Malabsorption refers to an inability of the intestines to properly absorb nutrients, vitamins or minerals. Causes may include enzyme deficiencies; pancreas, gallbladder or liver disease; loss of normal bacterial flora (colonies) in the intestines; intestinal parasites; surgery of the stomach or intestines; cystic fibrosis; milk (lactose) intolerance; vitamin B12 malabsorption; celiac disease (sprue) or immunological disorders such as HIV and AIDS. Risk increases with a family history of malabsorption; alcohol abuse; excessive use of laxatives; or travel to countries where food and water sources are contaminated leading to episodes of acute diarrhea.
 

Malaria is an infection that produces high fevers, chills and body shaking. It is spread primarily at night by biting Anopheles mosquitoes infected with the parasite (single cell microscopic organism) called Plasmodium. The cycle of infection includes:
• A mosquito bites a person infected with malaria.
• The malaria parasites grow inside of the mosquito for about 1 week.
• The infected mosquito then bites a healthy person.
• The malaria parasites enter the bloodstream and grow within the person's liver.
• Symptoms may begin as early as 8 days to 4 weeks after infection.
• In some cases, parasites may lie dormant (asleep) within the body's liver. This may delay symptoms for several months, 1 year or even 4 years.
Malaria is most common in tropical and developing countries such as Africa, Central and South America, Mexico, South East Asia, Haiti, the Dominican Republic, the Middle East, India, Pakistan, New Guinea, Vanuatu and the Solomon Islands. However, today new cases of malaria are also appearing in developed countries. This is primarily due to improved and increased international travel, airport malaria (transport of infected mosquitoes in airplanes), as well as people leaving malaria high-risk areas in search of work or fleeing wars (refugees). Moreover, malaria cases have increased in high-risk areas due to increased outdoor activities (new road building, mining, logging, farming and irrigation projects), warmer temperatures, higher resistances to drug treatments, and poor health care resources. Though malaria can affect anyone, it is especially harmful for children and pregnant women. Children who live in malaria, high-risk areas have been known to die from this disease, 1 every 30 seconds.

Symptoms may include:

• High fevers of 103 to 104º F, rising over a 1-2 hour period
• Flu-like symptoms (sweats, chills, shaking, headache, muscle aches, and tiredness)
• Back pain, dizziness, and weakness
• Nausea, vomiting and diarrhea
• Pale skin due to anemia (abnormally low levels of red blood cells)
• Jaundice (yellowing of skin and eyeballs)

WHAT YOUR DOCTOR CAN DO:

• Diagnose the problem by asking about your symptoms, doing a physical exam, and ordering laboratory blood tests that look for the parasites.
• Prescribe antimalarial medications and/or antibiotics depending on type of malaria infection and severity of disease.
• Recommend hospitalization for patients requiring intravenous (IV) therapy to treat dehydration (fluid loss) or blood transfusions to treat severe anemia.
• Prescribe antimalarial medications for person planning to travel to high-risk areas.

WHAT YOU CAN DO:

• See your doctor 4-6 weeks before traveling to a high-risk area. Depending on your destination, your doctor may prescribe vaccines for other diseases and antimalarials.
• Take antimalarials as directed. DO NOT skip or stop taking any doses without talking to your doctor first. If you have been exposed to malaria, stopping the medicine early may allow the parasite to start growing again and make you ill.
• It is important to start antimalarial treatment BEFORE your travel date.
• Some medications require that you start taking the medicine 1-2 days to 1 week before arriving in malaria high-risk areas. You may also be required to take daily or weekly doses while in the malaria high-risk areas as well as dosing after leaving the area. Check with your doctor or pharmacist for specific dosing schedules.
• Antimalarials may cause mild side effects like nausea, vomiting or loose stools. Talk to your doctor or seek medical attention if you suffer any severe side effects.
• Buy your antimalarial medications in the United States. Sources from foreign countries may not be reliable. Check with your travel agent about rules regarding travel to foreign countries with U.S. issued medications.
• Sleep under insecticide-treated (preferably, Permethrin), mosquito nets if available. If not, ordinary mosquito nets and window and door screens do offer some protection.
• Apply mosquito repellents to skin that contain between 20-35% of a chemical called DEET. Try it on a small area first. Some insecticides can cause severe allergic reactions.
• Spray insecticide or repellant onto clothing as well. Mosquitoes can bite through clothing.
• DO NOT apply insecticides onto young children without talking to your doctor first.
• Avoid areas with standing, pools of water if possible.
• Wear light-colored clothing (shirts with long sleeves and long pants) when outdoors, especially during dusk to dawn. Mosquitoes infected with malaria tend to bite during these hours. 

WHAT YOU CAN EXPECT:

• Though no medication can protect your from malaria 100 percent, it is better to take the antimalarials BEFORE, DURING and AFTER visiting high-risk areas.
• Malaria can be cured with prescription medications if diagnosed early. Treatment depends on the type of parasite, where infected, the patient's age, and illness severity.
• If not properly treated, some forms of malaria may cause kidney failure, seizures (convulsions), pulmonary edema (fluid in the lungs), mental confusion, coma, and death.

CALL 1061 OR SEEK IMMEDIATE MEDICAL ASSISTANCE If you develop an unexplained fever with flu-like symptoms, especially if you have recently traveled to a malaria, high-risk area.