Malaria is a febrile illness characterized by fever and related symptoms that are related to the life cycle of the malaria parasite in red blood cells. The first symptoms after infection are called the primary attack and typically include fever, chills, and flu-like symptoms. Further attacks known as paroxysms occur regularly as the parasite invades new red blood cells and can cause anemia, enlarged spleen, coma, and other complications if severe. Cerebral malaria, severe anemia, acute renal failure, and other severe manifestations can occur. Pregnant women and children are more vulnerable to severe disease.