Quartan fever

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. == 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. == 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. 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. Medical procedures that diagnose quartan fever • Blood smears can be used to detect the parasites within red blood cells, thick blood smears are typically used initially to detect the parasites, then it is followed by thin blood smears which can detect the parasites as the morphology of erythrocytes is maintained through the process. • Peripheral blood films stained with Giemsa stain are a method of blood examination used to diagnose the presence of Plasmodium malariae, and detect quartan fever. therefore serological tests are used to detect past encounters with Plasmodium virus rather than acute cases where a patient has just been infected with P. malariae and has quartan fever. • Polymerase chain reactions (PCR) are used to diagnose Plasmodium malariae, the cause of quartan fever, as well as to distinguish mixed infections with different species of Plasmodium. == Prevention ==

Ways to minimise exposure to the Anopheles mosquito include: • Indoor residual sprays are one of the most utilised methods of malaria prevention by the Global Malaria Eradication Campaign. Spraying is a method used to control malaria epidemics. • Nets treated with insecticide are effective at preventing mosquito contact for three years. The World Health Organization (WHO) specifically protects younger children and pregnant women to reduce the risk of spreading quartan fever within the population. • House improvement is also a method of prevention. Traditional houses constructed from natural materials are susceptible to gaps that allow entry to Anopheles. House improvements, including sealed windows and doors, reduce the risk of coming in contact with the infected mosquitoes. Clothing can act as a physical barrier to prevent mosquitoes from feeding on exposed flesh, and treating beds and clothing with insecticides or repellents can further reduce the chances of infected mosquitoes biting and transmitting quartan fever to individuals. ==References==