Going somewhere hot and humid? What you should know about malaria!
If you plan to visit a country with a warm and humid climate you definitely should be aware of malaria, a potentially serious disease occurring in tropical and subtropical regions in a wide band around the equator. Affected are areas like Africa, Central and South America, the Caribbean, South and Southeast Asia, the Middle East and the South Pacific.
Some of the malaria-related information on the internet might sound scary, for example that at present there is no effective vaccination against it. But don’t let that stop you. Instead inform yourself, follow the recommendations about prevention and precaution and you’ll be well prepared for a memorable journey.
The aim of this article is not to tell you everything about malaria or to make any final recommendations, but we want to at least make you aware of the risks and best practices, and to also give you a list of topics that you should educate yourself about.
By the way, in many countries there is a separate branch of medicine called “travel medicine” or “tropical medicine.” In Germany it’s called Reise- or Tropenmedizin, and you simply go to the doctor, list your destinations and they immediately tell you which pills or vaccinations (if any) you need for your trip. They’ll also give you the shots: all together or in several sessions, depending on the necessary medication.
Malaria is transmitted by the bite of an infected female Anopheles mosquito. Biting habits vary somewhat, but female Anopheles are mostly active between dawn and dusk.
So not every mosquito bite is infectious, but prevention is essential even during the daytime since there are other mosquitoes that transmit other diseases, like dengue fever, etc.
These are somewhat annoying, but effective nonetheless:
- Use an effective mosquito repellent (this varies by region, so ask a local doctor or the locals what works best).
- Keep doors, windows and other openings closed to prevent the entry of mosquitoes.
- Light up an anti-mosquito spiral when sitting outside.
- Very important: use a bed net. But don’t obsess about the choice of insecticide-impregnated or not, since the insecticide wears off quite quickly.
- If you go outside after sunset wear loose-fitting clothing with long sleeves, socks and long trousers.
Even though there is no vaccination against malaria, there are various medications that you can take to prevent infection with malaria (malaria prophylaxis).
“Prevention” means that you take a small dose of pills before, during and after spending time in an area threatened by malaria. This works very well for most people, but it does not guarantee 100% prevention.
Note that you should definitely continue to take the pills as prescribed (even after returning back home).
There is also a possibility of side-effects (nausea, hallucinations), especially with Lariam, but luckily it has mostly been replaced by newer, better tolerable medications (Malarone, Atovaquon, etc.).
Emergency Treatment (Stand-By)
These are the first signs of a malaria infection:
- fever (don’t forget to take a thermometer)
- discomfort (you may feel cold, shivery, shaky and sweaty)
- muscle pain, tenderness
- the whites of the eyes and the skin turn yellow
If you experience some combination of these, even if you took malaria prophylaxis, seek medical attention ASAP. Simple, cheap, quick and reliable tests are usually available in malaria-prone countries, and malaria is curable if discovered quickly and treated properly.
The same medication which is used as prophylaxis is also used as treatment, but in a much higher dose. If you believe that you have malaria and cannot find a doctor, start taking the medication according to the instruction leaflet. If you vomit after swallowing a pill, take another one immediately.
Prevention or Stand-By
This is not an easy question. Most prophylaxis can only be taken for a limited period of time (a few months), so if you are spending a longer time in an endangered area, you are limited to physical prevention (see above) and stand-by medication.
On the other hand, the emergency treatment is primarily for saving lives, so take prophylaxis whenever the duration of stay is limited and the risk is high.
Cost and Sources of Medication
Malaria medication is usually quite expensive and it might only be available via prescription, so you might be tempted to buy it abroad. According to German doctors this is not a good idea because you don’t know if you are getting the genuine medication, if it is full-strength, if it has been stored properly, etc.
You might also be tempted to save money by not doing the full prophylaxis (before and after the trip). This too is a bad idea, because you will not have the full protection, which makes the malaria parasites more resistant to the medication.
But just to end on a positive note, some health insurance companies (at least some in Germany) cover the complete costs of your anti-malaria medication.
We hope this information doesn’t frustrate or discourage you. Amazing countries and unique experiences are awaiting you, so know the facts, take physical prevention and prophylaxis seriously, and you will be reducing the risks of infection significantly.
We assure you it’s worth the effort! 😉
Selected sources of further information:
- The Guidelines for malaria prevention in travellers from the UK are incredibly detailed. The country recommendations (page 38ff), the traveller information leaflet (page 57) and the FAQ (page 80ff) are very helpful.
- Information from the World Health Organization about malaria.
- Wikipedia article about malaria tests.