Malaria: Q&A for travellers

What is malaria?

An infection caused by a tiny parasite, injected into the bloodstream by Anopheles mosquitoes, which bite at dusk and at night in most parts of the tropics. Possible symptoms include fever, headache, shivering, feeling unwell, diarrhoea, and jaundice. Its severity can range from minimal, in local people who have survived multiple infections in the past, to death within 24 hours of the first symptoms, in the most serious cases. Malaria is notorious for mimicking less serious diseases, a fact that easily leads to life-threatening delays in treatment.

Are there many types?

Most dangerous is the Plasmodium falciparum parasite, which causes 95 per cent of infections in Africa, though only 50 per cent in Asia and Latin America. Rapid deterioration is possible, sometimes with reduced blood flow through tiny vessels in the brain – “cerebral malaria”. Another species, Plasmodium vivax, causes milder symptoms, which often don’t appear until weeks or months after the person has returned home – vivax malaria is seldom fatal.

Who is most at risk?

All travellers from non-malarial countries are highly vulnerable. Also at special risk: migrants visiting their countries of origin, pregnant women, frequent travellers who become complacent, five-star travellers who think they are invincible, and last-minute travellers with no time to obtain proper protection. It is also a matter of odds: the longer you spend in a malarial area, the greater the probability of being exposed.

What can I do to protect myself?

Get specialist advice, every trip. For low-risk destinations – such as much of Thailand – the following suffice: DEET-based insect repellents, covering up, and using a mosquito-killer or bed net at night. But where the risk is higher – such as in most parts of tropical Africa – you need antimalarial pills as well. There are several options and it’s always possible to find one that suits you. Follow instructions carefully, and finish the course. Prevention is not 100 per cent foolproof, so report any illness immediately, and don’t forget to mention that you have been abroad.

• Dr Richard Dawood is a specialist in travel medicine at the Fleet Street Clinic, London (020 7353 5678) and the editor of Travellers’ Health: how to stay healthy abroad (OUP).

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Malaria: Q&A for travellers