Netflix's new adaptation of Little House on the Prairie devotes its fourth episode to a malaria outbreak that strikes the Ingalls family in Independence, Kansas, and showrunner Rebecca Sonnenshine has explained how she dramatised the ordeal. Rather than simply depicting characters bedridden with fever — which she felt was not inherently a story — she used their hallucinations as a device to reveal the family's backstory, giving the illness narrative genuine stakes and filling in why the Ingallses left Wisconsin without their relatives.

In the fever dreams, Pa (Luke Bracey) sees his younger brother George (Connor Paton), who ran away to fight in the Civil War, while Ma (Crosby Fitzgerald) envisions her sister Eliza (Catherine Bérubé), who opposed her departure with Charles. The episode draws on the "Fever 'N' Ague" chapter of Wilder's novel, ties into a letter from Caroline's sister introduced in episode three, and features Dr George Tann (Jocko Sims). Young Laura (Alice Halsey) avoids the fever at first — possibly owing to the coffee she drinks with Pa — leaving her "the last one standing" until she too begins seeing visions of her grandmother (Megan Follows) back in the Big Woods of Wisconsin.