Malaria

Malaria is a serious tropical disease that mosquitoes spread from person to person. If it isn't diagnosed and treated quickly, it can kill.

One mosquito bite is enough to infect a person.

If you're travelling to an area where malaria is common, you should know what its symptoms look like, so you can get medical help quickly.

The symptoms of malaria are much like those of flu. They usually appear 6 to 30 days after the mosquito bite, though sometimes it can take up to a year before anything shows.

The first symptoms of malaria include:

• a high temperature (fever)
• headache
• sweats
• chills
• muscle aches or pains
• vomiting and or diarrhoea

These symptoms can start mild, so they may be hard to recognise as malaria.

Malaria is a serious illness, and it can get worse very quickly. If it isn't treated quickly, it can be fatal.

The effects of malaria are usually more severe in:

• babies
• young children
• pregnant women
• older people

• you or your child develop symptoms of malaria during or after a visit to an area where the disease is found, even if it has been several weeks, months or a year after you return from travelling

Tell the doctor that you have been in a country with a risk of malaria, including any brief stopovers.

Malaria is caused by the Plasmodium parasite. Infected mosquitoes pass the parasite to people when they bite.

There are 5 different types of Plasmodium parasite that cause malaria in humans. They're found in different parts of the world (though they do overlap in some areas), and the infection can be more or less severe depending on the type.

All types of malaria cause the same symptoms, and all need immediate medical attention. You can't tell which type you have from the symptoms alone.

• Plasmodium falciparum: mainly found in Africa, this is the most common type of malaria parasite and causes most malaria deaths worldwide, though treatment does cure the infection.
• Plasmodium vivax: mainly found in Asia and South America, this parasite causes milder symptoms, but it can stay in the liver for years. If it isn't treated properly, the symptoms can come back.
• Plasmodium ovale: fairly uncommon and usually found in West Africa.
• Plasmodium malariae: quite rare and usually found only in Africa.
• Plasmodium knowlesi: very rare and found in parts of southeast Asia.

Malaria is spread by mosquitoes carrying the Plasmodium parasite. They are called "night-biting" mosquitoes because they bite most often between sunset and sunrise.

A mosquito becomes infected when it bites a person who already has malaria. It then passes the parasite on to the next person it bites. Malaria can't pass directly from one person to another.

When an infected mosquito bites you, the parasite enters your blood and travels to your liver. There it develops for days to weeks before going back into the blood. This is the point where symptoms start, and you need urgent treatment.

Malaria can also be spread by a person with the infection through blood transfusions and sharing needles, although this is very rare.

Malaria is found in tropical and subtropical regions of the world. You won't find it in the UK or Europe.

If you want to know the risk of malaria in a particular country, Travel Health Pro has more information.

Malaria is a serious illness, and it can be fatal if it isn't diagnosed and treated quickly. Severe complications can develop within hours or days of the first symptoms, so you should get urgent medical help as soon as possible.

When the malaria parasite destroys red blood cells, it can lead to severe anaemia. In anaemia, the red blood cells can't carry enough oxygen to your muscles and organs. You may feel drowsy, weak and faint as a result.

In rare cases, malaria can reach the brain. This is called cerebral malaria, and it can make the brain swell, which sometimes leaves permanent brain damage. It can also cause fits (seizures) or coma.

Severe malaria can also lead to other complications, including:

• liver failure and jaundice, which means yellowing of the skin and whites of the eyes
• shock, which is a sudden drop in blood pressure
• pulmonary oedema, which is a build-up of fluid in the lungs
• acute respiratory distress syndrome (ARDS)
• abnormally low blood sugar, known as hypoglycaemia
• kidney failure
• swelling and rupturing of the spleen
• dehydration

If you get malaria while you're pregnant, both you and your baby have a higher risk of serious complications, such as:

• premature birth (birth before 37 weeks of pregnancy)
• low birth weight
• restricted growth of the baby in the womb
• stillbirth
• miscarriage
• death of the mother

Pregnant women are advised not to travel to regions where there is a risk of malaria.

If you're pregnant and thinking of travelling to a high-risk area, see your doctor, midwife, obstetrician or travel health advisor for a full discussion. Not all antimalarial tablets are safe in pregnancy, so you need specific advice.

If you travel to an area that has malaria, you can catch the infection. So take steps to prevent it, and if symptoms do appear, get treatment straight away.

Malaria can often be avoided if you follow the ABCD approach to prevention. The letters stand for:

• Awareness of risk: find out if you're at risk of getting malaria
• Bite prevention: use insect repellent, cover your skin with clothing, and use a mosquito net so mosquitoes can't bite you
• Check if you need antimalarial prevention tablets by visiting a travel health clinic. If you do, make sure you take the right tablets at the right dose and finish the course
• Diagnosis: get medical advice immediately if you have symptoms of malaria, even up to a year after you return from travelling

Keeping mosquitoes from biting you is one of the best ways to prevent malaria. It matters most in the early evening and at night, because that's when the mosquitoes bite.

There are several steps you can take to avoid being bitten.

• mosquitoes can't bite through clothing, so wear light, loose-fitting clothes that cover your arms and legs
• put insect repellent on all areas of your skin that clothing doesn't cover, including your face and neck
• remember to reapply the repellent often
• sleep under a mosquito net that's been treated with an insecticide, or in a room with effective air conditioning

The most effective repellents contain 50% diethyltoluamide (DEET). You can find these as:

• sprays
• roll-ons
• sticks
• creams

There's no evidence that other remedies protect against malaria. This includes homeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, yeast extract spread (Marmite), tea tree oils and bath oils.

Antimalarial tablets can help stop you from getting a malaria infection. But for the best protection, you must also follow the advice on preventing mosquito bites.

You have to start taking the tablets before you travel, and keep taking them the whole time you're in the risk area. You must also go on taking them for a period after you leave the risk area.

How long you need to take them depends on which tablet you are given.

The tablets don't stop malaria from getting into your body. What they do is stop the infection from developing inside you, so you don't fall ill.

If you stop taking your antimalarial tablets early, even when you are back home, you could still become ill with malaria.

Before you travel, your doctor may ask you to take a short trial course of antimalarial tablets. The point is to check that you don't get side effects or have a bad reaction to them. If you do, the doctor can prescribe a different antimalarial before you leave.

• Make sure you get the right antimalarial tablets before you go. Visit a travel health clinic and ask which antimalarial is best for you.
• Follow the instructions that come with your tablets carefully.
• Make sure you finish the full course of tablets.

There's currently no vaccine that protects against malaria.

The antimalarial tablets you're recommended to prevent malaria depend on the following:

• where you're going
• any relevant family medical history
• your medical history, including any allergies to medicine
• any medicine you're currently taking
• any problems you've had with antimalarial medicines in the past
• your age
• if you're pregnant

If you've taken antimalarial medicine in the past, don't assume it's suitable for future trips.

The type of antimalarial you need depends on which strain of malaria the mosquitoes in an area carry. It also depends on if they're resistant to certain types of antimalarial medicine.

The main types of antimalarials used to prevent malaria are:

• Atovaquone plus proguanil (also known as Maloff protect or Malarone)
• Doxycycline (also known as Vibramycin-D)
• Mefloquine (also known as Lariam)

To find out which antimalarial medicine is best for you, visit your local travel clinic.

If malaria is diagnosed and treated quickly, you should fully recover. Treatment should start as soon as possible.

Treatment begins in a hospital to make sure complications don't suddenly develop. You take tablets or capsules. If someone is very ill, the medicine is given through a drip into a vein in the arm (intravenously).

Treatment for malaria can leave you feeling very tired and weak for several weeks.

The type of medicine and how long you need to take it will depend on:

• the type of malaria you have
• how severe your symptoms are
• if you took preventative antimalarial tablets
• your age
• if you are pregnant