Travel Health Questions

Depends on destination. Common ones: hepatitis A and B, typhoid, and — for parts of Africa, South America, and Asia — yellow fever, Japanese encephalitis, rabies, meningococcal. Yellow fever requires an official certificate for entry to some countries. Ideally, see a travel medicine clinic 4-6 weeks before departure since some vaccines need multiple doses. Government travel medicine centres are cheaper; private clinics are faster.

Only drink bottled or well-boiled water (also for brushing teeth in high-risk areas), avoid ice unless from safe water, eat food that's been cooked hot and served hot, peel fruit yourself, avoid raw vegetables and unpasteurised dairy. If it happens: stay hydrated with ORS, most cases resolve in a day or two. Antibiotics are only for severe cases with fever or blood in stool — see a doctor there or on return.

ORS sachets, paracetamol, antihistamine, mild anti-diarrhoeal (loperamide), antiseptic wipes and bandages, any prescription medications with extra supply, mosquito repellent, sunscreen, motion-sickness pills if needed. For remote destinations, add a broad-spectrum antibiotic prescribed by your doctor for emergency use. Carry medicines in original packaging with prescriptions for customs.

Yes — treatment costs in the US, Europe, and even parts of South-East Asia can bankrupt a family. Basic travel insurance covers medical emergencies, hospitalisation, and evacuation. Read the policy: pre-existing conditions, adventure sports, and age limits often have exclusions. For domestic travel in India, most regular health insurance works — but check network hospitals in your destination city.

Stay hydrated (skip alcohol and excess coffee), walk the aisle every 1-2 hours, do calf pumps in your seat, wear loose comfortable clothing, consider compression socks for flights over 4 hours (especially if you're older, pregnant, or have circulation issues). Jet lag: sunlight and movement at the destination help reset the clock faster than staying indoors. Melatonin can help but isn't essential.

Keeping your family healthy every day is easy when you focus on small, fun, and consistent daily habits.

Evaluation is ongoing from admission through discharge and into outpatient rehabilitation. Expected outcomes by phase: Resuscitation phase (0–48 hours) — urine output 0.5–1 mL/kg/hr maintained throughout; haemodynamic stability (MAP >65 mmHg, HR <120 bpm); no signs of compartment syndrome in circumferential limb burns (assess Doppler pulses and capillary refill hourly); pain score maintained at or below the patient's acceptable threshold on a 0–10 NRS. Acute care phase (day 3–discharge) — no systemic signs of wound infection (afebrile or improving trend, WBC normalising, wound cultures negative or colonisation only); progressive wound healing or successful skin grafting with >80% graft take; adequate nutrition confirmed by achieving caloric targets (verify via dietitian review and albumin/prealbumin trending upward); patient demonstrating range-of-motion exercises and participating in physiotherapy. Discharge — patient/caregiver able to perform wound dressing independently with return demonstration; verbalises warning signs of infection requiring emergency attendance; knows how to apply compression garments for scar management; follow-up with burns clinic or plastic surgery confirmed. If any outcome is not met, revise the care plan: escalate to burns surgeon for non-healing wounds, adjust fluid rate if output is outside target, involve physiotherapy earlier for mobility, and consider psychiatric or social work referral for body image concerns or home safety issues that contributed to the injury.

Four established options. (1) SOTC Golden Wings — dedicated senior tours with slower pace, in-house doctor for group, from ₹80,000. (2) Veena World Senior Special — accessible destinations + medical support, from ₹65,000. (3) Thomas Cook Silver Streaks — senior-friendly itineraries, from ₹75,000. (4) IRCTC Bharat Gaurav Tourist Train — Indian domestic trips with grab bars and doctor on board, from ₹35,000. Ask specifically about: pace of daily walking (2-5 km limit for most seniors), altitude of destinations (avoid over 8,000 ft with heart or lung conditions), and access to hospitals near hotels. Book through a travel-insurance-included package for best value.

Six rules. (1) Carry all medications in original labelled bottles in cabin/hand baggage — never in checked luggage (temperature and loss risk). (2) Bring a written prescription from the treating doctor in English + generic drug names (not just brand names, which vary by country). (3) Pack 1.5x the trip duration supply in case of delays. (4) Refrigerated meds (insulin, some biologics) need an approved medical cool bag; airlines allow with prior notice. (5) Controlled substances (opioids, benzodiazepines) need special customs declaration in Singapore, UAE, Japan — check destination rules 4 weeks ahead. (6) Keep a printed list with generic names, doses, timing, and treating doctor's phone number in wallet.

For anyone over 60, prioritise a policy with medical coverage of at least ₹50 lakh + pre-existing disease (PED) waiver + emergency medical evacuation + 24x7 India-language helpline. Standard providers: TATA AIG Travel Elder (from ₹4,500 for 15 days USA/Europe with ₹50L cover), ICICI Lombard Overseas Elder Plan, Bajaj Allianz Silver Explorer. Read the fine print on PED — some policies exclude diabetes and hypertension complications unless declared and endorsed. For seniors above 75, cover premium jumps 2-3x. Domestic trips need less coverage but consider it if going to remote or high-altitude destinations.

Four you must not ignore. (1) Hypothermia — shivering, confusion, slurred speech, drowsiness when the room is cold; check with an oral or ear thermometer, anything under 35°C is a medical emergency, warm gradually and call 108. (2) Chest tightness or breathlessness — cold air constricts blood vessels and raises heart-attack risk by around 30% in Indian winter months. (3) Sudden joint stiffness or worsening arthritis — a normal winter flare, but manage with warm compresses and analgesics if severe. (4) Persistent cough or fever — flu and pneumonia are winter killers in seniors; get vaccinated if not already done.

Keep the bedroom and living room at 20-22°C during the day and no colder than 18°C at night — below this, blood pressure rises and cardiovascular risk goes up. Practical setup for Indian homes: layered clothing (thermals + sweater + shawl), warm socks and slippers indoors, hot water bottle or electric blanket (never left on unattended — burn risk), and safe space heater with a fireproof mat below. Ventilate rooms briefly twice daily to reduce indoor pollution and avoid stuffiness. Never use gas or kerosene heaters in a closed room — carbon monoxide poisoning is silent and often fatal.

Two are essential. (1) Annual influenza (flu) vaccine — best taken October-November before peak flu season; costs ₹500-1,500 in private clinics; ICMR + IAP endorse it for everyone over 65 and anyone with diabetes, heart disease, or COPD. (2) Pneumococcal vaccine (PPSV23 + PCV13 combination) — one-time or every 5 years depending on risk; especially critical for anyone with diabetes, CKD, heart failure, or immunosuppression; costs ₹3,000-5,500. Both together dramatically reduce winter hospitalisation risk. Ask your GP; most Indian city hospitals stock these year-round.

Prefer low-altitude, well-connected destinations with tertiary hospitals nearby. Good picks: Kerala backwater cruises (Alleppey, Kumarakom); Puducherry (flat, walkable, French colonial architecture); Rishikesh (spiritual + Ganga aarti + close to AIIMS Rishikesh); Goa (beaches + wheelchair-friendly resorts); Munnar and Kodaikanal for hills without extreme altitude. Avoid: Leh-Ladakh (11,500 ft, altitude sickness risk for anyone with heart/lung/HbA1c>8%); Kedarnath/Amarnath (steep trek, high altitude); Andamans in monsoon (limited emergency evacuation).

Aim for the 45-15 rule — 45 minutes seated, 15 minutes standing or moving. Sitting for 8+ hours daily is linked to 34% higher risk of premature death per a 2016 Lancet meta-analysis, even in people who exercise separately. Practical fixes: set a Pomodoro timer to stand every 25 minutes, take phone calls while walking, keep a water bottle far from your desk so refills force you up, invest in a ₹2,000-8,000 standing desk converter, and do 5 desk stretches (neck, shoulder, wrist, back, ankle) between tasks. Aim for 7,000-10,000 daily steps even when working from home.

Follow the 20-20-20 rule endorsed by the American Optometric Association: every 20 minutes, look at something 20 feet (6 meters) away for 20 seconds. Add: adjust screen brightness to match room light, keep the screen an arm's length away and slightly below eye level, use night-mode after sunset, blink consciously (screen work drops your blink rate 60%), and get 15-minute outdoor exposure daily for eye focus range. If you get frequent headaches, dry eyes, or blurred vision after work, see an ophthalmologist — you may need computer glasses or lubricating drops.

Three habit swaps work better than any diet. (1) Eat meals off your desk at set times — kitchen-only eating breaks the mindless graze cycle; studies show desk-eaters consume 20-40% more calories daily. (2) Pre-portion snacks in the morning (roasted chana, sprouts, fruit) so you're not opening the biscuit packet. (3) Drink 2 liters of water before 4 pm — thirst is often mistaken for hunger. Also: don't keep sugary drinks in the fridge, walk 5 minutes after every meal (drops post-meal blood-sugar spikes), and get 7-8 hours of sleep (sleep deprivation raises ghrelin/hunger hormone within 24 hours).

Three boundaries that work. (1) A physical work zone — even a small corner desk, not the sofa or bed — signals brain when you're 'in' or 'out' of work mode. (2) A firm end-time — close the laptop, change clothes, leave the room; the physical ritual matters more than the exact hour. (3) One meal a day with no screens, phone, or work chat. WFH burnout in India is real — a 2023 Deloitte survey found 74% of Indian remote workers reported burnout symptoms. If you're feeling constant exhaustion, cynicism about work, and reduced sense of accomplishment for 4+ weeks, consult a mental health professional; workplace burnout is now a WHO-recognised occupational phenomenon.

800-1,000 IU daily is the standard for adults over 60, and it goes up to 2,000 IU daily if serum 25(OH)D is below 20 ng/mL (deficient). Around 70% of Indian seniors are vitamin-D-deficient — winter's lower sun exposure worsens this. Get 25(OH)D tested (₹500-1,200 in private labs) and start supplementation based on the level. Weekly high-dose 60,000 IU sachets for 8-12 weeks are commonly prescribed for deficient cases, followed by daily maintenance. Combined with adequate calcium (1,200 mg/day for over-60s), this reduces winter fall-related fracture risk.

Falls, burns, electrical hazards, and poisoning are among the top causes of injuries at home. Most can be avoided by following safety protocols.

Smoke detectors should be tested monthly and batteries replaced twice a year. The entire unit should be replaced every 10 years.

Yes, especially if you have toddlers. Safety gates, outlet covers, corner protectors, and locked cabinets are essential in preventing accidents.

Install grab bars, improve lighting, declutter pathways, and ensure medication safety. Learn more about supporting older adults at Zocvi’s guide on the eight needs of the elderly.

Essentials include bandages, antiseptic, tweezers, painkillers, gloves, allergy medication, and a first aid manual.

For a burn patient the nursing diagnoses are prioritised using Maslow's hierarchy, placing physiological and life-threatening problems first. Priority 1 — Fluid Volume Deficit related to fluid loss through burn wounds and evaporation: large burns (>20% TBSA in adults, >15% in children) trigger massive capillary leak within the first 24–48 hours; uncorrected, this leads to hypovolaemic shock and organ failure. Priority 2 — Acute Pain related to tissue damage and exposed nerve endings: even minor burns cause severe pain that is both physiological and a barrier to cooperation with wound care. Priority 3 — Impaired Skin Integrity related to thermal, chemical, or electrical injury: loss of the skin barrier drives infection risk, fluid loss, and impaired thermoregulation. Priority 4 — Risk for Infection related to disruption of skin barrier and immunosuppression from burn injury: burn patients are among the most infection-susceptible in any care setting; infection remains a leading cause of burn mortality after the resuscitation phase. Additional diagnoses that appear after the acute phase: Impaired Physical Mobility related to pain, contracture, and immobilisation; Imbalanced Nutrition: Less Than Body Requirements related to hypermetabolic state (burn patients may require 2–3× normal caloric intake); Disturbed Body Image related to scarring and disfigurement.

Fluid resuscitation in the first 24–48 hours is the most critical intervention for any burn >15–20% TBSA. The Parkland formula is the most widely used: 4 mL × body weight (kg) × %TBSA burn (second and third degree only; first degree excluded) = total Ringer's Lactate volume in the first 24 hours. Half is given in the first 8 hours from the time of injury (not admission — if the patient arrives 4 hours post-burn, the first half must be given in the remaining 4 hours), the second half over the following 16 hours. Nursing responsibilities: establish two large-bore peripheral IV lines (or central/intraosseous if peripheral access is impossible); use Ringer's Lactate (Hartmann's), not normal saline, to avoid hyperchloraemic acidosis; insert a urinary catheter and measure hourly urine output — target 0.5–1 mL/kg/hr in adults, 1 mL/kg/hr in children; titrate the infusion rate to maintain this output, not to follow the formula rigidly; monitor haematocrit (rising Hct suggests haemoconcentration), electrolytes, and serum lactate for evidence of tissue perfusion. In India, Modified Brooke formula (2 mL/kg/%TBSA) is sometimes used in resource-limited settings. Colloids (albumin) are generally not added in the first 8–12 hours to avoid driving third-space oedema. Document all fluids given and received against the calculated target on a running fluid balance chart.

Wound care and infection prevention are inseparable in burn nursing — every dressing change is an infection-control event. Assessment before each dressing change: note wound colour (red/pink = healing; grey/black = eschar/necrosis; green = Pseudomonas infection; malodour suggests bacterial colonisation), measure wound area, document any blistering or separation. Procedure: perform hand hygiene and don sterile gloves; debride loose eschar and necrotic tissue gently using sterile technique; cleanse the wound with chlorhexidine solution or normal saline (do not use hydrogen peroxide or iodine — cytotoxic to healing cells); apply topical antimicrobial agent per protocol — silver sulfadiazine 1% (most common in India; do not use on face or in sulpha-allergic patients), silver-impregnated dressings (e.g. Mepilex Ag) for partial-thickness burns, or mafenide acetate for burns with eschar penetration needed; apply non-adherent primary layer + absorbent secondary layer + conforming bandage; change dressings every 24–48 hours or when soiled. Infection surveillance: monitor temperature (fever or hypothermia), WBC, C-reactive protein, and wound swab cultures; Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), and Klebsiella are the most common burn wound pathogens; systemic antibiotics are not given prophylactically — start only on culture-confirmed systemic infection. Isolation: place patients with major burns in single rooms; barrier nursing (gown, gloves, mask) for all contacts.

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The bite injects fewer than a hundred parasite sporozoites into your bloodstream, a tiny number, but they head straight for the liver within an hour. Inside a liver cell, each sporozoite multiplies silently over 7-30 days into tens of thousands of new parasites (merozoites). When the liver cell bursts, those merozoites flood into your bloodstream and start invading red blood cells. Each infected red cell then bursts every 48-72 hours, releasing more parasites, and this is when you first feel sick. So the mosquito bite is small, but the liver stage is a hidden multiplier that turns a handful of parasites into millions before symptoms even begin.

Because the parasite's blood-stage cycle is synchronised. All the infected red blood cells burst at roughly the same time, every 48 hours for P. vivax and P. ovale (tertian fever), 48 hours for P. falciparum (though often less regular), and 72 hours for P. malariae (quartan fever). Each mass rupture releases parasites plus toxic parasite waste products into the bloodstream, which triggers the immune system to spike fever, chills, and shivering, the classic malaria paroxysm. Between paroxysms, the parasite is quietly invading fresh red blood cells and you feel relatively normal. This cyclical pattern is so distinctive that a fever every other day in someone who has been in an endemic area should trigger a malaria test even before other symptoms develop.

Both P. falciparum and P. vivax are prevalent in India but they behave differently. P. falciparum is more common in Odisha, Chhattisgarh, Jharkhand, and the North-East and causes almost all severe and fatal malaria, cerebral malaria, kidney failure, ARDS, severe anaemia. It progresses fast and can kill within days if untreated. P. vivax is more widespread across the country and causes fewer deaths but has two features that matter: relapses can occur months to years after the original infection because dormant liver-stage parasites (hypnozoites) can reactivate, and chronic P. vivax weakens people over time. Any fever after being in a mosquito-endemic area should be tested regardless of which species is more common there, waiting to see if it is just viral fever can be dangerous with P. falciparum.

Yes, directly. The WHO's paucibacillary (PB) vs multibacillary (MB) split decides the multidrug therapy (MDT) regimen and duration. Paucibacillary, five or fewer skin lesions, no bacilli seen on skin smear, is treated with rifampicin and dapsone for 6 months. Multibacillary, more than five lesions or bacilli present on smear, is treated with rifampicin, dapsone, and clofazimine for 12 months. The Ridley-Jopling five-type classification (TT/BT/BB/BL/LL) adds prognostic detail: which type predicts how likely a patient is to develop reactions (immune complications during or after treatment), how much nerve damage to anticipate, and how contagious the case is. In India, NLEP centres use both systems. WHO for treatment decisions, Ridley-Jopling for clinical description and follow-up planning.

One feature is diagnostic when present: reduced or absent sensation in the patch. A leprosy skin lesion is typically hypopigmented (lighter than surrounding skin) or slightly reddish, has well-defined edges, and, critically, does not feel normal to touch, pinprick, or temperature. Ringworm and eczema itch and burn; leprosy lesions are usually numb or feel dull. To check at home: lightly touch the patch and adjacent normal skin with a wisp of cotton, then repeat with something warm and something cool. If the patch does not sense any of these normally, seek medical evaluation. Other clues: a thickened nerve near the patch that you can feel as a firm cord under the skin (common in the ulnar nerve near the elbow, the great auricular nerve in the neck, or the common peroneal nerve near the knee) is another leprosy-specific finding. Ringworm and eczema do not thicken nerves.

Yes on both counts. India has the largest annual case count in the world, over 100,000 new cases detected each year through NLEP surveillance, concentrated in Bihar, Chhattisgarh, Jharkhand, Odisha, and parts of Maharashtra. And yes, leprosy is completely curable with multidrug therapy, the bacteria are killed within days of starting rifampicin, and full treatment (6-12 months depending on type) prevents relapse. What is not always reversible is the nerve damage and disability that develops before diagnosis, which is why early detection matters more than treatment access. NLEP provides diagnosis and MDT free of charge at every district hospital and most primary health centres, there is no financial barrier to treatment. The barrier is often social: fear of stigma delays presentation.

Casual social contact, sharing a workspace, brief conversations, handshakes, carries very low transmission risk because leprosy requires prolonged close exposure to spread. Household contacts and prolonged close contacts of untreated multibacillary cases have meaningfully elevated risk (roughly 5-10 times general population), which is why NLEP actively traces household contacts. Two protective factors: BCG vaccination in childhood offers partial protection; and once a patient starts multidrug therapy, they become non-infectious within days as the bacteria are killed by rifampicin. If you are a household contact of a diagnosed case, ask about single-dose rifampicin post-exposure prophylaxis (SDR-PEP). WHO now recommends this for close contacts and it reduces subsequent leprosy risk by roughly 50-60%. Do not wait for symptoms; contact tracing is the standard of care.

Latent TB means the M. tuberculosis bacteria are in your body but contained by your immune system inside granulomas, you have no symptoms, are not infectious, and cannot spread the disease. Chest X-ray is usually normal; TB is detected only through Mantoux test or IGRA blood test. Active TB means the bacteria have broken out of containment and are multiplying, causing symptoms (persistent cough, weight loss, night sweats, low-grade fever) and making you infectious to others. Roughly 5-10% of people with latent TB will develop active TB at some point in their lifetime, with the risk highest in the first 2 years after exposure and in anyone whose immune system weakens (HIV, diabetes, steroids, TNF inhibitors, aging). Whether latent TB needs treatment depends on individual risk. WHO recommends preventive treatment for household contacts of active TB cases, HIV-positive people, people starting immunosuppressive drugs, and healthcare workers with recent conversion. India's NTEP is expanding preventive TB treatment access, particularly for household contacts.

Ask for a peripheral blood smear as your primary test, thick smear for detection, thin smear for species identification. A rapid diagnostic test (RDT) is a reasonable add-on, especially if you are in a smaller clinic or evening hours when a microscopist may not be available; RDT gives a result in 15-20 minutes. If both are negative but fever and symptoms persist for another 24-48 hours, a repeat smear at a good centre or a PCR test at a tertiary hospital is the next step. Do not rely on RDT alone if your clinical picture is convincing, low-parasitemia infections and non-falciparum species (P. vivax, P. ovale) can be missed by rapid tests.

In government hospitals, both RDT and blood smear are typically free or nominal. In private labs, RDT and blood smear together are usually affordable and results come back the same day. RDT within 20-30 minutes, smear within 2-4 hours if the lab has a technician on shift. PCR is only available at larger hospitals and reference laboratories; it is significantly more expensive and takes 24-72 hours depending on the batch schedule. For anyone with fever in an endemic area, testing should not be delayed by cost, a delayed diagnosis in P. falciparum malaria can escalate to cerebral malaria within days.

A negative RDT does not rule out malaria, especially in the first 24-48 hours of illness or in P. vivax infection where parasite levels can be low. Next steps: (a) request a thick and thin blood smear read by an experienced microscopist, this is more sensitive than an RDT and identifies the species; (b) if smear is also negative but fever continues past 48 hours, repeat the smear, parasitemia rises with each fever cycle and can become detectable; (c) discuss PCR testing at a tertiary centre if smears remain negative but symptoms are strongly suggestive; (d) in parallel, work up other causes of fever in India, dengue, typhoid, chikungunya, leptospirosis, urinary infection, since these can co-exist or mimic malaria.

Very urgent, especially if you have travelled to sub-Saharan Africa, the Indian North-East, Odisha, Chhattisgarh, or parts of South-East Asia where P. falciparum is common. Get tested the same day. P. falciparum malaria can progress to severe disease within 24-72 hours of first symptoms, cerebral malaria, kidney failure, severe anaemia, ARDS. Tell the doctor exactly where you travelled, when, and whether you took prophylaxis. If travel was to a P. vivax or P. ovale region, symptoms can appear weeks to months after return because these species can lie dormant in the liver, any unexplained fever within a year of travel to an endemic zone warrants a malaria test, not just antibiotics for a presumed viral illness.

Modern malaria RDTs have sensitivity of roughly 90-95% for detecting Plasmodium falciparum at typical fever-onset parasite levels, meaning they catch most cases but can miss around 5-10%. Sensitivity for P. vivax is lower, around 80-90%, because the antigens vary more across strains. Sensitivity drops significantly when parasite counts are very low (early in the illness or in asymptomatic carriers). Blood smear microscopy remains the gold standard, with sensitivity approaching 95% in expert hands and the ability to identify species and quantify parasite load. In practice, RDT is the fast first test almost anywhere in India; blood smear confirms the diagnosis and guides treatment intensity. A negative RDT with persistent malaria-suggestive symptoms should always trigger a follow-up smear rather than being taken as definitive.

RDTs use protein-based antibodies that degrade at high temperatures, accuracy drops meaningfully when kits are stored above 30°C for extended periods, which is a real issue in Indian summers and in rural clinics without air conditioning. Storage above 40°C can produce false negatives even for kits well within their expiry date. Practical implications: kits held in unrefrigerated pharmacy shelves during peak summer months (April-June) may perform worse than the manufacturer's stated sensitivity; kits transported without cold-chain protection in field settings often lose reliability. This is why WHO recommends RDT lot testing before deployment in endemic areas. For patients: if an RDT result seems inconsistent with your clinical picture, ask for a blood smear rather than trusting the RDT alone, the smear does not have storage-related accuracy issues.

Malaria RDT kits are available in India but not typically sold for home use, they are meant for clinical or field-worker settings and are usually sold to hospitals, primary health centres, NGOs, and pharmacies for point-of-care testing rather than direct-to-consumer. Even where available at retail pharmacies, home use is not recommended because: interpreting a faint test line correctly needs practice, a negative result does not rule out early-stage malaria and needs follow-up, and any positive result immediately needs a doctor visit for treatment (antimalarials are prescription-only). Practical alternative: same-day RDT plus blood smear at a diagnostic lab or general practitioner clinic is inexpensive and available in most Indian cities. Do not delay treatment while trying to diagnose at home if you have symptoms consistent with malaria after mosquito exposure.

A positive RDT confirms malaria and shifts focus immediately to two things: (a) determining severity, a doctor evaluates whether it is uncomplicated malaria (treatable at home with oral antimalarials) or severe malaria (needs hospitalisation and IV artesunate). Severe malaria indicators include altered consciousness, seizures, jaundice, dark urine, breathing difficulty, or extreme weakness. (b) identifying species, this determines the drug regimen. For P. falciparum in India, artemisinin combination therapy (ACT) is first-line; for P. vivax, chloroquine plus primaquine (primaquine treats the dormant liver stage to prevent relapse). The doctor will also order a follow-up blood smear to quantify parasite load and check response to treatment at day 3. Do not self-treat with over-the-counter antimalarials on a positive RDT, the wrong drug or dose can drive resistance and worsen outcomes.

Neither. Malaria is caused by a single-celled parasite called Plasmodium, technically a protozoan, one of the oldest kinds of life on earth. Five species infect humans: P. falciparum (the most dangerous, common in Africa and parts of India's North-East and eastern states), P. vivax (the most widespread in India, causes relapsing infections), P. ovale, P. malariae, and P. knowlesi (rare, mainly South-East Asian forest exposure). Because it is a parasite and not a bacterium or virus, malaria does not respond to antibiotics or antiviral medicines. It needs specific antimalarial drugs, chloroquine, artemisinin-based combinations, or primaquine, depending on the species and drug-resistance pattern in the region.