Security: Malaria

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What Is Malaria?
Malaria is a serious infectious disease characterized by high fevers and chills. It is spread among humans by mosquitoes in tropical areas. Malaria is caused by a blood-borne, microscopic, single-celled parasite.

There are four kinds of malaria that cause disease in humans: P. falciparum, P. vivax, P. ovale and P. malariae. P.falciparum malaria is the most serious strain. It can cause rapid death through shock and multiple organ failure if it is not recognized and treated promptly. P.falciparum is the most difficult strain to prevent and to treat because it has developed resistance to chloroquine (chloroquine-resistant falciparum malaria or CRPF) and other traditional anti-malaria drugs. Although P.vivax, P. ovale, and P. malariae can cause a serious illness with fever and chills, most patients survive even if diagnosis and treatment are delayed.

Where Is Malaria A Risk To Travelers?
Information about malaria transmission and drug resistance patterns at a given destination can change daily. Most travel health specialists receive updates on these changes and adapt the changes to individual travelers' health status and travel itinerary.

What Can Travelers Do To Prevent Malaria?
Preventing mosquito bites and taking medication to prevent malaria constitue the best defense:

• Stay indoors or guard against bites between dusk and dawn when mosquitoes are most active.

• Sleep under an insecticide (permethrin) impregnated bednet, if possible, even when indoors.

• Wear clothing that covers arms and legs, and use an insect repellent containing DEET on exposed skin when outdoors.

• Take anti-malaria drugs on schedule - for the entire recommended dosing period - whether or not you think you received a mosquito bite.

Other Tips
Medications commonly prescribed for malaria include: chloroquine (Aralen), mefloquine (Lariam), doxycycline (Vibramycin, Doryx), atovaquone/proquanil (Malarone) and primaquine.

See a travel physician at least one month prior to departure for specific dosing and schedule information. All malaria medications must be started prior to departure and some must be continued weeks after you return. Antimalarial drugs act by inhibiting parasite development during the incubation period of the disease.

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How Do I Know If I Have Malaria?
Following the bite of an infected mosquito, symptoms have been reported as early as eight days afterwards and as late as one year after travel. Common signs and symptoms of malaria include: fever, chills, headache, muscle aches, vomiting, abdominal pain and diarrhea. If you have a fever of above 102 degrees and chills, or a severe flu-like illness while traveling or during the year after returning, seek professional medical care immediately.

Because of the variable incubation periods and emerging drug resistance, it is possible to be stricken with an attack of malaria weeks to months after returning home, even if anti-malaria drugs were taken as prescribed.

Elaine C. Jong, M.D. University of Washington, Co-Director, UW Medical Center Travel and Tropical Medicine Service and Hall Health Travel Clinic, Clinical Professor, Department of Medicine

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