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Stages of Malaria

Reviewed by medical experts · For informational purposes only

Introductory summary

Stages of malaria: liver stage, blood stage, the chill-fever-sweat attack, dormant relapse and recovery.

Malaria passes through several stages inside the body. Knowing them explains why symptoms come and go and why some types return.

Stage 1: bite and liver stage

An infected mosquito injects parasites called sporozoites. They travel to the liver within minutes and multiply there. You feel nothing at this stage. It lasts about 1 to 2 weeks for most types.

Stage 2: blood stage

The parasites leave the liver and enter red blood cells. They multiply inside the cells, then burst them. Each burst releases more parasites and causes the fever. Symptoms start here.

Stage 3: the clinical attack

An attack usually has three phases:

  • Cold stage: shivering and chills for 15 minutes to an hour
  • Hot stage: high fever, headache and vomiting for several hours
  • Sweating stage: heavy sweating and fall in temperature, followed by tiredness

Stage 4: dormant liver stage (vivax and ovale)

Some parasites can sleep in the liver for months. They wake later and cause a relapse. This is why a medicine for the liver stage is added.

Stage 5: severe disease or recovery

With prompt treatment most people recover fully within a few days to weeks. If untreated, especially with falciparum, the illness can move to severe malaria within days.

Spread stage

After a few days in the blood, some parasites form gametocytes, which can infect a new mosquito that bites the person.

Ayurvedic view

Ayurveda describes fever stages by Dosha involvement and by timing. This is an interpretive framework and is not a method for staging malaria.

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