Infectious Diseases
Travelers' Health

Symptoms of Malaria

By
Heidi Moawad, MD
Heidi Moawad, MD
Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.
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Updated on July 25, 2022
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Lindsay Cook, PharmD
Lindsay Cook, PharmD
Medically reviewed by Lindsay Cook, PharmD

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Malaria is an infection caused by a parasite. If you have malaria, you are likely to experience a number of vague symptoms that are typical of most infections, as well as some trademark symptoms that are more specifically associated with a malaria infection.

The physical effects of malaria occur largely because the parasite invades red blood cells, producing toxins, causing anemia (diminished red blood cell function), and potentially blocking small blood vessels throughout the body.

malaria symptoms
© Verywell, 2018. 

Frequent Symptoms

Symptoms of the illness tend to occur in cycles, which correspond to the life cycle of the parasite. During different phases of the parasite’s life cycle, there is a variation in how the organism affects red blood cells and there is a variation in the impact of the toxins on the body.

There are several different species of malaria parasites, and they all cause similar symptoms. The different symptoms manifest at different phases of the illness.

You are likely to experience an incubation period after exposure to the parasite, with a delay in symptom onset. The first signs of malaria occur between one to four weeks after exposure and may take substantially longer in some instances.

The most common symptoms of malaria are:

  • Headaches
  • Fatigue 
  • Low energy
  • Nausea 
  • Vomiting 
  • Myalgia (muscle aches)
  • Stomach upset 
  • Diarrhea

Cyclic Symptoms

Cycles of fever that last from six to 24 hours may alternate with rounds of chills, shaking, and daytime sweating or night sweats. This cyclic characteristic is often the most recognizable sign of malaria, distinguishing it from other illnesses and infections. This feature will typically prompt your healthcare provider to test you for malaria.

Cyclic Malaria Symptoms

  • Fever—which can be very high
  • Chills
  • Sweats
  • Night sweats
  • Shaking

Less Common Symptoms

Malaria can affect several body systems, particularly if it is untreated. Less common symptoms of malaria include:

  • Jaundice (yellowing of the skin or whites of the eyes)
  • Coughing
  • Shortness of breath caused by fluid in the lungs
  • Expanded abdomen caused by an enlarged spleen
  • Hypoglycemia (low blood sugar)

If you notice these, particularly after travel to a malaria-prone area, seek prompt medical attention.

Complications

If you have immune system deficiencies, or if you are not in good health, you are more likely to develop complications. However, a healthy person with a strong immune system may also develop complications from malaria, even with recommended treatment.

In areas where malaria is endemic, children and pregnant women with malaria are at high risk of developing severe complications. Older children and adults in these areas may develop partial immunity and often experience milder cases. People with no exposure to malaria that travel to malaria-endemic regions are also at risk of getting a severe malaria infection.

Thrombocytopenia 

A low platelet count can interfere with blood clotting, manifesting as excessive bleeding or excessive blood clots.

Anemia 

Hemolytic anemia (rupture of the blood cells) occurs with malaria. Sometimes the infection can become advanced, causing a severely low red blood cell count or profoundly diminished red blood cell function. The symptoms of anemia include fatigue, headaches, and low blood pressure.

Kidney Involvement 

Parasites inside the red blood cells may cause blockage of tiny vessels in the kidneys, or red blood cells may clump due to toxins. This can interfere with normal kidney function and may also cause pain. 

Brain Involvement 

Cerebral malaria, a condition in which the parasite is present in the blood cells in the brain, is relatively uncommon. Symptoms include seizures, motor weakness, vision loss, decreased consciousness, coma, and permanent neurological deficits or even death.

Loss of Consciousness or Coma

A rare complication of malaria, unresponsiveness can occur as a result of advanced disease, even without cerebral malaria.

Death

Malaria can result in death due to widespread complications. Prompt attention to symptoms is crucial to preventing complications and mortality.

Children are more likely to die from malaria complications than adults with the infection.

During Pregnancy

Pregnant women have been found to have a higher than usual susceptibility to malaria. If the infection is not treated during pregnancy, it may cause birth defects or the baby may be born with malaria infection.

Recurrent Infections 

Most people who have a healthy immune system develop partial immunity to malaria. Repeated infections generally produce milder symptoms than initial infections, with a longer than usual incubation period.

However, it is possible for recurrent infections to become severe and progress, producing serious complications. This is why preventive measures are necessary, even if you've already had the infection.

When to See a Healthcare Provider

If you have fevers, fatigue, new headaches, or persistent headaches, you should see your healthcare provider—these are common signs of most infections. If you have cyclical fevers, chills, and sweats, this is specifically suggestive of malaria infection.

Malaria Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Man

You should be familiar with the common signs and symptoms of malaria if you have been in a tropical climate and notice that you were bitten by mosquitoes, as this is the way through which malaria is transmitted.

Frequently Asked Questions

  • What are the common signs and symptoms of malaria?

    Malaria, a disease caused by different species of Plasmodium parasite, typically results in headache, fever, fatigue, dry cough, nausea, or vomiting in the initial stages. The "classic" sign is malaria paroxysm, the cycling of cold symptoms (chills and shivering) with hot symptoms (sweating and fever) every few hours.

  • What are the signs of severe malaria?

    While most malaria cases are uncomplicated, roughly one in 20 cases result in severe disease, typically caused by the species Plasmodium falciparum. Symptoms tend to develop rapidly and can become life-threatening very quickly.

    Possible signs and symptoms include:

  • How soon after infection do malaria symptoms appear?

    Symptoms of malaria typically start eight to 17 days following infection but may develop later for people who have taken prophylactic (preventive) antimalarial drugs. A malaria species called Plasmodium malariae can take up to 40 days to become symptomatic and has even been known to cause disease years later.

  • How long do malaria symptoms last?

    If properly treated, an uncomplicated malaria infection will resolve within two weeks. If left untreated, malaria symptoms can rebound periodically over the course of years.

  • How deadly is malaria?

    The World Health Organization (WHO) estimates that malaria causes over 400,000 deaths every year. Children under age 5 account for the lion’s share of deaths, most of which occur in sub-Saharan Africa. In the United States, malaria was declared eliminated in 1951.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Bartoloni A, Zammarchi L. Clinical aspects of uncomplicated and severe malaria. Mediterr J Hematol Infect Dis. 2012;4(1):e2012026. doi:10.4084/MJHID.2012.026

  2. Centers for Disease Control and Prevention. About Malaria.

  3. Iron-Deficiency Anemia. National Heart Lung and Blood Institute.

  4. Idro R, Marsh K, John CC, Newton CR. Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome. Pediatr Res. 2010;68(4):267-74. doi:10.1203/PDR.0b013e3181eee738

  5. Doolan DL, Dobaño C, Baird JK. Acquired immunity to malaria. Clin Microbiol Rev. 2009;22(1):13-36, Table of Contents. doi:10.1128/CMR.00025-08

  6. Buck E, Finnigan NA. Malaria. In: StatPearls [Internet].

  7. Xia J, Wu D, Wu K, et al. Epidemiology of Plasmodium falciparum malaria and risk factors for severe disease in Gubei province, China. Am J Trop Med Hygiene. 2020;103(4):1534-9. doi:10.4269/ajtmh.20-0299

  8. Zekar L, Sharman T. Plasmodium falciparum malaria. In: StatPearls [Internet].

  9. World Health Organization. Malaria.

  10. Centers for Disease Control and Prevention. Elimination of malaria in the United States.

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.  

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