Plasmodium vivax - Clinical Manifestation, Prognosis, Epidemiology, Reservoir, Transmission, Control, Treatment

Last Modified: July 19, 2026 by Reshma Maharjan

Clinical Manifestation of Plasmodium vivax

The incubation period of malaria by Plasmodium vivax is 8 days to 31 days. Although they cause the most widespread malaria, they are less severe than P. falciparum, and death from Plasmodium vivax is less common.

Malaria paroxysm

  • shivering and cold followed by fever which can last from 2 hours to 6 hours

  • fever can reach as high as 40.6°C (105°F)

  • other symptoms accompanying fever include dry skin, headaches, nausea, and vomiting

  • finally, the fever subsides with the patient sweating heavily

Malarial fever

  • caused by rupture of mature schizonts from the infected host liver cells

  • In cases infected by Plasmodium vivax and P. ovale, schizonts are released every 48 hours, thus malaria fever occurs every 48 hours

  • enlarged spleen and anemia are also associated with children

Relapse

  • feature of Plasmodium vivax infection

  • caused by the activation of hypnozoites in the liver cells

  • the relapse rate is at 50% within 5 weeks (short-term relapse) or 5 years (long-term relapse) from the initial syndrome

  • the type of relapse depends upon the strain of Plasmodium vivax infecting the individual

Figure: malaria clinical manifestation (Source: nature)

Complication of Plasmodium vivax

In cases of a ruptured spleen, which has been enlarged due to malaria infection, it may be life-threatening

Prognosis of Plasmodium vivax

The Plasmodium vivax malaria infection is treatable with the administration of anti-malarial drugs.

Epidemiology of Plasmodium vivax

Plasmodium vivax is widely distributed- even more than P. falciparum. However, they have low morbidity and mortality.

The occurrence of Plasmodium vivax is more common in temperate countries than in tropical countries.

Geographically, they are found in South America, Australia, tropical and subtropical Africa, Northern Africa, China, Korea, USSR, Pakistan, Sri Lanka, Bangladesh, India, etc.

Reservoir, Source, Transmission of Plasmodium vivax

Man is the only source and reservoir of the Plasmodium vivax.

Transmission occurs during the blood meal by sporozoite-infected female Anopheles mosquitoes. The congenital transmission also occurs in cases of Plasmodium vivax.

Prevention, Control of Plasmodium vivax

The prevention and control of Plasmodium vivax infection are based on

  • successful treatment of infected individuals

  • reduction of transmission by controlling mosquito population especially around housing by eliminating breeding places, spraying oils and chemicals in breeding sites

  • using mosquito nets while sleeping, and netted windows in endemic areas

  • wearing protective clothing

  • use of mosquito repellants

  • chemoprophylaxis

Treatment of Plasmodium vivax

  • Chloroquine (for the erythrocytic stage), primaquine (for the liver stage of the parasite), fanasil (sulphorthodimethoxine), and mefloquine are the drugs of choice

  • in recent years, resistance to primaquine has been reported and hence large doses are used in some parts of Asia and New Guinea

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