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:
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.