Advertisement

How to manage fever in malaria?

Dr Afzal Mir
Senior Lecturer and Consultant Physician,
University Hospital of Wales, Cardiff

Q: Without medicine how does the malarial fever subside? Does rise of temperature in malaria has any beneficial effect in altering the pyrogen produced by malarial germs or not? As such there is no remedy for viral infection, are we right to subside the temperature of the viral infection by the antipyretics?

A:These are profound questions and require some understanding of human biology. However, here is a brief explanation. The temperature reaction in malaria is caused by the release of malarial sporozoites from the red blood cells, and these organisms flood the circulation and there is a temperature response from the body. The latter activates the body thermostat which stimulates perspiration, and as the sweat evaporates the temperature settles down.It is a moot point whether this temperature reaction has any beneficialeffects. One would expect that human body's reaction ought to have somepurpose. Temperature reactions, particularly from TAB vaccine, have beenused empirically for treatment. As regards your last point, antipyreticsare used to provide symptomatic relief and do not have any effect on viralor bacterial infections. In younger infants temperature should be reducedby tepid sponging because a high temperature may cause a fit (febrileconvulsions) in children younger than 3 years.