50 times does sound like a lot, but if you're in your mid twenties that only comes out to twice a year. Considering the frequency in my childhood, I think it's honestly closer to seventy or eighty. To be clear, I'm counting cases where I developed symptoms and had to be treated - you do build a tolerance to it over time, to the point that many people get infected with the malarial parasite but don't notice any symptoms (it's not really understood how or why that acquired immunity works, but it does seem to pass from mother to child and persist until the child is about four or so months old).

It starts out with a persistent headache, sometimes a cough (but with no congestion - this is critical for figuring out early enough that it's not just a cold). The most obvious tell though is that some of my muscles start feeling sore and I start feeling inexplicably tired. At this point I would start preparing for a possible full-on case; basically making sure that I have a proper stock of NSAIDs, easy-to-eat foods, multivitamin and mineral syrup, and oral rehydration solution (I measure and make mine with regular sugar and salt) - malaria tends to completely suppress your appetite, and it's vital to keep your blood sugar and iron up even if you can't eat at all.

Sometimes the illness just subsides, but if I find myself developing a fever (usually a day or so after the headache starts) then I immediately make time to go and get tested. The whole process including getting results takes about an hour or two (mostly spent getting to a health care centre). If I'm malaria positive then I get prescribed an artemisinin-based combination therapy and sent home - the test and the full course of therapy are free under most health insurance plans, and cost about $6 to $15 out-of-pocket depending on the brand and hospital (an afterthought for someone in my position, but prohibitively expensive for millions of people who live on $2 a day or less).

The medication course is three days long, and very strict about the dosage - two doses taken eight hours apart, and then four taken every twelve hours afterwards. It's fast-acting enough that most people feel a lot better after the first day of treatment, but you have to complete the course and make sure you're getting excess nutrition even though you feel "fine". If I pick up on things and start the ACT early enough, the fever doesn't have time to develop; sometimes it hits hard/seemingly out of the blue, though, in which case I'd get increasing muscle aches and shivering chills even though the body temperature is climbing and climbing (the chills are extremely deceptive - I've seen people beg for sweaters and blankets while running a fever of over a hundred degrees). I take NSAIDs (usually ibuprofen) to manage the fever, along with warm green or ginger tea to help with the shivering. Once I start sweating, the worst of it is over - it's a sign of the fever breaking.

I usually take time off for the length of the ACT, and I'm generally okay to work by the time I'm done with it. It might take up to a week afterwards for the fatigue and lowered appetite to completely lift though. All in all, it's rather like the flu in that the vast majority of otherwise healthy people just manage it at home, but different in that there's a known, effective treatment for malaria so you can avoid most of the suffering altogether if you can afford to be responsible with your health.