General information 基本信息
Organism: 5 Plasmodium species (P. falciparum, P. vivax, P. ovale, P. malariae, P. knowlesi)
致病生物体：5种疟原虫（恶性疟原虫，间日疟原虫，卵形疟原虫，三日疟原虫，诺氏疟原虫）
P. falciparum is responsible for most severe disease.
恶性疟原虫常导致严重的疾病。
P. vivax and P. ovale are responsible for recrudescent disease.
间日疟和卵形疟常导致疾病复发。
Transmission via the female Anopheles mosquito, which bites at night or in the early morning.
传播途径是雌性按蚊咬伤，经常在晚上或凌晨发生。
Endemic in Asia, Africa, Central America, and South America
流行区是亚洲，非洲，中美洲，和南美洲
Clinical presentation 临床表现
Initially, the patient presents with an acute febrile illness: fever, chills, headache, nausea, lethargy, and upper respiratory symptoms.
首先，病人常以急性发热性疾病就诊：发烧，寒战，头疼，恶心，嗜睡，及上呼吸道症状。
Infection with P. falciparum can further progress to severe organ dysfunction.
恶性疟感染会发展成严重的器官衰竭。
The disease course is unpredictable in the non-immune individual.
对于一个没有免疫的病人来说，病程是不可预测的。
Diagnosis 诊断
Thick and thin peripheral blood smears demonstrating organism
厚和薄末梢血涂片可显示寄生虫
Thick smear – confirms Plasmodium parasites
厚涂片－可证实有疟原虫的存在
Thin smear – allows speciation of Plasmodium parasites
薄涂片－可鉴别疟原虫类别
Hyperparasitemia is associated with increased mortality
高疟原虫血症与高死亡率密切相关
Treatment 治疗
P. falciparum or species unidentified
恶性疟或不明种类
For severe malaria, IV quinine (quinidine if quinine not available)
重度感染，静脉奎宁；如没有奎宁，可用奎宁丁
IV artesunate is available from the CDC as a quinidine/quinine alternative.
做为奎宁和奎宁丁的替代药，可以向CDC寻求静脉青蒿琥酯
DO NOT USE Chloroquine for severe malaria
严重的疟疾不要用氯奎。
Patients with evidence of complicated malaria (>3% parasitemia, signs of organ dysfunction, alterations in mental status) should be admitted to an ICU.
对于有明确复杂疟疾病人（3％以上疟原虫血症，器官衰竭表现，神志改变）要收入加强监护病房

University of Maryland Section for Global Emergency Health
马里兰大学国际急诊健康部
Author 作者: Emilie J.B. Calvello, MD, MPH

References 参考文献:
Center for Disease Control. (2012). Malaria. Retrieved November 9, 2012, from http://www.cdc.gov/MALARIA

Wattal, C. et al. Infectious disease emergencies in returning travelers: special referece to malaria, dengue and chikungunya. Med Clin North Am. 2012 Nov; 96(6): 1225 – 1255.