Malaria is a serious concern for travelers heading to certain tropical and sub-tropical destinations, especially Africa, South Asia and South America. The disease is transmitted by the female Anopheles mosquito which injects the disease-causing parasite, Plasmodium, into its human host through its saliva during a blood meal.
There are five different species responsible for malaria in humans, and they vary in the severity of disease they cause. The most deadly form is commonly found in sub-Saharan Africa. Around 1,700 malaria cases are diagnosed in the US each year in returning travelers. Malaria can be severe and even fatal if left untreated, so it is essential to be prepared before traveling by bringing personal protection to prevent mosquito bites and taking antimalarials to prevent disease.
Symptoms of malaria can appear up to a month after infection and often resemble the flu. Common symptoms are fever, headache, muscle aches, tiredness, sweats, and chills. There may also be nausea and vomiting. If you experience these symptoms while away or after returning home, you should seek medical attention immediately. Malaria can be diagnosed by examining a blood smear under a microscope or using a rapid detection test. Serious complications can occur if the infection is not treated such as respiratory distress, anemia, and kidney failure.
There are some basic measures to help prevent malaria, focusing on preventing mosquito bites:
- Insecticidal mosquito nets should be placed around beds to prevent bites from occurring during the night.
- Insect repellent should be applied to the skin to discourage mosquitoes from landing and therefore biting.
- Wearing long sleeves and trousers helps reduce the amount of skin accessible to mosquitoes.
It is especially important to take an antimalarial drug before, during and after traveling to a high-risk country in case an infected mosquito does manage to bite you. These drugs kill the parasite at certain stages of its life cycle.
One example is doxycycline, a broad spectrum antibiotic which is effective at preventing malarial disease by killing the parasite once it enters the red blood cells. Doxycycline is available by prescription to adults and children over 8 years of age, in the form of tablets or capsules. It is taken once per day, starting a couple of days before travel and continuing for 4 weeks after returning home. The drug is useful for last-minute travelers as the course only needs to be started shortly before travel, whereas other antimalarials such as chloroquine need to be started 1-2 weeks before travel.
Furthermore, it is one of the least expensive options and protects against other infections such as leptospirosis. Doxycycline is also used in the treatment of malaria in combination with other drugs.
Before traveling, you should visit your doctor to be prescribed an antimalarial which will be chosen based on the country you are visiting. This is a much safer option than buying the drugs abroad. Doxycycline is a good choice for those who are traveling to areas where chloroquine or other drug resistance is a problem. It is also essential to recognize the symptoms associated with malaria and ensure medical attention is received quickly so that treatment can begin. When malaria is treated quickly, a full recovery is likely.