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How to prevent malaria while travelling
T
here are many myths
surrounding the disease,
ranging from “I hardly ever
get bitten by mosquitoes
so I’m not at risk” to “I am
staying in a five star hotel so I’ll be
fine”, but the facts are that it only takes
one bite from an infected mosquito to
contract malaria.
British travellers are increasingly
visiting malaria hotspots with a
200% increase in travel in the past
fifteen years. As they visit more
exotic locations they are increasingly
putting their health at risk by not
taking the correct precautions. Travel
should be fun but people should be
malaria aware.
Where in the world
Malaria can be found in over 100
countriesthatarevisitedbymorethan
125 million international travellers
every year. High risk areas are usually
found throughout the equatorial
regions where the climate is hot and
wet throughout the year. Over two
thirds of malaria cases are contracted
in Africa and protection is still needed
in parts of Central South America and
South East Asia. Travellers in central
and South America, especially areas
in the northern Amazon rainforest,
should also take precautions.
How does the disease spread?
The disease is spread by the female
Anopheles mosquito, which transfers
the plasmodium parasite when it
feeds on human blood. This particular
mosquitolikestobitebetweensunrise
and sunset. There are four different
species of the Plasmodium parasite
each developing varying severities of
The Travel Magazine March 2015
By Sharron Linvingston
Malaria, one of the
world’s biggest killers,
is an infectious
disease passed on by
a mosquito bite. The
following separates
facts from myths,
answers frequently
asked questions and
helps prevent malaria
while travelling.
© PD-USGov-HHS-CDC
malaria:
1.	Plasmodium falciparum (the
most lethal form)
2.	Plasmodium vivax
3.	Plasmodium ovale
4.	Plasmodium malariae
Once a person is bitten by an infected
mosquito, the plasmodium parasite is
released into the bloodstream where
it makes its way to the person’s liver.
The parasite can travel to the liver
within 30 minutes where it will
rapidly multiply before re-entering
the bloodstream to attack the red
blood cells.
www.thetravelmagazine.net
Myth: I hardly ever get bitten and
barely react to mosquito bites so I
don’t need antimalarials
Fact: Everyone’s bodies react
differently to mosquito bites but this
is no indication of whether you have
been bitten by a malaria-carrying
mosquito. It only takes one bite to
contract malaria
Myth: Antimalarials are not 100%
effective therefore there is no point
taking them
Fact: Antimalarials tend to be
between 90 – 100% effective, and
in combination with good bite
prevention, can help stop you
contracting malaria. Remember,
malaria can be deadly
March 2015The Travel Magazine
How should travellers
protect themselves?
Although our taste for travel to
exotic destinations has grown,
unfortunately our attitudes to
pre-travel health advice is not
quite as adventurous. A survey in
2003 revealed that nearly 60% of
respondents failed to seek travel
health advice, while a quarter of
those surveyed were unaware of the
risk. As well as misconceptions about
how dangerous malaria is, there are
also many myths about how people
should protect themselves. People
may falsely believe that staying in
five star hotels will offer protection.
The fact is that mosquitoes don’t
discriminate between someone
staying in five star luxury and
someone sleeping rough in the jungle
– they will bite you whatever type of
accommodation you are in.
Before travel
It is imperative that travellers know
whether or not the country they are
visiting is malarious. They should
seek advice from their healthcare
professional before travelling in
order to obtain the right information.
Travellers should take their itinerary
to their doctor at least eight weeks
before they are due to travel but can
still seek advice at the last minute.
Some advice/protection is better than
none.
There are different forms of anti-
malarial medication – a health-care
professional (GP, practice nurse or
travel clinic) will be able to advise on
the most suitable one.
During travel
The risk of being bitten can be
minimised by using insect repellent
with 50% DEET (diethyltoluamide)
on both skin and cotton clothes. Keep
arms and legs covered at night and
sleepunderanimpregnatedmosquito
net, if possible in an air conditioned
room with screens on the windows.
If a traveller has been prescribed
antimalarials the important thing is
to continue to take the medicine as
instructed.
After travel
It is vital that travellers complete the
prescribed course once they have
returned home from their trip as the
parasite can lay dormant in the liver
for some time. Medical attention
should be sought immediately if flu-
like symptoms such as: headache,
vomiting, fatigue and fever develop.
Symptoms of the most deadly form
of malaria are usually experienced
between one week and three months
after infection. Other less dangerous
forms of the disease can manifest
symptoms more than a year after the
person has been bitten.
Myth: All antimalarials have bad
side-effects, which are worse than
catching malaria
Fact: Catching malaria could put
you in hospital and out of action for
weeks, or even kill you. There are
different types of antimalarials – talk
to your healthcare professional about
the best one for you
Myth: I’m taking homeopathic
medicines to protect against malaria
so I don’t need to do anything else to
protect myself
Fact: There is no evidence that
homeopathic or herbal medication
will protect you from malaria. Seek
advice on antimalarial medication
from a healthcare professional before
you travel.
Malaria myths
It is important that UK travellers
separate myths from facts when
protecting themselves from a deadly
disease such as malaria:
Some common myths:
•	 Garlic, vitamin B and ultrasound
devices will not protect you
against malaria
•	 Eating Marmite® or other
savoury yeast extract spreads will
not prevent malaria
•	 Staying in a four or five star hotel,
will not stop you getting bitten or
contracting malaria. Mosquitoes
don’t discriminate
•	 Drinking gin and tonic will not
stop you getting bitten
Key Facts
•	The UK is one of the biggest
importers of malaria among
industrialised countries.
•	Every year approximately
2,000 British travellers return
home with malaria.
•	It only takes one bite from an
infected mosquito to contract
malaria.
•	Malariaisaninfectiousdisease
caused by a tiny parasite that
invades red blood cells.
•	Malaria can present from
any time from about a week
up to a year after exposure.
Over 50% of cases among UK
travellers tend to be people
aged between 25 and 54.
•	The incidence of malaria in
children has tripled over the
past 30 years.
•	Malaria is a preventable
infection but can be fatal if left
untreated – an average of nine
people in the UK die each year
of malaria.
•	Travellers are at risk when
visiting malarious destination
areas without taking bite
avoidance measures and
antimalarial medication.
www.thetravelmagazine.net
March 2015The Travel Magazine
QIs malaria a real danger to British
travellers?
AUnfortunately the answer is yes.
Travel figures have revealed an
increase of nearly 150% in travel to
popular malarious destinations such
as Africa and India over the past
ten years. Every year, some 2000 UK
travellers contract malaria and on
average nine will die as a result of
infection. Even if treated, malaria can
be painful and debilitating, so it is
advisable to protect yourself.
Your healthcare professional will
know if you are travelling to an at-
risk destination and will be able to
offer you advice about preventing the
disease.
QHow can I contract malaria?
AMalaria is an infectious disease
that is transmitted by certain
types of mosquito. It only takes one
bite from an infected mosquito to
contract malaria. While feeding on
your blood, an infected mosquito
releases the malaria parasite into
your body, which rapidly goes to the
liver and reproduces before spreading
back into your bloodstream.
QDo I really need to bother taking
precautions?
AYes, malaria is potentially very
dangerous. The good news is that
it is preventable by avoiding getting
bitten in the first place and by taking
antimalarial medication.
In most cases it can be treated if
diagnosed quickly enough, so if you
suffer from flu-like symptoms having
visited a malarious country within
the past year, then you should seek
immediate medical help from your
doctor.
QIn which countries can I contract
malaria? Am I safe if travelling
in the dry season?
AMalaria exists in areas such
as Africa, South America, Asia
and South East Asia. In some areas
mosquitoes may be more active
duringthewetseason,butmosquitoes
can bite all year round. You should
not assume that by travelling in the
‘dry season’ you are safe as it only
takesonebitebyaninfectedmosquito
at any time of the year to contract
malaria. Your healthcare professional
will be able to tell you if your
destination is malarious and give you
the right advice and medications.
QI have heard that the side-effects
of antimalarial medications
are unpleasant, even worse than
catching malaria. Is this true?
AAntimalarial medications can
cause some side effects, but there
are different types available and your
healthcare professional will advise
you as to which one is right for you.
Malaria can put you in hospital
for weeks and can be fatal in some
cases. It is better to protect yourself
against malaria than risk contracting
a potentially fatal disease. If you have
concerns, speak to your healthcare
professional.
QI have heard that some
antimalarial medications are
ineffective as malaria has become
resistant to them, is this true?
AIn some parts of the world, some
of the older drugs may not give
full protection. It is best to speak to
your healthcare professional who
can give you up-to-date information
on all medications and which ones
are suitable for you and the countries
you are travelling to.
QWhen I have travelled before,
other travellers seem to be
taking different medication to protect
against malaria. Why is this?
AThere are a number of different
medications and different ones
suit different people. What’s right
for one traveller may not be right
for another. Also, other travellers
may be following a completely
different itinerary to you and taking
a medication that’s suitable for their
particular destination. You should
always keep to the advice given to
you by your healthcare professional
who should have taken your travel
itinerary and individual health needs
into account. Above all, maintain
taking your medication and don’t be
swayed into doing otherwise.
QFellow travellers have told
me that I don’t need to use
antimalarials, I wonder if I should
bother?
AWhile fellow travellers are a
great source of information for
where to go, what to see and how
Malaria: Frequently Asked Questions
A swamp in Cambodia © Leon petrosyan/wimimedia
www.thetravelmagazine.net
The Travel Magazine March 2015
to get about in different countries,
they are probably not completely
up to speed about travel health. It
is strongly recommended that you
seek expert pre-travel health advice
six to eight weeks before you travel
to ensure that you are protecting
yourself against malaria and other
infectious diseases.
QI am only travelling to a
malarious area for two days
throughout my entire trip, is it worth
taking antimalarial medication for
such a short duration?
AYes, as it only takes one bite from
an infected mosquito to contract
malaria. Take your travel itinerary to
a health care professional six to eight
weeks before you travel and explain
where you will be travelling to and
how long you will be staying. You
will be advised whether you need
to take antimalarial medication and
how long you should take them for. It
is important to follow the advice you
are given to ensure you are protected
against malaria during and after your
travels.
QI have been given antimalarial
medication which I’ve been told
I have to keep taking after I get back
from my trip. Is this right?
AAll antimalarial medication
needs to be taken before, during
and after your travels. Taking it
everyday and completing the full
course is very important. This is
because the malaria parasite can
sit in the liver long after you’ve left
the malarious area. It needs to be
eradicated by fully completing the
course of medication. Failure to do so
could be fatal.
QI’ve heard that if I eat garlic this
will stop me from being bitten by
a mosquito and help prevent malaria.
Is this true?
AThere are a lot of myths and
inaccurate information about
protecting yourself from malaria.
There is no scientific evidence that
eating garlic, Marmite® (or any other
savoury yeast extract), or taking
vitamin B will protect you from
malaria. There is also no scientific
evidence that homeopathic or herbal
medications are effective against
malaria. Seek advice on how to avoid
getting bitten and on antimalarial
medication from a healthcare
professional before you travel.
QMy friend is from Africa and he
is going home to visit his family
for three weeks. He says he doesn’t
need to take any protection as he was
born there and is immune to malaria.
Is this true?
AIf the endemic population
are fortunate enough not to
contract malaria in childhood they
may develop a natural immunity to
the disease. However, if they leave
a malarious area for six months or
longer that immunity fades. If your
friend is returning home then he is
potentially at risk of contracting the
disease. He is best to take pre-travel
advice from a healthcare professional
and not to assume he is safe, as it
only takes one bite from an infected
mosquito to catch malaria.
QWhere can I get advice about
malaria?
AYou should book an appointment
with your healthcare profess-
ional six to eight weeks before your
travels. Many local surgeries operate
dedicated travel health clinics
managed by a specialist travel nurse.
It’s worth telephoning your surgery
to find out if they offer this clinic and
on what day of the week you will be
able to visit the clinic. Pharmacists
will be able to offer you some travel
health advice, but they will not be in
a position to offer you the full range of
anti malarial medications as you may
need a prescription for these. The other
option is a private travel clinic, which
can be found in your local directory.
QWhat happens if I do contract
malaria?
AMalaria, though potentially
fatal, is treatable if diagnosed
quickly. If while travelling or
within one year of travelling, you
developflu-like symptoms (such as
fever, chills, pain, weakness, muscle
aches, vomiting, cough, diarrhoea or
abdominal pain) you must urgently
seek medical attention and tell your
doctor that you have been travelling
in a malarious area.Antimalarial drug © Tomhannen/wikimedia
www.thetravelmagazine.net

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How to prevent malaria while travelling

  • 1. How to prevent malaria while travelling T here are many myths surrounding the disease, ranging from “I hardly ever get bitten by mosquitoes so I’m not at risk” to “I am staying in a five star hotel so I’ll be fine”, but the facts are that it only takes one bite from an infected mosquito to contract malaria. British travellers are increasingly visiting malaria hotspots with a 200% increase in travel in the past fifteen years. As they visit more exotic locations they are increasingly putting their health at risk by not taking the correct precautions. Travel should be fun but people should be malaria aware. Where in the world Malaria can be found in over 100 countriesthatarevisitedbymorethan 125 million international travellers every year. High risk areas are usually found throughout the equatorial regions where the climate is hot and wet throughout the year. Over two thirds of malaria cases are contracted in Africa and protection is still needed in parts of Central South America and South East Asia. Travellers in central and South America, especially areas in the northern Amazon rainforest, should also take precautions. How does the disease spread? The disease is spread by the female Anopheles mosquito, which transfers the plasmodium parasite when it feeds on human blood. This particular mosquitolikestobitebetweensunrise and sunset. There are four different species of the Plasmodium parasite each developing varying severities of The Travel Magazine March 2015 By Sharron Linvingston Malaria, one of the world’s biggest killers, is an infectious disease passed on by a mosquito bite. The following separates facts from myths, answers frequently asked questions and helps prevent malaria while travelling. © PD-USGov-HHS-CDC malaria: 1. Plasmodium falciparum (the most lethal form) 2. Plasmodium vivax 3. Plasmodium ovale 4. Plasmodium malariae Once a person is bitten by an infected mosquito, the plasmodium parasite is released into the bloodstream where it makes its way to the person’s liver. The parasite can travel to the liver within 30 minutes where it will rapidly multiply before re-entering the bloodstream to attack the red blood cells. www.thetravelmagazine.net
  • 2. Myth: I hardly ever get bitten and barely react to mosquito bites so I don’t need antimalarials Fact: Everyone’s bodies react differently to mosquito bites but this is no indication of whether you have been bitten by a malaria-carrying mosquito. It only takes one bite to contract malaria Myth: Antimalarials are not 100% effective therefore there is no point taking them Fact: Antimalarials tend to be between 90 – 100% effective, and in combination with good bite prevention, can help stop you contracting malaria. Remember, malaria can be deadly March 2015The Travel Magazine How should travellers protect themselves? Although our taste for travel to exotic destinations has grown, unfortunately our attitudes to pre-travel health advice is not quite as adventurous. A survey in 2003 revealed that nearly 60% of respondents failed to seek travel health advice, while a quarter of those surveyed were unaware of the risk. As well as misconceptions about how dangerous malaria is, there are also many myths about how people should protect themselves. People may falsely believe that staying in five star hotels will offer protection. The fact is that mosquitoes don’t discriminate between someone staying in five star luxury and someone sleeping rough in the jungle – they will bite you whatever type of accommodation you are in. Before travel It is imperative that travellers know whether or not the country they are visiting is malarious. They should seek advice from their healthcare professional before travelling in order to obtain the right information. Travellers should take their itinerary to their doctor at least eight weeks before they are due to travel but can still seek advice at the last minute. Some advice/protection is better than none. There are different forms of anti- malarial medication – a health-care professional (GP, practice nurse or travel clinic) will be able to advise on the most suitable one. During travel The risk of being bitten can be minimised by using insect repellent with 50% DEET (diethyltoluamide) on both skin and cotton clothes. Keep arms and legs covered at night and sleepunderanimpregnatedmosquito net, if possible in an air conditioned room with screens on the windows. If a traveller has been prescribed antimalarials the important thing is to continue to take the medicine as instructed. After travel It is vital that travellers complete the prescribed course once they have returned home from their trip as the parasite can lay dormant in the liver for some time. Medical attention should be sought immediately if flu- like symptoms such as: headache, vomiting, fatigue and fever develop. Symptoms of the most deadly form of malaria are usually experienced between one week and three months after infection. Other less dangerous forms of the disease can manifest symptoms more than a year after the person has been bitten. Myth: All antimalarials have bad side-effects, which are worse than catching malaria Fact: Catching malaria could put you in hospital and out of action for weeks, or even kill you. There are different types of antimalarials – talk to your healthcare professional about the best one for you Myth: I’m taking homeopathic medicines to protect against malaria so I don’t need to do anything else to protect myself Fact: There is no evidence that homeopathic or herbal medication will protect you from malaria. Seek advice on antimalarial medication from a healthcare professional before you travel. Malaria myths It is important that UK travellers separate myths from facts when protecting themselves from a deadly disease such as malaria: Some common myths: • Garlic, vitamin B and ultrasound devices will not protect you against malaria • Eating Marmite® or other savoury yeast extract spreads will not prevent malaria • Staying in a four or five star hotel, will not stop you getting bitten or contracting malaria. Mosquitoes don’t discriminate • Drinking gin and tonic will not stop you getting bitten Key Facts • The UK is one of the biggest importers of malaria among industrialised countries. • Every year approximately 2,000 British travellers return home with malaria. • It only takes one bite from an infected mosquito to contract malaria. • Malariaisaninfectiousdisease caused by a tiny parasite that invades red blood cells. • Malaria can present from any time from about a week up to a year after exposure. Over 50% of cases among UK travellers tend to be people aged between 25 and 54. • The incidence of malaria in children has tripled over the past 30 years. • Malaria is a preventable infection but can be fatal if left untreated – an average of nine people in the UK die each year of malaria. • Travellers are at risk when visiting malarious destination areas without taking bite avoidance measures and antimalarial medication. www.thetravelmagazine.net
  • 3. March 2015The Travel Magazine QIs malaria a real danger to British travellers? AUnfortunately the answer is yes. Travel figures have revealed an increase of nearly 150% in travel to popular malarious destinations such as Africa and India over the past ten years. Every year, some 2000 UK travellers contract malaria and on average nine will die as a result of infection. Even if treated, malaria can be painful and debilitating, so it is advisable to protect yourself. Your healthcare professional will know if you are travelling to an at- risk destination and will be able to offer you advice about preventing the disease. QHow can I contract malaria? AMalaria is an infectious disease that is transmitted by certain types of mosquito. It only takes one bite from an infected mosquito to contract malaria. While feeding on your blood, an infected mosquito releases the malaria parasite into your body, which rapidly goes to the liver and reproduces before spreading back into your bloodstream. QDo I really need to bother taking precautions? AYes, malaria is potentially very dangerous. The good news is that it is preventable by avoiding getting bitten in the first place and by taking antimalarial medication. In most cases it can be treated if diagnosed quickly enough, so if you suffer from flu-like symptoms having visited a malarious country within the past year, then you should seek immediate medical help from your doctor. QIn which countries can I contract malaria? Am I safe if travelling in the dry season? AMalaria exists in areas such as Africa, South America, Asia and South East Asia. In some areas mosquitoes may be more active duringthewetseason,butmosquitoes can bite all year round. You should not assume that by travelling in the ‘dry season’ you are safe as it only takesonebitebyaninfectedmosquito at any time of the year to contract malaria. Your healthcare professional will be able to tell you if your destination is malarious and give you the right advice and medications. QI have heard that the side-effects of antimalarial medications are unpleasant, even worse than catching malaria. Is this true? AAntimalarial medications can cause some side effects, but there are different types available and your healthcare professional will advise you as to which one is right for you. Malaria can put you in hospital for weeks and can be fatal in some cases. It is better to protect yourself against malaria than risk contracting a potentially fatal disease. If you have concerns, speak to your healthcare professional. QI have heard that some antimalarial medications are ineffective as malaria has become resistant to them, is this true? AIn some parts of the world, some of the older drugs may not give full protection. It is best to speak to your healthcare professional who can give you up-to-date information on all medications and which ones are suitable for you and the countries you are travelling to. QWhen I have travelled before, other travellers seem to be taking different medication to protect against malaria. Why is this? AThere are a number of different medications and different ones suit different people. What’s right for one traveller may not be right for another. Also, other travellers may be following a completely different itinerary to you and taking a medication that’s suitable for their particular destination. You should always keep to the advice given to you by your healthcare professional who should have taken your travel itinerary and individual health needs into account. Above all, maintain taking your medication and don’t be swayed into doing otherwise. QFellow travellers have told me that I don’t need to use antimalarials, I wonder if I should bother? AWhile fellow travellers are a great source of information for where to go, what to see and how Malaria: Frequently Asked Questions A swamp in Cambodia © Leon petrosyan/wimimedia www.thetravelmagazine.net
  • 4. The Travel Magazine March 2015 to get about in different countries, they are probably not completely up to speed about travel health. It is strongly recommended that you seek expert pre-travel health advice six to eight weeks before you travel to ensure that you are protecting yourself against malaria and other infectious diseases. QI am only travelling to a malarious area for two days throughout my entire trip, is it worth taking antimalarial medication for such a short duration? AYes, as it only takes one bite from an infected mosquito to contract malaria. Take your travel itinerary to a health care professional six to eight weeks before you travel and explain where you will be travelling to and how long you will be staying. You will be advised whether you need to take antimalarial medication and how long you should take them for. It is important to follow the advice you are given to ensure you are protected against malaria during and after your travels. QI have been given antimalarial medication which I’ve been told I have to keep taking after I get back from my trip. Is this right? AAll antimalarial medication needs to be taken before, during and after your travels. Taking it everyday and completing the full course is very important. This is because the malaria parasite can sit in the liver long after you’ve left the malarious area. It needs to be eradicated by fully completing the course of medication. Failure to do so could be fatal. QI’ve heard that if I eat garlic this will stop me from being bitten by a mosquito and help prevent malaria. Is this true? AThere are a lot of myths and inaccurate information about protecting yourself from malaria. There is no scientific evidence that eating garlic, Marmite® (or any other savoury yeast extract), or taking vitamin B will protect you from malaria. There is also no scientific evidence that homeopathic or herbal medications are effective against malaria. Seek advice on how to avoid getting bitten and on antimalarial medication from a healthcare professional before you travel. QMy friend is from Africa and he is going home to visit his family for three weeks. He says he doesn’t need to take any protection as he was born there and is immune to malaria. Is this true? AIf the endemic population are fortunate enough not to contract malaria in childhood they may develop a natural immunity to the disease. However, if they leave a malarious area for six months or longer that immunity fades. If your friend is returning home then he is potentially at risk of contracting the disease. He is best to take pre-travel advice from a healthcare professional and not to assume he is safe, as it only takes one bite from an infected mosquito to catch malaria. QWhere can I get advice about malaria? AYou should book an appointment with your healthcare profess- ional six to eight weeks before your travels. Many local surgeries operate dedicated travel health clinics managed by a specialist travel nurse. It’s worth telephoning your surgery to find out if they offer this clinic and on what day of the week you will be able to visit the clinic. Pharmacists will be able to offer you some travel health advice, but they will not be in a position to offer you the full range of anti malarial medications as you may need a prescription for these. The other option is a private travel clinic, which can be found in your local directory. QWhat happens if I do contract malaria? AMalaria, though potentially fatal, is treatable if diagnosed quickly. If while travelling or within one year of travelling, you developflu-like symptoms (such as fever, chills, pain, weakness, muscle aches, vomiting, cough, diarrhoea or abdominal pain) you must urgently seek medical attention and tell your doctor that you have been travelling in a malarious area.Antimalarial drug © Tomhannen/wikimedia www.thetravelmagazine.net