A Traveller's Guide: Malaria Awareness

With travel to long-haul destinations becoming more accessible and last minute bookings to exotic places on the rise, UK travellers are increasingly at risk of contracting diseases such as malaria. Travellers need to know the facts.

How does malaria affect UK travellers?

• Every year approximately 2,000 British travellers return home with malaria and the UK is one of the biggest importers of malaria among industrialised countries.
• British travellers are increasingly going to countries where malaria is prevalent; there has been a 150% increase in travel to malarious destinations amongst British travellers in the last ten years.

How dangerous is malaria?

• The most severe form of malaria (Plasmodium falciparum) is on the increase amongst British travellers.
• Malaria is a preventable infection but can be fatal if left untreated - an average of nine people die each year from malaria in the UK.
• Malaria is transmitted by an infected mosquito. It only takes one bite from an infected mosquito to contract malaria.

How can I protect myself?

• You are at risk when travelling to malarious areas if you do not take precautions to prevent yourself from being bitten and also if you do not take antimalarials. You should ideally seek advice from a healthcare professional eight weeks before you travel but can still seek advice at the last minute. Some advice/protection is better than none.
• There are different forms of antimalarials available - the appropriate health care professional (GP, practice nurse, pharmacist or travel clinic) will be able to advise on the most suitable one for you.
• Wherever you go, enjoy yourself, but make sure you are malaria aware.

Malaria Hotspots

Malaria Hotspots is a website dedicated to raising malaria awareness amongst British travellers.

For more information, real-life video stories, games, podcasts, travel tips and more, just visit the website.

www.malariahotspots.co.uk

More information about malarious destinations...

Important: Understanding this malaria map

• This map is only intended to highlight destinations with possible malaria risk.
• Countries outlined in RED are considered by the World Health Organisation (WHO) to have some malaria risk. It does not necessarily mean that the entire country is affected, as malaria may be restricted to certain areas or regions.
• This map is an illustrative guide only.
• Malaria risk can change rapidly and you should always seek accurate and up to date advice.
• Expert advice must be sought before travelling to a potentially malarious destination.
• Always consult a health care professional before travelling to any potential malaria destination.

South America

Malaria is present in South America, though in many countries it is restricted to specific areas / regions. The south of the continent is generally malaria free. For up to date and accurate advice visit a health care professional before your travel.

Africa

Malaria is widespread throughout the majority of Africa. The most deadly form of malaria, falciprium, is also the most common and certain antimalarial medications may not be very effective. Always get up to date, expert advice from a health care professional before travelling to any potential malaria destination.

South East Asia

Malaria is present in a number of countries throughout South East Asia, though in some countries it is restricted to specific areas / regions. Always get up to date, expert advice from a health care professional before travelling to any potential malaria destination.

Far East Asia

There is malaria risk in China, though not normally in densely populated urban centres. There is also some risk in the northern rural parts of South Korea. Always get up to date, expert advice from a health care professional before travelling to any potential malaria destination.

North America, Western Europe, Eastern Europe and Australasia

Malaria does not generally occur in North America, Western Europe, Eastern Europe or Australasia.

Looking for more information on malaria risk in specific countries?

Go to www.fitfortravel.nhs.uk

Important: Planning your travel

If possible, it is important to plan your travel in advance and share your detailed travel plans with your health care professional. Just because your ultimate destination may be malaria free, your journey to or from it may take you through an infected area. www.fitfortravel.nhs.uk is a specialist travel site operated by NHS Scotland which may help in giving background information.

FAQs

Question: Is malaria a real danger to British travellers?

Answer: Unfortunately the answer is yes. Travel figures have revealed an increase of nearly 150% in travel to popular malarious destinations such as Africa and India over the past ten years. Every year, 2,000 UK travellers contract malaria and on average there are nine deaths. Even if treated, malaria can be painful and debilitating so it is advisable to protect yourself.

Your healthcare professional will know if you are travelling to an atrisk destination and will be able to offer you advice about preventing the disease.

Question: How can I contract malaria?

Answer: Malaria is an infectious disease which is transmitted through certain types of mosquitoes. It only takes one bite from an infected mosquito to contract malaria. Whilst feeding on your blood, an infected mosquito releases the malaria parasite into your body, which rapidly goes to the liver and reproduces before spreading back into your bloodstream. For more information about how malaria develops please see page 3.

Question: Do I really need to bother taking precautions?

Answer: Yes, malaria is potentially very dangerous and affects thousands of British travellers each year. The good news is that it is preventable by avoiding getting bitten in the first place and by taking antimalarial medication.

If you contract malaria in most cases it can be treated if diagnosed quickly enough. If you suffer from 'flu like symptoms having visited a malarious country within the last year, then you should seek immediate medical help from your doctor. To read the stories of people who've had malaria go to page 6.

Question: In which countries can I contract malaria? Am I safe if travelling in the dry season?

Answer: Malaria exists in areas such as Africa, South America, Asia and South East Asia. In some areas mosquitoes may be more active during the wet season, but mosquitoes can bite all year round. You should not assume that by travelling in the 'dry season' you are safe as it only takes one bite by an infected mosquito at any time of the year to contract malaria. Your healthcare professional will be able to tell you if your destination is malarious and give you the right advice and medications. See page 2 for more info.

Question: I have heard that the side-effects of antimalarial medications are unpleasant, even worse than catching malaria. Is this true?

Answer: Antimalarial medications can cause some side effects, but there are different types available and your healthcare professional will advise you as to which one is right for you. Malaria can put you in hospital for weeks and can be fatal in some cases. It is better to protect yourself against malaria than risk contracting a potentially fatal disease. If you have concerns speak to your healthcare professional.

Question: I have heard that some antimalarial medications are ineffective as malaria has become resistant to them, is this true?

Answer: In some parts of the world, some of the older drugs may not give full protection. It is best to speak to your healthcare professional who can give you up to date information on all medications and which ones are suitable for you and the countries you are travelling to.

Question: When I have travelled before, other travellers seem to be taking different medication to protect against malaria, why is this?

Answer: There are a number of different medications and different ones suit different people. What's right for one traveller may not be right for another. Also other travellers may be following a completely different itinerary to you and taking a medication that's suitable for their particular destination. You should always keep to the advice given to you by your healthcare professional who should have taken your travel itinerary and individual health needs into account. Above all, make sure you take the full course of medication and don't be swayed into doing otherwise.

Question: Fellow travellers have told me that I don't need to use antimalarials, I wonder if I should bother?

Answer: While fellow travellers are a great source of information for where to go, what to see and how to get about in different countries, they are probably not completely up to speed about travel health. It is strongly recommended that you seek expert pre-travel health advice at least eight weeks before you travel to ensure that you are protecting yourself against malaria and other infectious diseases.

Question: I am only travelling to a malarious area for two days throughout my entire trip, is it worth taking antimalarial medication for such a short duration?

Answer: It only takes one bite from an infected mosquito to contract malaria. Take your travel itinerary to a health care professional at least eight weeks before you travel and explain where you will be travelling to and how long you will be staying. You will be advised whether you need to take antimalarial medication and how long you should take them for. It is important to follow the advice you are given to ensure you are protected against malaria during and after your travels.

Question: I have been given antimalarial medication which I've been told I have to keep taking, even after I get back from my trip. Is this right?

Answer: All antimalarial medication needs to be taken before, during and after your travels. Taking it as instructed and completing the full course is very important. This is because the malaria parasite can sit in the liver long after you've left the malarious area. It needs to be eradicated by fully completing your course. Failure to do so could be fatal.

Question: I've heard that if I eat garlic this will stop me from being bitten by a mosquito and help prevent malaria. Is this true?

Answer: There are a lot of myths and inaccurate information about protecting yourself from malaria. There is no scientific evidence that eating garlic, Marmite® (or any other savoury yeast extract spread), or taking vitamin B will protect you from malaria. There is also no scientific evidence that homeopathic or herbal medications are effective against malaria. Seek advice on how to avoid getting bitten and on antimalarial medication from a healthcare professional before you travel.

Question: My friend is from Africa and she is going home to visit her family for three weeks. She says he doesn't need to take any protection as she was born there and is immune to malaria. Is this true?

Answer: If people who grow up in a malarious area are fortunate enough to survive childhood they may develop a natural partial immunity to the disease. However, once they have left that malarious area, this immunity begins to fade after about six months. If your friend is returning home then he is potentially at risk of contracting the disease. He is best to take pre-travel advice from a healthcare professional and not to assume he is safe, as it only takes one bite from an infected mosquito to catch malaria.

Question: Where can I get advice about malaria?

Answer: You should book an appointment with your healthcare professional at least eight weeks before your travels. Many local surgeries operate dedicated travel health clinics managed by a specialist travel nurse. It's worth telephoning your surgery to find out if they offer this clinic and on what day of the week you will be able to visit the clinic. Pharmacists will be able to offer you some travel health advice, but they will not be in a position to offer you the full range of antimalarial medications as you may need a prescription for these. The other option is a private travel clinic which can be found in your local directory.

Question: What happens if I do contract malaria?

Answer: Malaria though potentially fatal, is treatable if diagnosed quickly. If whilst travelling or within one year of travelling, you develop 'flu like symptoms (such as fever, chills, pain, weakness, muscle aches, vomiting, cough, diarrhoea or abdominal pain) you must urgently seek medical attention and tell your doctor that you have been travelling in a malarious area. To see stories of people who've had malaria take a look at Been There, Been Bitten.

Malaria travel tips

Before you travel

During your travels

After your travels

Been there, been bitten

Name: Alex Beard
Age when contracted malaria: 20
Occupation: Freelance journalist
Where did she contract the disease: Ghana
Type of travel: Study Gap

Situation:

Alex contracted the most dangerous form of malaria, falciparum, while studying at Accra University in Ghana. Shortly into Alex's trip her strict routine began to weaken and Alex soon forgot to take her antimalarials. After three weeks of feeling incredibly ill Alex gave in and saw a doctor. After tests she was diagnosed with malaria.

Outcome:

Alex continued her travels after a short rest, but suffered from two relapses. It took her over a month to feel herself again. Since her return to England she has been in and out of hospital and has suffered from liver, stomach and various neurological problems. All are believed to stem from malaria. Alex knows that she is lucky to be alive especially as a fellow traveller died from malaria.

Name: Simon Reeve
Age when contracted malaria: 33
Occupation: Television presenter
Where did he contract the disease: Africa
Type of travel: On location filming the 'Equator' TV series

Situation:

Simon took antimalarial medication with him during his travels but omitted to take one or two of his tablets and, as a result, was not fully protected against contracting malaria.

Outcome:

Simon had to stop filming for emergency treatment. He was confined to bed until he was well enough to continue with his journey around the Equator.

Other Downloadable Advice Guides

Guide to Travel Health

by Dr Sebastian Kalwij

Dr Sebastian Kalwij is gapyear.com's travel health expert. He's been involved with travel health projects all over the World, and is now a GP in London. In this guide he takes you through the major health issues that you need to be aware of before you go and whilst on the road. There's information on everything from vaccinations to sun safety, but we have to stress that this is not a substitute for a visit to your GP!

Guide to Gap Year Work Experience

by Elizabeth Clark

Gap years are about more than volunteering in the rainforest or sunning yourself on a beach in Australia. Alongside taking a year out to earn money to pay for university, one of the fastest growing types of gap year, is spending some time trying to get work experience that will help you work out which career is right for you and also, hopefully, give you a bit of a head start over everybody else.

Guide to Travel Photography

by Lucy Cartwright

Want to come back from your gap year with some awe-inspiring photos? Just want to avoid blurry snaps of randoms with red-eye? Lucy Cartwright talks you through what kit to take, pre-trip preparation, lighting, framing and how to get the best from the situations you're most likely to encounter. You don't need a load of expensive gadgets to come back with a photo album to be proud of.

Guide to Vegetarian Travel

by Laura Chapman

Quorn to be wild? Or, to put it more simply; like to travel but don't eat meat? You sound like the sort of person who could use this handy guide. Laura Chapman has covered all the major gap year destinations, rated them for veggie-friendliness and suggested some 'in case of emergency' dishes for each of them. Beats the hell out of eating Super Noodles for a year anyway.

Guide to Buying and Driving a Car in Oz

by Carolyn Martin

The best way to see Australia is with the freedom of your own vehicle. Go where you want, when you want and stop off at every single novelty outsize fibreglass fruit along the way if you damn well see fit. If you like the sound of this, but are put off by the red tape and expense involved, this is the guide for you!