Quartan fever

Last updated
Quartan fever
P malariae schizont4.jpg
P. malariae schizont in a thick blood smear
Specialty Infectious disease
Symptoms Fever
DurationFever in 72 hour intervals
CausesPlasmodium spread by mosquitos
Diagnostic method Blood tests
Medication Chloroquine

Quartan fever is one of the four types of malaria which can be contracted by humans. [1]

Contents

It is specifically caused by the Plasmodium malariae species, one of the six species of the protozoan genus Plasmodium . Quartan fever is a form of malaria where an onset of fever occurs in an interval of three to four days, hence the name "quartan". [2] It is transmitted by bites of infected female mosquitoes of the genus Anopheles . Symptoms include fevers which range from approximately 40–41 °C (104–106 °F) and occur periodically in 72 hour intervals. Although cases of malaria have occurred throughout the world, quartan fever typically occurs in the subtropics. Quartan fever is considered to be a less severe form of malaria fever that can be cured by anti-malarial medication, and prevention methods can be taken in order to avoid infection. [3]

Signs and symptoms

Cause

The female Anopheles mosquito is a vector which transmits quartan fever to people. Mature mosquitoes carry uninucleate sporozoites in their salivary glands; these sporozoites enter a human's bloodstream when mosquitoes puncture human flesh during feeding.  Sporozoites attack and inhabit liver parenchymal cells, called hepatocytes, in order to develop further. Once the uninucleate sporozoites have matured, the sporozoites then develop into uninucleate merozoites. Uninucleated merozoites mature into an erythrocytic stage called schizonts which contain merozoites. The schizonts, an infected erythrocyte, then rupture to release these merozoites; leading to more infections in the red blood cells. Uninucleated merozoites can also mature into uninucleate gametocytes which can invade and infect other female Anopheles mosquitoes during feeding, thus spreading the disease onto a wider population of humans. [3]

Anopheles Mosquito feeding (video taken County Durham, UK.)

Diagnosis

Fevers in intervals of 72 hours distinguish quartan fever from other forms of malaria where fevers range in 48 hour intervals or fever spikes that occur sporadically. [3]

Early indications of quartan fever include having irritated spots, welts, hives and burning skin, however this is dependent on individual's tolerance to mosquito bites and may not be evident on some people. With the Anopheles malaria mosquitoes, the welts are most likely to not appear unless there are severe allergic reactions. [4]

The prepatent period is the time interval for when parasites infect a host and when they can be detected on a thick blood film. For quartan fever, P. malariae has a prepatent period ranging from 16 to 59 days. Specifically in the case of quartan fever, the rupturing of liver stage schizonts releases merozoites. This stage of the P. malariae life cycle is known as the "ring stages" and are the first stages which can be detected in human blood for diagnosis. [5]

Medical procedures that diagnose quartan fever

Prevention

Ways to minimise exposure to the Anopheles mosquito include:

Anopheles mosquito larvae, taken by Steffen Dietzel

Treatment

Related Research Articles

<span class="mw-page-title-main">Malaria</span> Medical condition

Malaria is a mosquito-borne infectious disease that affects humans and other vertebrates. Human malaria causes symptoms that typically include fever, fatigue, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin 10 to 15 days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria.

Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target groups, young children and pregnant women. As of 2018, modern treatments, including for severe malaria, continued to depend on therapies deriving historically from quinine and artesunate, both parenteral (injectable) drugs, expanding from there into the many classes of available modern drugs. Incidence and distribution of the disease is expected to remain high, globally, for many years to come; moreover, known antimalarial drugs have repeatedly been observed to elicit resistance in the malaria parasite—including for combination therapies featuring artemisinin, a drug of last resort, where resistance has now been observed in Southeast Asia. As such, the needs for new antimalarial agents and new strategies of treatment remain important priorities in tropical medicine. As well, despite very positive outcomes from many modern treatments, serious side effects can impact some individuals taking standard doses.

<i>Plasmodium</i> Genus of parasitic protists that can cause malaria

Plasmodium is a genus of unicellular eukaryotes that are obligate parasites of vertebrates and insects. The life cycles of Plasmodium species involve development in a blood-feeding insect host which then injects parasites into a vertebrate host during a blood meal. Parasites grow within a vertebrate body tissue before entering the bloodstream to infect red blood cells. The ensuing destruction of host red blood cells can result in malaria. During this infection, some parasites are picked up by a blood-feeding insect, continuing the life cycle.

<i>Plasmodium falciparum</i> Protozoan species of malaria parasite

Plasmodium falciparum is a unicellular protozoan parasite of humans, and the deadliest species of Plasmodium that causes malaria in humans. The parasite is transmitted through the bite of a female Anopheles mosquito and causes the disease's most dangerous form, falciparum malaria. It is responsible for around 50% of all malaria cases. P. falciparum is therefore regarded as the deadliest parasite in humans. It is also associated with the development of blood cancer and is classified as a Group 2A (probable) carcinogen.

<span class="mw-page-title-main">Gametocyte</span> Eukaryotic germ stem cell

A gametocyte is a eukaryotic germ cell that divides by mitosis into other gametocytes or by meiosis into gametids during gametogenesis. Male gametocytes are called spermatocytes, and female gametocytes are called oocytes.

Recrudescence is the recurrence of an undesirable condition. In medicine, it is usually defined as the recurrence of symptoms after a period of remission or quiescence, in which sense it can sometimes be synonymous with relapse. In a narrower sense, it can also be such a recurrence with higher severity than before the remission. "Relapse" conventionally has a specific meaning when used in relation to malaria.

<i>Plasmodium vivax</i> Species of single-celled organism

Plasmodium vivax is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria. Although it is less virulent than Plasmodium falciparum, the deadliest of the five human malaria parasites, P. vivax malaria infections can lead to severe disease and death, often due to splenomegaly. P. vivax is carried by the female Anopheles mosquito; the males do not bite.

<i>Plasmodium ovale</i> Species of single-celled organism

Plasmodium ovale is a species of parasitic protozoon that causes tertian malaria in humans. It is one of several species of Plasmodium parasites that infect humans, including Plasmodium falciparum and Plasmodium vivax which are responsible for most cases of malaria in the world. P. ovale is rare compared to these two parasites, and substantially less dangerous than P. falciparum.

<i>Plasmodium malariae</i> Species of single-celled organism

Plasmodium malariae is a parasitic protozoan that causes malaria in humans. It is one of several species of Plasmodium parasites that infect other organisms as pathogens, also including Plasmodium falciparum and Plasmodium vivax, responsible for most malarial infection. Found worldwide, it causes a so-called "benign malaria", not nearly as dangerous as that produced by P. falciparum or P. vivax. The signs include fevers that recur at approximately three-day intervals – a quartan fever or quartan malaria – longer than the two-day (tertian) intervals of the other malarial parasite.

<i>Plasmodium knowlesi</i> Species of single-celled organism

Plasmodium knowlesi is a parasite that causes malaria in humans and other primates. It is found throughout Southeast Asia, and is the most common cause of human malaria in Malaysia. Like other Plasmodium species, P. knowlesi has a life cycle that requires infection of both a mosquito and a warm-blooded host. While the natural warm-blooded hosts of P. knowlesi are likely various Old World monkeys, humans can be infected by P. knowlesi if they are fed upon by infected mosquitoes. P. knowlesi is a eukaryote in the phylum Apicomplexa, genus Plasmodium, and subgenus Plasmodium. It is most closely related to the human parasite Plasmodium vivax as well as other Plasmodium species that infect non-human primates.

Plasmodium eylesi is a parasite of the genus Plasmodium subgenus Plasmodium.

<span class="mw-page-title-main">History of malaria</span> History of malaria infections

The history of malaria extends from its prehistoric origin as a zoonotic disease in the primates of Africa through to the 21st century. A widespread and potentially lethal human infectious disease, at its peak malaria infested every continent except Antarctica. Its prevention and treatment have been targeted in science and medicine for hundreds of years. Since the discovery of the Plasmodium parasites which cause it, research attention has focused on their biology as well as that of the mosquitoes which transmit the parasites.

Plasmodium fieldi is a parasite of the genus Plasmodium sub genus Plasmodium found in Malaysia. This species is related to Plasmodium ovale and Plasmodium simiovale. As in all Plasmodium species, P. fieldi has both vertebrate and insect hosts. The vertebrate hosts for this parasite are primates.

<span class="mw-page-title-main">Mass drug administration</span>

The administration of drugs to whole populations irrespective of disease status is referred to as mass drug administration (MDA) or mass dispensing.

<span class="mw-page-title-main">Apicomplexan life cycle</span> Apicomplexa life cycle

Apicomplexans, a group of intracellular parasites, have life cycle stages that allow them to survive the wide variety of environments they are exposed to during their complex life cycle. Each stage in the life cycle of an apicomplexan organism is typified by a cellular variety with a distinct morphology and biochemistry.

Pregnancy-associated malaria (PAM) or placental malaria is a presentation of the common illness that is particularly life-threatening to both mother and developing fetus. PAM is caused primarily by infection with Plasmodium falciparum, the most dangerous of the four species of malaria-causing parasites that infect humans. During pregnancy, a woman faces a much higher risk of contracting malaria and of associated complications. Prevention and treatment of malaria are essential components of prenatal care in areas where the parasite is endemic – tropical and subtropical geographic areas. Placental malaria has also been demonstrated to occur in animal models, including in rodent and non-human primate models.

The mainstay of malaria diagnosis has been the microscopic examination of blood, utilizing blood films. Although blood is the sample most frequently used to make a diagnosis, both saliva and urine have been investigated as alternative, less invasive specimens. More recently, modern techniques utilizing antigen tests or polymerase chain reaction have been discovered, though these are not widely implemented in malaria endemic regions. Areas that cannot afford laboratory diagnostic tests often use only a history of subjective fever as the indication to treat for malaria.

Plasmodium coatneyi is a parasitic species that is an agent of malaria in nonhuman primates. P. coatneyi occurs in Southeast Asia. The natural host of this species is the rhesus macaque and crab-eating macaque, but there has been no evidence that zoonosis of P. coatneyi can occur through its vector, the female Anopheles mosquito.

<i>Plasmodium cynomolgi</i> Species of single-celled organism

Plasmodium cynomolgi is an apicomplexan parasite that infects mosquitoes and Asian Old World monkeys. In recent years, a number of natural infections of humans have also been documented. This species has been used as a model for human Plasmodium vivax because Plasmodium cynomolgi shares the same life cycle and some important biological features with P. vivax.

References

  1. Garcia, Célia R. S.; Markus, Regina P.; Madeira, Luciana (2001). "Tertian and Quartan Fevers: Temporal Regulation in Malarial Infection". Journal of Biological Rhythms. 16 (5): 436–443. doi:10.1177/074873001129002114. ISSN   0748-7304. PMID   11669417. S2CID   6409247.
  2. "quartan". English Oxford living Dictionaries. 2019. Archived from the original on April 14, 2019. Retrieved 29 March 2019.
  3. 1 2 3 Crutcher, James M. (1996). Medical Microbiology. 4th edition. Galveston: The University of Texas Medical Branch at Galveston.
  4. "Insect Bite Prevention". IAMAT. 25 January 2019. Retrieved 13 May 2019.
  5. 1 2 3 Collins, William E. (2007). "Plasmodium malariae: Parasite and Disease". Clinical Microbiology Reviews. 20 (4): 579–592. doi:10.1128/CMR.00027-07. PMC   2176047 . PMID   17934075.
  6. 1 2 3 "Rapid Diagnostic Tests: How They Work". CDC. 2018. Retrieved 9 May 2019.
  7. "AIDS info". HIV/AIDS Glossary. Retrieved 9 May 2019.
  8. 1 2 3 4 5 6 7 Tizifa, Tinashe A (8 February 2018). "Prevention Efforts for Malaria". Current Tropical Medicine Reports. 5 (1): 41–50. doi:10.1007/s40475-018-0133-y. PMC   5879044 . PMID   29629252.
  9. 1 2 Kayentao, K (23 February 2012). "Intermittent preventive therapy for malaria during pregnancy using 2 vs 3 or more doses of sulfadoxine-pyrimethamine and risk of low birth weight in Africa: systematic review and meta-analysis". JAMA. 309 (6): 594–604. doi:10.1001/jama.2012.216231. PMC   4669677 . PMID   23403684.
  10. "Mosquito Life Cycle". EPA. 13 March 2017. Retrieved 3 May 2019.
  11. C Beier, John (1 February 2012). "Attractive toxic sugar bait (ATSB) methods decimate populations of Anopheles malaria vectors in arid environments regardless of the local availability of favoured sugar-source blossoms". Malaria Journal. 11: 31. doi: 10.1186/1475-2875-11-31 . PMC   3293779 . PMID   22297155.
  12. 1 2 "LABEL: CHLOROQUINE- chloroquine phosphate tablet". DAILY MED. 8 July 2010. Retrieved 10 May 2019.
  13. 1 2 "Malaria". 2019. Retrieved 10 May 2019.