Malaria – April International UK offers advice on what you need to know before travelling

This life threatening disease is caused by parasites that are transmitted to people through the bites of infected mosquitoes. Prevention is certainly better than cure, as any bout of malaria is likely to reoccur throughout life.

Malaria is still common in many parts of the world, although it is usually more prevalent in rural areas than major cities. Approximately 40% of the world’s population - mostly those living in the poorest countries - are at risk of malaria. Of these, more than 500 million become severely ill with malaria every year and more than one million die from the effects of the disease.
Expatriates and international businessmen travelling from malaria-free areas to disease ‘hot spots’ are especially vulnerable to the disease, as they have a low natural immunity and little resistance to the disease. An even higher category of risk is pregnant women, as the illness can result in high rates of miscarriage and maternal death. Most malaria cases and deaths are in sub-Saharan Africa. However 109 countries in total can be affected, including: Asia, Latin America, the Middle East and parts of Europe, so it is crucial that travellers check whether malaria precautions are needed.

Malaria transmission rates can differ depending on local factors such as rainfall patterns, the proximity of mosquito breeding sites and the types of mosquito species in the area, so some areas are more dangerous at certain times of the year. A local Doctor or travel clinic will be able to let you know whether your forthcoming trip or relocation should involve malaria preventative medicine.

You cannot be vaccinated against malaria, but you can protect yourself in a number of ways:

Basic precautions include:
• Mosquitoes bite at any time of day but most bites occur in the evening, so use mosquito nets for night time, and insect repellent for the body and the room.
• If you are out at night wear long sleeved clothing and long trousers.
• Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin.
• If sleeping in an unscreened room or out of doors, a mosquito net (which should be impregnated with insecticide) is a sensible precaution. Portable, lightweight nets are available.
• Garlic, Vitamin B and ultrasound devices do not prevent bites.

Taking Anti-Malaria Tablets
• Start before travel as guided by your travel health advisor -with some tablets you should start three weeks before, so make sure you check well before any trip.
• Take the tablets regularly, preferably with or after a meal.
• It is extremely important to continue to take them for four weeks or as directed after you have returned, to cover the incubation period of the disease. Atovaquone/proguanil (Malarone) requires only 7 days post-travel)

Drugs Most Commonly Used for Malaria Prevention
Travellers must always ensure they use a drug which they can tolerate and one which is appropriate for their destination(s). Your doctor or pharmacist will give advice in this respect, but remember, no drug is 100% effective.
In Britain, chloroquine and proguanil can be purchased from local pharmacies or chemists. All other drugs require a doctor's prescription.

Symptoms
The common first symptoms of malaria are fever, headache, chills and vomiting, which usually appear 10 – 15 days after a person is infected. If not treated promptly with effective medicines, malaria can cause severe illness and is often fatal.

Prompt Treatment
If you do get a fever between one week after first exposure and up to one year after your return, you should seek medical attention immediately and tell the doctor that you have been in a malaria infected area, so they know to check for the disease. Otherwise, it could go unnoticed for several days.

Debbie Purser, CEO at April International UK, specialist provider of international healthcare insurance to both individuals and company employees, commented: “Malaria is still virulent in many parts of the world, although many governments and charitable organisations such as The Bill and Melinda Gates Foundation are working hard to reduce the number of deaths from malaria in Africa. In the meantime, travellers should be cautious and be aware of the dangers of this sometimes fatal disease. There is no vaccine against this disease and so despite precautions, visitors can sometimes be prone to infection. Finding the right international health insurance policy which allows for flexibility, provides 24 hour access to trained medical staff on the phone and of course includes repatriation is also key, as depending on which part of the world you are visiting, the right treatment may not be available locally.”