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Protect yourself from Malaria

05 July 2013

By Faheem Shafi - Superintendent Pharmacist

Malaria is a deadly, but entirely preventable disease. Each year, there are between 1500 and 2000 people diagnosed with malaria on returning to the UK. Any traveller visiting a malarious area can become infected unless essential precautions are taken for protection against the disease.

As a pharmacist, I’m often amazed by some travellers’ approach to taking anti-malaria medication. There are usually two types of travellers: those that decide not to take precautions against malaria as ‘I have been to India many times before and have never taken any tablets and nothing ever happens to me’ and those customers who plan ahead and ask for a recommendation of the most suitable anti-malarial. 

What is Malaria? 

Malaria is an infectious disease transmitted through the female mosquito carrying a parasite of the Plasmodium species. One bite from an infected mosquito is enough to contract malaria which is a potentially fatal disease claiming the lives of one million people a year worldwide. 

Symptoms of Malaria

It is important to be aware of the symptoms of malaria before travelling to countries where it is present. Symptoms are similar to flu and include: fever, headache, aching muscles, sweats, chills, vomiting and diarrhoea. Onset of symptoms can develop within seven days of a mosquito bite but usually appear between 10-15 days. However, it can take up to a year or longer for symptoms to develop. If left untreated, malaria can be fatal and it is important to seek immediate medical attention if any of these symptoms appear after return from a holiday.   

 

 Malaria Prevention 

There are four simple steps you can follow to maximise your chances of preventing malaria. Simply follow the ABCD rule for malaria prevention:

  • A wareness of risk of malaria
  • B ite prevention 
  • C hemoprophylaxis (taking antimalarial medication as prescribed)
  • Prompt D iagnosis and treatment if necessary 

Awareness of Risk of Malaria 

The risk of contracting malaria varies from country to country and areas of high and low risks are also present within the same country. It is important to seek advice from your doctor or pharmacist, feel free to contact us on 0800 012 6779. Alternatively, consult our travel page to find out if anti-malarial medication is required for your travel destination. 

The type of holiday and season of travel is also very important. Travelling to rural areas on a safari holiday is likely to carry a greater risk than staying in urban hotels. Malaria is also more common during the monsoon or wet season as warm temperatures and stagnant waters provide an ideal breeding environment for mosquitos. 

Bite Prevention 

There are various measures you can take to avoid mosquito bites. 

  1. Insect repellents: Choose a repellent which can be sprayed on both clothes and exposed skin. The insect repellent should contain an ingredient called diethyltoluamide (DEET). Preparations containing 50% DEET last for up to 12 hours compared to lower concentrations which only last a few hours. It is safe to use DEET if pregnant or breast-feeding and in babies and children over two months age. 
  2. Cover up: It is advisable to cover up exposed areas of skin while outside after sunset when mosquitos are most active. Wearing long sleeved tops, trousers and socks will help to reduce the risk of being bitten. 
  3. Sleep tight: If sleeping outdoors or in a room without a window screen, a mosquito net should be used impregnated with an insecticide. The net should be intact without holes and long enough to tuck into the sides of the mattress to reduce the chances of mosquitos entering the net. Spray the room with an insecticide or use a plug-in vaporiser to kill any mosquitoes that may have entered the room during the day. 

Chemoprophylaxis (antimalarial medication)

Medicines for malaria prevention are available on prescription or over the counter. These include: Malarone, Lariam, Doxycycline, Paludrine and Avloclor. It is important to take an anti-malarial which will afford adequate protection against malaria every time you travel to a new destination (for further information, visit our travel destination page or www.fitfortravel.nhs.uk).  The choice of medication will depend on the country of travel as some countries are more endemic (carry a greater risk of malaria) than others. Further considerations when choosing the right anti-malarial depend on existing medical conditions, medication currently being taken, length of stay and any side-effects experienced with taking anti-malarial medication in the past.

It is essential to take your anti-malaria medication regularly and exactly as prescribed. This can involve taking the medication up to one week before travel to allow the body to build up a level of protection against malaria. Side effects may also occur during this time, so you should seek advice from your doctor or pharmacist if necessary. It is very important to continue your medication both during your stay and after your return from holiday (or leaving the malaria area) in order to continue protection in case you are bitten by an infected mosquito.

Many travellers believe that taking anti-malaria medication is no longer necessary after returning to the UK as they are no longer in a malaria zone. This is very risky as symptoms of malaria could still develop if the medicine regimen is not followed as advised. 

Anti-malarial medication has several potential side-effects including: nausea, (sickness), vomiting and diarrhoea. Severe side-effects are rare but possible so please ensure you read the patient information leaflet before starting a course of anti-malarial. Taking tablets on a full stomach after a meal reduces any possible side-effects you may experience. Always seek advice from your doctor or pharmacist if you experience any side-effects. 

Special Considerations

Babies and children need to be adequately protected against malaria by ensuring the correct dose of anti-malarial medication is prescribed and given.  Pregnant women should avoid malarial areas as they are at severe risk of contracting the disease and women who are not pregnant should avoid becoming pregnant if taking mefloquine. In both cases, it is advisable to speak to the doctor before intending to travel.  Travellers with epilepsy, liver and kidney problems and some forms of mental illness have a restricted choice of anti-malarial medicines they can take and will also need to seek advice from their doctor or pharmacist before travel for the most appropriate anti-malarial. 

Diagnosis and treatment

Travellers returning to the UK developing feverish illness and other symptoms as mentioned above; especially in the first 3 months and up to a year; should seek medical attention in order for proper diagnosis and treatment of possible contraction of malaria to be effective.

Summary

Travellers going on holiday to areas where there is any risk of malaria must seek advice on anti-malarial requirements. Malaria is a fatal disease which is avoidable by taking adequate measures of protection. Whilst no regimen is 100% effective, it is the combination of such preventative measures that will provide significant protection against malaria. Always seek advice from your doctor or pharmacist for advice on anti-malarial medication you may need when planning your holiday.

Feel free to contact us on FREEPHONE: 0800 012 6779 or by email: info@clinidirect.co.uk 

 
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