As one of the most dangerous and widespread diseases in the world, malaria is a condition that is
constantly evolving. By looking at how the condition has changed and spread throughout the world, we can
gain a clearer understanding of how to avoid it effectively when travelling.
Every traveller should be aware of the potential risks posed by infectious conditions such as malaria. Put
simply, malaria is a serious tropical disease, spread by mosquitos. It can be fatal if left untreated, and
a single mosquito bite is all it takes for someone to become infected with malaria.
Despite still being a significant travel health risk today, the origins of malaria date back millions and
millions of years. In fact, fossil mosquitoes have been found in geological strata 30 million years old. What’s more, a variety of studies have suggested that
P.falciparum malaria probably jumped from great apes to man, most likely by a single host
transfer by vector mosquitos. Findings indicate that
malaria traces back to gorillas.
As well as having a long and complex history behind it, the condition also has a huge geographical spread.
Let’s take a closer look at malaria risk levels across time periods and around the world.
A timeline of malaria
We’ve already mentioned that, as well as being a dangerous and widespread condition, malaria is also an
ancient one. In truth, the origins of malaria dates back hundreds of millions of years, yet it remains a
significant health risk in several parts of the world today. Below is a timeline of how malaria has
transformed over millennia.
Half a billion years ago: Existence of a pre-parasitic ancestor of the vector mosquito
150 million – 200 million years ago: Appearance of early Dipterans, ancestors of
130 million years ago: Evolution of two-host life cycle in Dipterans and vertebrates
130 million years ago: Divergence of the bird and mammalian malaria parasites
100 million years ago: Divergence of P.malariae, P.ovale and P.vivax
5 million years ago: Evolution of P.falciparum
2-3 million years ago: Divergence of P.vivax from P.cynomolgi
10,000 years ago: Malaria appears in Africa
10,000 – 5,000 years ago: Malaria appears in Mesopotamia, the Indian peninsula and
4000 – 10,000 years ago: Appearance of the lethal strain of P.falciparum
5000 years ago: Malaria appears in China
4000 – 5000 years ago: In Africa, Anophelines develop highly anthropophilic
3000 years ago: The lethal P.falciparum strain of malaria reaches India
2500 – 2000 years ago: Malaria reaches the shores of the Mediterranean
1000 – 500 years ago: Malaria reaches Northern Europe
Late 15th Century: Malaria reaches the New World and much of the western hemisphere
Mid-18th Century: Malaria spreads across North America
19th Century: Malaria is now present across the globe
Early 20th Century: Millions of people die from malaria all over the world
Early 1950s: Malaria has almost disappeared from North America and from almost all of
Present: Malaria fatalities almost entirely limited to sub-Saharan Africa.
The World Health Organisation (WHO) estimates that 219 million cases of malaria
occurred across the globe in 2017. Of these cases, around 435,000 people died from the disease. This
number mostly consisted of children under 5 years of age in sub-Saharan Africa.
International travellers could find themselves at risk of malaria infection in 87 countries around the
world, most notably in Africa, Asia and the Americas. Those who do become infected with malaria often
experience initial flu-like symptoms, as well as fever and chills. If left untreated, these symptoms can
escalate into severe complications and even fatality.
Symptoms of malaria usually appear after a period of seven days or longer, though it can be sooner.
Malaria is caused by the Plasmodium parasite, transmitted by female Anopheles mosquitos
which bite between dusk and dawn. Five strands of the Plasmodium virus regularly infect humans.
These are falciparum, vivax, ovale, malariae and knowlesi. While P.falciparum is the most dangerous strand, P.vivax
is now the most geographically widespread of the human malarias, as it is estimated to account for
100-300 million clinical cases of the infection across Asia, Central and South America, and the Middle
The deadly P.falciparum strand of malaria is considered a serious public health concern in most
countries within sub-Saharan Africa.
In many instances, malaria can be prevented. An easy way to remember the precautions you should take is by
thinking of them as the ABCD approach. This consists of:
Awareness of risk: find out whether your destination carries a risk of malaria before you
Bite prevention: avoid mosquito bites by using things such as insect repellent and an
insecticide-treated mosquito net. You should also cover your arms and legs whenever possible
Check whether you need anti-malarial medication: Explore the various treatment options
available. Always ensure you use the right dose and finish your course of medication
Diagnosis: Seek immediate medical advice if you develop any malaria symptoms for as long
as up to a year after you return from your travels abroad.
Always speak to your GP if you’re planning to visit an area where there is a malaria risk.
Malaria risk countries
One of the most important questions to ask yourself when travelling is whether malaria is a risk factor in
your destination. Being aware of potential malaria risks before you travel is essential, as the
most serious forms of malaria can become life-threatening after just 24 hours.
Most malaria cases in 2017 were within the WHO African Region (92%, or around 200 million). This is
followed by the WHO South-East Asia Region (5% of cases) and the WHO Eastern Mediterranean Region (2%).
Almost 80% of global malaria cases occurred within just 15 countries in sub-Saharan Africa and India, and
five countries accounted for almost half of all malaria instances worldwide: Nigeria (25%), Democratic
Republic of the Congo (11%), Mozambique (5%), India (4%) and Uganda (4%).
If you’re planning to travel further than Europe, you should carefully research any potential malaria
risks in your area.
Understanding malaria is key to avoiding the condition when travelling further afield. If you’re
worried that you may be at risk of the condition while travelling, contact Express Pharmacy today. We can
provide effective anti-malarial
medication such as Malarone and Doxycycline. Speak to one of our pharmacists today by calling 0208 23
07 03 or by using our discreet online Live Chat service.
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 Liu, W. et al. Origins of the
human malaria parasite Plasmodium falciparum in gorillas. Nature. September 2010
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 World Health Organisation. Malaria, Information for
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