GPAtlas🧭 When to suspect
Malaria is a parasitic infection caused by Plasmodium species and transmitted by the bite of the female Anopheles mosquito. It is not acquired in the UK – every case is travel-associated, so the diagnosis begins and ends with a travel history. Five species infect humans, but P. falciparum accounts for around three-quarters of UK cases and is the one that kills, capable of progressing to cerebral and multi-organ disease and to death within 24 hours of the first symptom.
Suspect malaria in anyone with a fever, or a history of fever, who has returned from or previously visited a malaria-endemic area in the past year – regardless of whether they took prophylaxis, and even if their temperature is normal when you see them. The shortest incubation is 6 days; most falciparum presents within 3 months and almost all within 6 months, while P. vivax and P. ovale can relapse a year or more after travel.
This matters because malaria is common and rising: there were 2,106 UK cases and 6 deaths in 2023 – the highest total since 2001. Around three-quarters occurred in people visiting friends and relatives (VFR) in their country of origin, and roughly 9 in 10 had taken no chemoprophylaxis. The two primary-care skills are simple: suspect it and arrange a same-day blood film, and recognise severe malaria and call 999.
| Species | Key features | UK relevance |
|---|---|---|
| P. falciparum | Severe, rapidly progressive; cerebral and multi-organ disease; can be fatal | ~75% of cases; mainly West Africa; usually presents < 3 months |
| P. vivax | Relapsing (dormant liver stages); rarely fatal but can be severe | Mainly South Asia; may present > 1 year later |
| P. ovale | Relapsing (dormant liver stages); generally milder | Mainly West Africa; may present > 1 year later |
| P. malariae | Indolent; quartan fever; chronic nephropathy reported | Least common; can present many years after exposure |
| P. knowlesi | Zoonotic (macaques); can be severe and rapidly progressive | Rare import from Southeast Asia |
|
🧠 Clinical pearl The typical UK malaria death is not an unlucky backpacker but a traveller of African or South Asian heritage visiting family, who took no prophylaxis because they grew up in the area and "never got ill there". Childhood semi-immunity wanes within 1–2 years of leaving an endemic country, so returning VFR travellers are fully susceptible again – and may under-perceive their risk. Target prevention advice at exactly this group. |
Source: UKHSA Malaria Prevention Guidelines · UK malaria treatment guidelines 2016 · NaTHNaC
🔒 Sign up free to read the full topic
You're viewing a free preview. Create a free account to unlock the rest.
Sign up free →Sample topics are open to everyone in the Free Sample Bundle.