What should you know about cerebral malaria?

Malaria is an infection transmitted by certain mosquitoes. In severe disease, infected red blood cells can interfere with blood flow and oxygen delivery in small vessels, including vessels in the brain. Cerebral malaria may cause confusion, unusual sleepiness, difficulty waking, seizures, abnormal behaviour, weakness, or loss of consciousness. It can occur with fever, chills, headache, or muscle aches, but brain-related changes are the defining concern.

A fever after travel to a malaria area needs prompt assessment even if the person initially feels better between episodes. A clinician may use a blood test and repeat testing when the first result does not explain the illness. Cerebral malaria cannot be diagnosed safely from symptoms alone at home.

Call emergency services or go to an emergency department immediately if malaria is possible and the person is confused, having a seizure, difficult to wake, fainting, or breathing abnormally. Tell the team about recent travel, mosquito exposure, prevention medicines, fever onset, and any medicines already taken. Keep a drowsy or unconscious person on their side if safe, and do not give food, drink, or tablets if swallowing is impaired.

Emergency care is needed for any change in consciousness, seizure, severe weakness, breathing difficulty, repeated vomiting, inability to drink, or rapidly worsening fever after possible malaria exposure. Seek same-day medical advice for fever, chills, headache, or muscle aches after travel, even when no neurological symptoms are present. Prompt treatment matters because severe malaria can worsen quickly.

Ask which blood tests are needed, whether repeat testing is required, and how the team will monitor brain function, breathing, blood sugar, and other organs. For future travel, ask about malaria prophylaxis, mosquito protection, and a travel health consultation suited to the destination.