Winter sun seekers – how to prevent malaria

Pharmaceutical Manager at Bupa UK
08 January 2018

After the festive period is over, lots of us look forward to getting some winter sun abroad. However, it’s important to remember travel risks, such as malaria. I recently travelled to Sierra Leone in Africa and it reminded me how serious malaria is, and how important it is to take the right precautions when visiting an affected country.

Here I explain the symptoms, how it spreads and how you can prevent it. I also encountered some common malaria myths while I was away, which I’ve covered here too.

A couple on holiday

What causes malaria?

Malaria is caused by the parasite Plasmodium. There are various types of Plasmodium, at least five of which can cause malaria in humans. After being bitten by an infected mosquito, the parasites develop in your liver before being transferred to your blood. Although the illness is preventable and curable, in 2016 there were an estimated 216 million cases of malaria across 91 countries.

What are the symptoms of malaria?

The symptoms of malaria include fever, headache and muscle pain, which is the body’s response to the parasite. The first symptoms may be mild and difficult to recognise as malaria, so a blood test should be taken to confirm the diagnosis. If you feel unwell while you’re away and develop a fever, it’s important you get medical help as soon as possible (within 24 hours). If malaria isn’t treated, the most severe form of malaria can lead to death.

How is malaria spread?

Most of the time, malaria is transmitted through the bites of female Anopheles mosquitoes when they seek out a blood meal to nourish their eggs. Anopheles mosquitoes lay their eggs in water. These hatch into larvae and eventually emerge as adult mosquitoes. The African mosquito has a long life span and a strong human biting habit.

These are the main reasons why nearly nine in every ten of the world's malaria cases are in Africa. Malaria is also found in South-East Asia, Eastern Mediterranean countries, Western Pacific areas and the Americas. Transmission also depends on weather conditions, and in many places the peak is during and just after the rainy season.

How can malaria be controlled and prevented?

If you’re planning to travel abroad, it’s really important you get advice from your doctor or travel clinic about how to prevent getting bitten. They can also help you get any medicines you might need, such as antimalarial tablets.

Your doctor or nurse will explain that mosquitoes bite between dusk and dawn, so you need to be extra careful during those times. But it’s also a good idea to protect yourself at all times of the day. Sleep under an insecticide-treated net, use a DEET-based mosquito repellent (DEET is a common active ingredient in insect repellents), and wear clothing that reduces skin exposure. No one method is 100 percent effective so you need to use all methods of protection. Even if you’re taking antimalarial tablets, you still need to take a proactive and combined approach to preventing bites.

Travel clinics can provide advice about if you need vaccinations or tablets for your trip, as well as the UK foreign travel advice website. It’s really important to take an active role in preventing malaria because it’s a global problem, and we can all do our part.

While I was in the travel clinic my adviser took pleasure in busting several malaria myths which I’ve outlined below.

Malaria myths

1) “I use mosquito repellent, so I won’t get malaria.”

It takes just one mosquito to infect a person. Repellent tends to reduce the number of bites but not completely eliminate them. It’s therefore a good idea to take antimalarial tablets as well as using repellent when travelling to high risk countries.

2) “I don’t take medicines because of the side-effects.”

There are now a variety of antimalarial medicines. Your doctor or travel medicine specialist can help you to choose one that works best for you.

3) “I’ll only take the medicines if I start feeling ill.”

As the initial symptoms can occur 10–15 days after infection, taking medicines only when you start to feel ill is likely to be too late. The disease may also get worse very quickly after the initial symptoms, and so those tablets wouldn’t be effective or helpful.

4) “You have to take anti-malarial medicines for a long time after you have left the country.”

The most commonly prescribed antimalarial tablet is called Atovaquone/Proguanil. You will need to take it once a day for a week after leaving a malaria affected area.

Check with your doctor which type of medicine you’re taking, as some need to be taken for longer (four weeks) after leaving an area that has malaria. Taking tablets for seven days or four weeks may be a small price to pay for avoiding a full malaria infection.

5) “Antimalarial tablets might mask the symptoms and cause the disease to go undiagnosed.”

If you take the medicines as your doctor advises you to, the tablets will kill any malaria parasites which enter your body before they can cause the disease. Remember though to use all methods of protection, as antimalarials are effective in about nine in every ten cases. They aren’t always effective.

7) “I’ll be staying in a hotel, so there’s no risk of me getting malaria.”

Hotels do make every effort to ward off mosquitoes with mosquito nets and sprays, and fans and air conditioning do help. But don’t rely on this – there is still a very real risk of catching malaria both inside and outside the hotel.

8) “I heard pregnant women can’t use antimalarials.”

Women who are pregnant are advised to avoid travelling to high-risk malaria areas entirely, because of the serious consequences for mum and baby of a malaria infection.

Women who are pregnant are more likely to get bitten and to get severe malaria. Rarely, malaria can pass from mum to baby. If the journey is unavoidable some antimalarial medicines are safe to use during pregnancy. It’s important to speak to your doctor if you’re pregnant and need to travel to high-risk areas.

Seek proper, professional health advice for your particular journey and circumstances. This will give you peace of mind, leaving you free to enjoy your trip abroad.

Logo for Masta, who Bupa works in partnership with to deliver travel health servicesBupa is proud to work in partnership with MASTA - the Medical Advisory Service for Travellers Abroad - to deliver travel health services including travel health advice, vaccinations, and antimalarials. Travel services are available at a range of Bupa Health Centres. MASTA‘s services are also available to those aged under 18.

Justin Hayde-West
Pharmaceutical Manager at Bupa UK

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