Friday, October 07, 2011

Cerebral Malaria

Tomato (yes, that really is her name) came to us unconscious but moaning in the arms of very worried family members. We started treatment for cerebral malaria but she soon went deeper into a coma without speech or movement. We sustained her with IV medications, injections, cool sponge baths and suppositories for fevers. At the 72 hour mark she moved for the first time on her own.  With closed eyes she reached with her hand and touched her ear. I think I danced in celebration. The next morning I called her name loudly several times in her face and she slowly and weakly opened her eyes. What an exciting occasion! She either lapsed back into the coma or went into a deep sleep after that but a few hours later opened her eyes again and swallowed a bit of water from a syringe.

We are so thankful. Cerebral malaria is scary and a quick killer. Sometimes people come to us complaining of mild malaria symptoms for weeks--this usually would be one of the three less severe/sudden onset kinds of malaria. In those kinds of malaria people often survive without treatment but are weak and sick for a long time. But with Falciparum (cerebral) malaria often an unconscious person will be brought who has been sick for only a day and they are already near death. Quick action is necessary.  I've seen strong, other-wise healthy young adult men be flattened by it to the point of fainting within hours of the onset.

Falciparum malaria is caused by the bite of the Anopheles mosquito.  The female anopheles mosquito is the one who carries and transmits the condition.  She needs a very warm climate and requires a "blood" meal to be able to reproduce. The males survives on nectar and other sources of sugar. The males do not bite humans. The female is not damaged by the malaria parasite she carries...but she will only live for about 30 days anyway. She has contracted the parasite from a blood meal she has taken as a young mosquito from a human with malaria. After about 10-20 days the parasite has matured in her to the point of being passed on through the her blood meals. She is only going to have 15 days or so to infect people with the matured parasite within her--but it certainly happens a lot in South Sudan.

About 10 days after being bitten, when the human host body has allowed the reproduction cycle of the Falciparum plasmodium parasite to take place  (in the blood and liver), there is an onset of symptoms.  The spymptoms in the human with Falciparum malaria will include fever, severe headache, dizziness, weakness, chills--sometimes accompanied by seizures, unconsciousness, joint pain, nausea and diarrhea.

I'm so happy to report that Tomato has recovered well and is at home.  She and her family are neighbors of one of my good friends in the closest town.  Her mother reports she is doing well.  Normal.  What a wonderful thing "normal" is! 


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