Malaria Test Kits

[NanLaew]

I have been feeling like crap since last Friday afternoon, exhibiting all the classic malaria symptoms with the only addition if some intense itching on the first and second nights. It was almost like a case of hives the first night when it really hit me.

I have 2 options for malaria testing; in Bangkok where I am working or the Bangkok-Pattaya Hospital where I will be this afternoon; on the way back from Sattahip. Any recommendations on best place to get checked out.

I used to carry malaria test kits when traveling but they have expired. Anyone know if these area available in Bangkok?

Thanks,

NL

[Sheryl]

Not to my knowledge. They are sold throughout Cambodia but in Thailand you need to go to a health facility.

I don't know where you have been traveling but there are very, very few places in thailand where you would be likely to contact malaria and they aren't places most people would have occasion to spend the night.

Also don't know what you mean by "all the classic malaria symptoms" as malaria presents very differently in different parts of the world (and different parts of the world have different strains). That you are still able to work and to travel makes it very, very unlikely you have malaria, in my experience.In this part of the world, the only consistent symptoms of malaria are very high fever accompanied by severe shaking chills.

Most people with these don't have malaria, though. These are also symptoms of many other things, including dengue and of chikungunya both of which are far more common.

[NanLaew]

Hi Sheryl. If you google up malaria symptoms, I have the commonly listed symptoms and I assume these are common to all forms and locations. So, I have a continuous headache, aching back, arms and legs, dry-fever (hot dry skin no sweats) but the aircon felt too cold so I turned it off. Then I started to get the sweaty fever so turned the aircon on but got under the covers, all shivery. The headache never, ever goes away, despite the tylenol. I mentioned the itching as it's NOT commonly listed, it was really bad the first night and my skin, especially my legs, had visible raised red spots. That went away with only intense itching of the hands returning the second evening. Total lack of energy and appetite and bowel discomfort but since I haven't eaten much (drinking plenty water though) it's still only mild diarrhea. Urine is still normal coloured so no worries there with renal issues. Last night, the skin was hot and dry again; I am going to purchase a thermometer today! Also really painful calf muscles like what one gets after a really hard work out.

I have been in Thailand mostly with trips to peninsular Malaysia and Sabah twice in the last 30-days so I think we can reduce the symptoms to what is likely to be experienced locally, in SE Asia.

Going to see the doctor this afternoon as it's just taking too long to kick this crud. To be honest, I have had a couple of bouts like these over the past several years but they are usually gone in 24-hours with no medication apart from rest and tylenol. I was wondering if certain people and physiologies respond differently in that some get malaria and have severe recurrences whilst others may have shorter, less frequent and much less severe attacks? One thing I did read that if there's NO headache, then Dengue could be considered more likely but boy, do I have a headache!

Thanks,

NL

[Sheryl]

What you describe does not sound like the types of malaria found in SE Asia.

Dengue would be consistent with the fever, headache and back aches, as would Chikungunya, but the raised itching rash from the onset of the illness would be odd. An itching rash does often occur in dengue but usually appears later in the illness, not at the start. Other possibilities include things like scrub or murine typhus and various tick fevers (if you have a history of tick bite or other insect bit noticeable enough to have left a mark, that would make these more likely).

Alternatively, if you have been taking any medication for the pain and/or fever, the rash could be an allergic reaction to the meds rather than part of the illness as such.

In any event a visit to the doctor is in order. Be sure to go to one working out of a hospital so that lab facilities are available as you need at minimum a complete blood count.

[NanLaew]

Ka-ching! The doc reckoned on the symptoms and looking at the low platelets count in the blood work that it is indeed dengue. They will be doing a retest on Thursday to see if the platelet count is still falling but she seemed pretty assured that is what ails me. The itching was only bad on day 1 and 2 of the current 5-day journey and hasn't been a feature since then. The cyclic nature of the fevers is almost predictable now.

Point of interest re- SE Asia... or more specifically Thai malaria; what are the symptoms? I have worked in malaria endemic regions of the world and was of the opinion that the 'usual' symptoms are universal and as generalized in google.

Edited August 10, 2011 by NanLaew

[Sheryl]

No, it varies. Among other things there are 4 distinct types of malaria, each caused a different parasite, and both symptoms and severity differs by type.

In addition, even within the same type of malaria, the disease presents a bit differently in different parts of the world (true of many diseases, not only malaria). Probably reflects differences in sub-types of the parasite or minor mutations that have occurred over time. Health care professionals who have worked in Africa and then come to SE Asia are struck by the differences even among people with the same general type of malaria, or so they tell me.( My own malaria experience is only in SE Asia.)

In addition to differences in symptoms and severity, there are marked regional differences in drug sensitivity both for cure and for prophylaxis. What you will find on most websites will not apply to this part of SE Asia. There are also marked differences in the mosquito vector which in turn translates into differences in where it is possible to get infected. In many parts of Africa, for example, the disease is present in small towns and villages; there are even parts of the world where it is present in cities. This is not the case in SE Asia, at least not mainland SE Asia.

In mainland SE Asia almost all new malaria infections are of the type called plasmodium falciparum, which is also the most serious type, but fortunately the mosquito vectors here live only in heavily forested areas (jungle) -- and only some of those, mainly near the Cambodian, Lao and Burmese borders. Even in those areas, there is usually no malaria transmission within the villages, as the clearings made by people do not provide a suitable habitat for the particular mosquito vector present here. Between this fact and that it is a night-biting mosquito, you basically have to be in uninhabitated jungle at night to get it. Hence westerners, tourists or otherwise, are very rarely infected in Thailand ..for that matter, Thai women and children aren't often infected either, it's mainly men who go into the jungle at night for hunting or smugglers going across the border at night etc. The symptoms are sudden onset of very severe shaking chills and high fever. It is extremely evident that the person is severely ill, it's not something a person could be walking around with. It can quickly progress to serious so immediate medical care is essential.

Dengue on the other hand is extremely common, and can be contacted anywhere in Thailand -- so much so that few expats living here have escaped having it, it's almost a rite of passage. So welcome to the club!