Until recently, the parasites that cause Malaria were categorized into 4 subtypes. Then a fifth was discovered. To keep it simple stupid let’s call the subtypes 1-5. They can be grouped into 3 classes:
- HELL: Subtypes 1 and 2 are rare and cause a mild course of the disease. But the little devil parasites will hide in your body and come out when you don’t think of them: you got chronic disease.
- PURGATORY: The most common subtype 3 makes you really suffer from the severe course of the disease (that can include unconsciousness and seizure) but then you are dismissed until the next mosquito carrying Malaria parasites bites you.
- CLOSE SHAVE: Subtypes 4 and 5 (the new kid) are mild course and you are done but unfortunately they are as rare as 1 and 2.

How do you find out which subtype(s) caused your disease?
- The simple test is counting parasites in your blood under the microscope. Limited sensitivity because if there are too few you don’t see them anymore: you reached the detection limit. Depending on the experience of the observer, it may also be difficult to distinguish the subtypes by their appearance.
- The far better results yields a PCR (Polymerase Chain Reaction) which “amplifies a single or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence” (cited from http://en.wikipedia.org/wiki/PCR ). You can imagine that sensitivity (detecting the parasites) and specificity (distinguishing them) are increased enormously if you basically have in your Petri dish tons of copies of the few parasites in your body. The disadvantage: few centers do it (one in Thailand) and it takes seven - ten days for the results to come back.

And in my case?
Right from the beginning it looked like I was lucky enough to have caught subtype 4 (plasmodium malariae) only but we are still waiting for the PCR outcome. Keep your fingers crossed.