i had to write a paper on malaria when I was an undergrad years ago, taking a microbiology class. it's truly a marvel of nature, or maybe even extra-terrestrial
I just did some digging, and found that the 2 strains common in the US were
P. falciparum and P. vivax, the #1 and #2 worst strains to get. Malaria helped Washington's forces cause Cornwallis to surrender. Anyway, I had always assumed that the malaria endemic here would have been the two milder forms
P. ovale and
P. malariae
Of them all, faciparum is the most prolific reproducer. It can be bad news because the concentration of parasites (each parasite invades a red blood cell and destroys it, causing it to rupture) can be as high as about 2 million per cubic mm of blood. Average human RBC concentration is about 5 million RBCs per cubic mm of blood. That would be hemolysis of about 40% of your red blood cells in a single day. Death in this manner ends up being hypoxia/anoxia
It's bad enough when all of this hemolysis occurs in arteries and veins, but all the gas exchange occurs in capillaries. A capillary is only just big enough in diameter to allow 1 RBC to pass through at a time. If an RBC lyses in a capillary, that particular capillary network is now effectively clogged, because the innards of RBCs are kinda gooey and sticky.