Steps to Avoid Contracting Malaria

 

By Dr.Adam Huber (MBBS)

Planning steps to reduce the risk of contracting Malaria while visiting or living in an endemic area should be high on the list of your travel priorities.  It’s a disease that’s fairly easy to catch and not so easy to shake; infection can be fatal or cause lifelong symptoms.  Travellers can often be careless when it comes to malaria: but the risks are not to be taken lightly.

How is the disease transmitted?

Malaria is transmitted by a certain type of mosquito (anopheline) which feeds at night.  Dusk and dawn are particularly active times. Be aware that mosquitoes that bite during the day may still carry other nasties such as dengue fever; so no bite is safe!

What are the consequences?

Once the malarial mosquito bites you, it injects a bug into your blood. There are 4 species of this bug. The most nasty is called p. falciparum which can be fatal if left untreated in as little as three days.  Treatment is usually through a high dose of anti Malaria drugs. The good news is that the disease can be fully cured if caught early enough, though relapses can occur throughout the rest of an infected person’s life.  Not nice.

Symptoms typically involve the onset of a high fever, chills, sweats, fatigue and you will feel generally crook. It sucks.

mossiepage Steps to Avoid Contracting Malaria

Where is Malaria prevalent?

You must be informed on the area to which you are travelling.  The risks of getting malaria are different from country to country and region to region. It pays to use the resources listed here and to talk to a travel health specialist if you are heading to an area known to be endemic with malaria.

The US Centre for Disease Control and Prevention has a comprehensive listing of Malaria affected areas (www.cdc.gov/MALARIA/risk_map).

For information on the spread of the disease and the dramatic effects on billions of people worldwide, see the World Health organisation’s site, in particular this article (www.who.int/features/factfiles/malaria/en/index.html).

Important things to consider

No Malaria tablet is 100% effective in preventing the disease

  • The best defence is simply not to get bitten, or to at least take all the steps you can to avoid getting bitten
  • You should take Malaria tablets as prescribed; see your doctor well in advance of your trip as some medications must be started well before you enter the at risk area, and taken for a period after you leave
  • Treat fevers immediately:  any fever in a malarial region (even if it occurs after you get home) should be considered to be malaria until proven otherwise – get to a doctor as soon as you can to be tested.

Prevention myths

Travellers seem to have many different methods of preventing bites, including things like taking Garlic capsules (the smell in your sweat supposedly keeping bugs at bay) and taking high amounts of vitamin B.  There is NO PROOF these actually work.

See your doctor and take the proper anti malarial tablets he prescribes to you. There are a few options. You need to tell your doctor your specific travel plans and ask about the possible side effects of the tablets you choose as there are a few different options.  See the page on Malaria medication for more information.

If you can prevent mosquito bites, you can prevent getting malaria

Some important tips for preventing bites:

  • Cover up! Light coloured long sleeve pants and shirts, plus long socks, preferably treated with repellent such as Permethrin (see below) should be worn if you are outside near dusk or dawn and while you sleep.
  • Dark colours attract mossies, as does strong smells so it’s best to avoid using scented deodorant or perfume/aftershave.
  • Use Mosquito repellent as regularly as possible.  Repellents with DEET as a major ingredient (check for those with over 30% such as ‘Bushmans’) are the most effective.  If you are using sunscreen as well let it soak in for at least twenty minutes before applying the repellent.
  • Repellents with over 50% DEET are usually not recommended.  These repellents can feel like they are taking your skin off, and are to be used only in high risk areas
  • Sleeping in an air-conditioned room under a treated mosquito net is recommended.  Always check your net for holes before you sleep (bring one from home as possible backup). If there’s no air-con, sleeping next to a fan is the next best bet, along with burning mosquito coils while you sleep. Cover exposed skin with repellent religiously.

Permethrin is an insecticide used to treat fabrics and mossie nets that has been shown to be highly effective in deterring the devious little biters.  If looking for a mozzie net try and get one that’s been treated with this stuff, same goes for your clothing.  You can buy the repellent and treat any of your clothes or nets – just follow the instructions carefully.

Best practice

  • Travelling with a thermometer is always good practice, especially so when in a malaria area.  A higher than normal temperature should be treated with urgency, as though you have Malaria.  You can still get the disease when taking tablets and no method of prevention is 100% effective.
  • The disease is diagnosed with a simple blood test.  Some people working or travelling in areas well out of range of medical care might take a self diagnosis kit, but this is for a minority.   With any suspicion just make your way to the nearest medical care asap!.
  • Mossies and other biting insects can be responsible for the transmission of a number of different diseases (e.g. sleeping sickness, Japanese B Encephalitis, dengue fever etc).  You need to be informed on these as well.
  • As always see your GP for the latest info well before you travel.  With the right precautions you will be able to enjoy travel in affected areas while minimising the risks.

For information on the spread of the disease and the dramatic effects on billions of people worldwide see the World Health organisation’s site, in particular this article (www.who.int/features/factfiles/malaria/en/index.html).

For a positive development in the fight against the disease this article from the LA times has news of a new malaria vaccine being trialled in Africa (http://latimesblogs.latimes.com/booster_shots/2009/11/massive-malaria-vaccine-trial-has-begun-in-africa.html).

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