Explained: Why Malaria spikes during the monsoon; causes, symptoms, prevention

With comorbidities being seen as one of the main reasons that make people succumb to Covid19 the ongoing monsoon poses a new challenge It brings with it the risk of disease malaria In 2020 Maharashtra had experienced a 22 per cent increase in the number of malaria cases which was unlike the five years before it which had seen a downward trendSince malaria is a disease commonly known to spread due to mosquitos and sees a higher incidence during the monsoon season there is a need to understand the disease betterMiddaycom reached out to Dr Monica Goel a senior consulting physician who has been actively treating malaria patients at PD Hinduja Hospital and Medical Research Centre She explains the characteristics of the disease and prevention methods in the ongoing Covid19 pandemicHow is malaria causedMalaria is a febrile illness caused by the bite of a female anopheles mosquito It is spread by various plasmodium species determining the severity of malaria in a particular patient The spread of malaria is more in places where stagnating water or hygiene is around buildings under construction where the breeding of mosquitoes takes place The person gets infected through the bite of the mosquito which injects the parasite into the blood streamWhat are its symptomsThese parasites then basically lead to a whole host of symptoms like fever shaking chills headache nausea vomiting and cause a drop in the patients platelet count which can be fatal if it goes below 10000 as patient can start bleeding profusely Severe cases of plasmodium vivax and plasmodium falciparum can cause multiorgan dysfunction leading to liver failure kidney failure acute tuberous sclerosis The patient may then have to be taken up for dialysisPlasmodium falciparum can also cause cerebral malaria which presents with severe headache can have convulsions can become comatose and clinch the diagnosis patient will have low hemoglobin low glucose and a low blood platelet countWhen do malaria cases generally pick up and peakThe basic peak and fall of malaria are spread across two seasons The peak is generally during the monsoons because of stagnation and puddles of water being formed The fall is generally during the winter months when the breeding of mosquitoes is lesserWhat are the general steps for prevention of malariaThe general preventive measures to maintain and prevent malaria would be using mosquito nets putting nets in the window using repellents Those who travel to endemic areas of malaria should take prophylaxes before their travel at least 10 days before continue till they finish their travel They should ensure that the drug they are taking is in consultation with their physician because many of the drugs used initially for the prophylaxes and treatment have caused patients to be resistant to both drugs Hence one needs to be careful on what drug therapy is consumedIn the current pandemic of COVID19 general sanitisation measures like fumigation to prevent the spread and upsurge of malaria cases in buildings hospitals should be doneIts really important that when we see a patient with a febrile illness and the RTPCR is negative that we dont check for other diseases as that wont be the correct approach It has to be a multidisciplinary approach We need to be sure that we are not missing out on a malaria diagnosis in these patients because sometimes this can be fatal especially when the platelet count of the patient drops and the patient goes into multisystem organ failure What are the risks for a person suffering from malaria during the Covid19 pandemicIn the current Covid pandemic we did see patients with malaria and dengue Some patients had a febrile illness and when their RTPCR was negative we checked them for malaria antigen However in the lockdown situation we saw a lesser number of malaria cases as opposed to what we have seen over the years in the city of Mumbai This was because people were not venturing out there was no construction activity and it was more of staying indoors and therefore the chances of getting bitten by the mosquitoes were lesserEven in last yearrsquos monsoon we saw fewer numbers of malaria cases than what we saw previously The worry is if the patient has a coinfection with malaria and the RTPCR test indicates positive for COVID19 virus If the patient has a low platelet count it can be an issue These patients cannot be given the standard molecular weight heparins or the anticoagulation which is generally administered to patients to prevent thrombosis in COVID19 So if there is a coinfection then it becomes tricky because we would need to monitor these patientsrsquo platelets and look at the INR values and thus our treatment mortality would be different and challengingDo the symptoms of malaria and Covid19 overlap Please suggest ways to detect malaria and tell it apart from Covid19The symptoms of malaria and COVID19 could overlap up to a certain extent with fever headache and mild shivers But COVID19 patients have a typical dry cough that is absent in malaria but it can be seen in some patients infected with dengue Of course with COVID19 if we have an undiagnosed fever in the patient If the RTPCR test is negative there is a need to evaluate for other futile illnesses The blood parameters of the lab workout would help doctors corelate and rule out the diagnosis looking at the inflammatory markers malaria antigen and platelet countAlso Read All you need to know about new lsquovariant of concernrsquo Delta Plus