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Your Common Sense Guide to Malaria

Posted Friday 03 May 2019 12:44 by in Anti Malaria by Johanna Galyen

High Fevers. Bone-breaking Chills. Abdominal Pain. And, oh, those muscles aches. Like you’ve just hiked 10 kilometres straight uphill with no relief! With symptoms like these, should you even visit countries that are at risk for malaria? Is it worth taking the chances? What should you do? Should you even travel?

The answer is a cautious maybe. Careful planning and taking the right precautions can help to ease any fears you have about travelling abroad. And it is always wise to “think about health in advance of your trip," says Bradley Connor, MD, a travel health specialist at Weill Medical College of Cornell University.

Here is some common sense advice to help keep you free of malaria:

1. Understand What Malaria Is

According to the World Health Organisation (WHO), malaria is caused by the Plasmodium parasite that the female Anopheles mosquito is infected with; this incredibly tiny parasite attaches itself to the mother mosquito and when she bites humans to feed her growing eggs, she injects the parasite into the human host as well.

The parasite makes its way through the bloodstream and eventually lands within the liver to grow. Each little parasite attaches itself to red blood cells, and produces more parasites until the red blood cell bursts open. When this happens, it releases all the growing parasites to attach themselves to even more red blood cells, and you start to feel very, very sick.

There are five specific species of the Plasmodium parasite that a mosquito can carry:

Plasmodium falciparum

Plasmodium malariae

Plasmodium vivax

Plasmodium ovale

Plasmodium knowlesi

Of the five types, plasmodium knowlesi is rarely contracted by humans, as it typically only infects monkeys. The deadliest of the types is Plasmodium falciparum. Scientists Against Malaria say, “Almost every malarial death is caused by P. falciparum” as it has a unique ability during the multiplication of the parasite to make the red blood cells become very sticky in the veins and capillaries. If the parasite is not treated (and killed) by medication, it can kill the person by clogging the blood supply that feeds the brain or other vital organs.

The other three types of malaria (malariae, vivax, ovale) can cause a great deal of misery, but they are rarely fatal.

2. Know the Hotspots for Malaria

When considering places to visit, remember, mosquitoes like warm and moist areas. Warm areas that have lakes, streams, rivers, and jungles. Most notably these will be in the tropics and subtropical areas where mosquito populations are greatest. Deserts typically have much lower mosquito populations due to the dry, arid conditions but in areas with water, such as an oasis, malaria-carrying mosquitos may be found.

According to the Centers for Disease Control, “The highest transmission is found in Africa, South of the Sahara, and in parts of Oceania such as Papua New Guinea.” If you are travelling anywhere along the equator, it is good to research your trip’s locations to see if you are at risk of contracting malaria. Fit for Travel is one such excellent website that can provide you with the most up-to-date information.

3. Be Prepared

Anti-malarial medications can help to kill the Plasmodium parasite within your body, and there are three main options to choose from:

Malarone – This medicine is started two days before your trip and continues for one week after you return. Side effects are usually minimal as this medicine is well tolerated in most people, but they can include coughing, headache, nausea, dizziness, and weakness.

Doxycycline – The medicine is taken two days prior to the beginning of your travels, and it continues until four weeks after your return. Side effects can be a heightened sensitivity to sunlight (you can get a nasty sunburn), and it can also cause blurred vision, headache, thrush, and diarrhoea.

Lariam – A once-a-week table to prevent malaria; this medicine is started (preferably) two weeks prior to your trip and continued until four weeks after your return. Lariam can cause some noticeable side effects like nausea, headache, abdominal pain, convulsions, nightmares and even depression.

4. Understand Your Current Health

Dr. Bradley Connor also says “If you have a chronic health problem, get a check-up before you leave." Travelling can bring out the best and worst in your health, so it is good to know what you are dealing with prior to leaving to ensure that you will feel great on your trip.

There are some travellers who should not visit areas that are endemic with malaria. Women who are currently pregnant should avoid travelling to areas with malaria if at all possible. The CDC states “infection in pregnant women can be more severe than in nonpregnant women. Malaria can increase the risk for adverse pregnancy outcomes, including prematurity, abortion, and stillbirth.”

Those who previously lived in endemic malaria areas, moved away, and want to return should also carefully reassess their health. For some types of malaria, the body can create immunities against the parasite. However, this immunity can quickly lessen over time, and they will be at the same risk as a first-time traveller.

Who else should be cautious about their health in areas with malaria?

Those on immune-suppressing drugs

Organ transplant patients

People undergoing chemotherapy or radiation therapy

Those who have recently undergone surgery or suffered a heart attack or stroke

5. Prevention 101: Don’t Get Bitten!

One of the best ways to avoid being bitten by the mosquito is to keep it away from your skin. Try these easy steps:

Stay inside during the late evening and early morning hours when mosquitoes are most active.

Wearing long sleeved clothing, trousers, and long skirts can help to shield you from the bites. Note: keep those shirt-tails tucked in to protect your back and stomach areas.

Wear socks and shoes; no sandals. It also helps to tuck your trousers into your socks to ensure that no skin is exposed.

Always sleep under a mosquito net – preferably one that has been treated with an insecticide.

Use bug spray that has 20-40% DEET in it. Picaridin and Lemon Eucalyptus oil are DEET-free options that can be used, but remember, they should be applied more frequently to provide the right protection.

6. Know The Symptoms

Most children and travellers know the sight of a mosquito bite; it is a red, raised itchy bump on your skin. However, the female Anopheles mosquito does not leave a mark at all. Additionally, the mosquito’s saliva can act as an anaesthetic, so most people do not even know that they were bitten by the mosquito until the symptoms start showing. Because of this, it is important to know the symptoms of malaria. The treatment of the disease works better and faster when it is first discovered versus waiting until you are extremely sick.

According to WebMD, the symptoms are shaking chills, high fever, profuse sweating, headache, nausea, vomiting, abdominal pain, yellowing skin, diarrhoea, muscle pain, convulsions (like a seizure), and bloody stools.

7. Keep Your GP Informed

Your general practitioner (GP) should be informed of your travels to areas that have malaria. This information can help them prepare you for the trip and keep you healthier. Additionally after, returning from these areas, you may want to have a follow-up appointment as well. This may seem as if you are overdoing it, but malaria can mimic many different illnesses initially. It can appear as flu-like symptoms, migraines, gastrointestinal illness (stomach bug), and even worse conditions like seizures or bleeding in the intestines. If your GP knows that you have visited areas with malaria, they can be vigilant to order the right tests if you do become ill.

Another important consideration is Plasmodium vivax. This type of malaria is one of the more confusing types. It can lie dormant (asleep) within your body for months or years, and then suddenly arise causing many symptoms. While it is typically not fatal in of itself, it can interfere with your current health problems and worsen them. If you already have difficult, chronic health conditions, you may struggle more than usual

It is our goal here at Express Pharmacy that you return from your travels with happy memories and are as healthy (or even healthier!) than when you left. Being prepared for malaria is very important, and we are here to help you get ready in the most effective way possible. Discover medications for your anti-malarial needs – here at Express Pharmacy. We can help you gain access to effective treatment swiftly and discreetly. Contact us today by calling 0208 123 07 03 or by using our online Live Chat service.


Is Malaria Really That Serious?

Posted Thursday 28 March 2019 17:41 by in Anti Malaria by Johanna Galyen

It’s been around for centuries. We all know we should avoid it, protect ourselves from it, use the right medications to prevent it, and a net to protect our beds at night from it – but why? Why is malaria such a big deal? It’s 2019, should you really worry about a tiny mosquito as you travel on holiday this summer? Why is such a tiny little pest causing so many problems?

The answer is rather scary. The World Health Organisation stated “There were an estimated 219 million cases of malaria in 90 countries. Malaria deaths reached 435,000 in 2017.” While many measures are in place to help lower these terrible statistics, the prevalence of malaria is something that should not be ignored.

You need to know the symptoms of malaria

After being bitten by a mosquito carrying malaria, there are no symptoms initially. Only the female Anopheles mosquitos carry malaria, and they’re actually carrying a parasite that is injected into your bloodstream when they bite. These little ladies do not leave a bite mark, and the site does not swell up or does spot itch as most people think of mosquito bites. This is one of the reasons that the bite is so dangerous; you probably don’t even know that it happened.

The symptoms can take one to two weeks to appear (or even a year) in your body because the parasite travels to your liver and begins to grow there. The National Health Service (NHS) says that Malaria’s symptoms are similar initially to a flu-like illness:

  • High fever, above 38° C
  • Chills and sweats alternating
  • Headaches
  • Muscle aches
  • Vomiting
  • Diarrhoea

Without proper care, malaria can cause liver failure, fluid in the lungs (pulmonary oedema), kidney failure, anaemia, and ultimately death.

You Need to Know Where Malaria is Prevalent

Malaria countries, or countries affected by Malaria, are located in Africa, Central and South America, some parts of the Caribbean, Asia, Eastern Europe, and the South Pacific. Mosquitos like warm, moist climates and thrive in areas near bodies of water.

Africa has the most significant amount of malaria, according to WHO, and “it was found that 92% of malaria cases and 93% of malaria deaths was prevalent here” in 2017. The World Health Organisation also stated that “In 2017, five countries accounted for nearly half of all malaria cases worldwide: Nigeria (25%), the Democratic Republic of the Congo (11%), Mozambique (5%), India (4%) and Uganda (4%).”

You Need to Know How to Protect Yourself

If you are travelling to an area that has Malaria, there are many necessary steps to protect yourself from this disease. Each of the three preventative steps is important, but none of them will protect 100%. Therefore, if possible, you should utilise all three ways simultaneously.

1.Anti-Malarial Medications

Anti-Malarial medications work to destroy the parasite within the body. Three of these medications are Doxycycline, Malarone or Lariam. Because Malaria is a parasite that has different growing stages, these medications must be taken prior, during, and after your trip (for a certain number of weeks) to ensure that your body has the right amount of malaria-fighting properties in it. If you do not take the medication in its entirety, some of the parasites may survive.

While the three medications are equal in their effectiveness, they each come with differing side effects and interactions. It is essential that you speak with your GP to ensure that you take the right medication for you.

2. Malaria Net for Your Bed

A simple mosquito net for your bed is very inexpensive. It is so financially cheap that you may wonder why a net is so important? To help you understand this, it is good to remember that the female Anopheles mosquito doesn’t start working at 8 am. She likes to work late at night around 10 pm to 2 am, which most people are going to bed or asleep at these times. To prevent even one mosquito from biting you, a simple net can help protect you.

3. Bug Spray

So if you’re taking the medications and using a net, is bug spray still needed? The answer is yes. Bug spray is helpful if you are going to be up and moving during the later hours of the evening, such as walking outside of your tent to use the restroom. According to Fit for Travel, it is best to use a bug spray that has at least DEET 20-30%, Picaridin 20%, or Lemon eucalyptus 30%. They each smell differently, have varying concentrations and warnings and should be reapplied at different intervals. It is important to look carefully at your bug spray's directions and follow it’s recommendations.

You Need to Know What To Do If You Think You Have Malaria

Just like most illnesses, the sooner you can begin treatment for Malaria, the better it is for your body. So if you start experiencing symptoms, it is best to get to your healthcare provider and be tested. It is crucial to inform your doctor that you have been in an area that has Malaria so they can order the right blood tests that may be missed otherwise.

A thick blood smear is currently the most sensitive test accord to Lab Test Online, and it is considered to be “the gold standard” of testing. By taking a few large drops of blood, smearing it on a glass slide, and looking at it under a microscope, the doctor can search for the Plasmodium parasite.

If you do have Malaria, your GP may prescribe medication for you. Currently, Artemisinin-based combination therapies (ACTs) are used to treat Malaria. In years past, Chloroquine was used, but many types of Malaria have become resistant against them. Some physicians may use anti-malarial drugs in combination with ACT therapy as well. Whichever medications you are prescribed, it is important to take the entire dose of medicine in the right quantity each day. Even if you start to feel better after a few days, you must take all of the medication to ensure that all of the parasites are destroyed.

Conclusion

Malaria is a serious illness that you should take the appropriate preventative steps to avoid. Even though it has been around for centuries, it is still a significant threat to your health in 2019. So as you plan for your holiday this season, be sure to research and make the right plans for your trip. A little bit of planning and preventative steps can ensure that you will be healthy and able to enjoy your time away!

Being prepared for Malaria is very important, and we are here to help you get ready in the most effective way possible. Discover medications for your anti-malarial needs – here at Express Pharmacy. We can help you gain access to effective treatment swiftly and discreetly. Contact us today by calling 0208 123 07 03 or by using our online Live Chat service.


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