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Fever is the main symptom of malaria. The most severe manifestations are cerebral malaria (mainly in children and persons without previous immunity), anemia (mainly in children and pregnant women), and kidney and other organ dysfunction (e.g., respiratory distress syndrome). Persons repeatedly exposed to the disease acquire a considerable degree of clinical immunity, which is unstable and disappears after a year away from the endemic-disease environment. Immunity reappears after malarial bouts if the person returns to an endemic-disease zone. Most likely to die of malaria are persons without previous immunity, primarily children or persons from parts of the same country (e...
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