for healthcare
providers in the United States. The most important thing for most providers
to remember is that anyone who travels to a malaria endemic area can contract
the illness, even with prophylaxis. The incubation period may be quite
long and the presentation may not be classic. But the periodic nature
of the fever is the main thing. Periodic fever that does not respond to
antipyretics and antibiotics should always raise a red flag that says,
"Possible malaria!"
Once the flag is raised a good travel history along with blood samples need to be taken. Malaria is a serious disease, but with prompt treatment, its victims can lead normal, healthy lives.
This concludes our program. Should you have any further questions or require any more resources, please feel free to contact me.
Best of Luck,
Patrick Heyman
Etiology
Pathogenesis
Morphology
Clinical Manifestations