Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness.
According to the Centers for Disease Control and Prevention (CDC), there are several medications recommended for the prevention of malaria in travelers. Determining which medication is best depends on several factors, such as your medical history and the amount of time before your scheduled departure. Strict adherence to the recommended doses and schedules of the antimalarial drug selected is necessary for effective protection.
Who is at risk?
The mosquitoes that spread malaria are found in Africa, Central and South America, parts of the Caribbean, Asia, Eastern Europe, and the South Pacific (See maps: Eastern Hemisphere and Western Hemisphere). Travelers going to these countries may get bit by mosquitoes and get infected.
There are three necessary aspects of the malaria life cycle:
- The Anopheles mosquito carries the parasite and is where the parasite starts its life cycle.
- The parasite (Plasmodium) has multiple subspecies, each causing a different severity of symptoms and responding to different treatments.
- The parasite first travels to a human‘s liver to grow and multiply. It then travels in the bloodstream and infects and destroys red blood cells.
Parasites of the genus Plasmodium cause malaria. Although there are many species of the malaria parasite Plasmodium, only five infect humans and cause malaria.
Plasmodium falciparum: found in tropical and subtropical areas; major contributor to deaths from severe malaria
P. vivax: found in Asia and Latin America; has a dormant stage that can cause relapses
P. ovale: found in Africa and the Pacific islands
P. malariae: worldwide; can cause a chronic infection
P. knowlesi: found throughout Southeast Asia; can rapidly progress from an uncomplicated case to a severe malaria infection
The most common Malaria symptoms are
- fever and chills,
- nausea and vomiting, and
- general weakness and body aches.
Protection from mosquitoes
Be aware that you are still at risk for malaria even with the use of protection.
To avoid mosquito bites, the CDC recommends the following:
- Apply insect repellent to exposed skin. The recommended repellent contains 20-35% percent N, N-Diethyl-meta-toluamide (DEET).
- Wear long-sleeved clothing and long pants if you are outdoors at night.
- Use a mosquito net over the bed if your bedroom is not air-conditioned or screened. For additional protection, treat the mosquito net with the insecticide permethrin.
- Spray an insecticide or repellent on clothing, as mosquitoes may bite through thin clothing.
- Spray pyrethrin or a similar insecticide in your bedroom before going to bed.
It’s not possible to avoid mosquito bites completely, but the less you’re bitten, the less likely you are to get malaria.
To avoid being bitten:
- Stay somewhere that has effective air conditioning and screening on doors and windows. If this isn’t possible, make sure doors and windows close properly.
- If you’re not sleeping in an air-conditioned room, sleep under an intact mosquito net that’s been treated with insecticide.
- Use insect repellent on your skin and in sleeping environments. Remember to reapply it frequently. The most effective repellents contain diethyltoluamide (DEET) and are available in sprays, roll-ons, sticks and creams.
- Wear light, loose-fitting trousers rather than shorts, and wear shirts with long sleeves. This is particularly important during early evening and at night, when mosquitoes prefer to feed.
Being aware of the risks
To check whether you need to take preventative malaria treatment for the countries you’re visiting, see the Fit for Travel website.
It’s also important to visit your GP or local travel clinic for malaria advice as soon as you know where you’re going to be traveling.
Even if you grew up in a country where malaria is common, you still need to take precautions to protect yourself from infection if you’re traveling to a risk area.
Nobody has complete immunity to malaria, and any level of natural protection you may have had is quickly lost when you move out of a risk area.