Malaria is a serious illness that can be fatal if not diagnosed and treated quickly. Pregnant women, babies, young children and the elderly are, particularly at risk.
The Plasmodium falciparum parasite causes the most severe malaria symptoms and most deaths.
As complications of severe malaria can occur within hours or days of the first symptoms, it’s important to seek urgent medical help as soon as possible.
Malaria in pregnancy
The World Health Organization (WHO) recommends that pregnant women should avoid travelling to areas where there’s a risk of malaria.
If you get malaria while pregnant, you and your baby have an increased risk of developing serious complications, such as:
- premature birth – birth before 37 weeks of pregnancy
- restricted growth of the baby in the womb
Visit your GP if you’re pregnant and travelling to a high-risk area. They may recommend taking antimalarial medication.
Prevention of Malaria
There’s a significant risk of getting malaria if you travel to an affected area. It’s very important you take precautions to prevent the disease.
Malaria can often be avoided using the ABCD approach to prevention, which stands for:
- Awareness of risk – find out whether you’re at risk of getting malaria.
- Bite prevention – avoid mosquito bites by using insect repellent, covering your arms and legs, and using a mosquito net.
- Check whether you need to take malaria prevention tablets – if you do, make sure you take the right antimalarial tablets at the right dose, and finish the course.
- Diagnosis – seek immediate medical advice if you have malaria symptoms, including up to a year after you return from travelling.
These are outlined in more detail below.
Being aware of the risks
To check whether you need to take preventative malaria treatment for the countries you’re visiting, see the Fit for Travel website.
It’s also important to visit your GP or local travel clinic for malaria advice as soon as you know where you’re going to be travelling.
Even if you grew up in a country where malaria is common, you still need to take precautions to protect yourself from infection if you’re travelling to a risk area.
Nobody has complete immunity to malaria, and any level of natural protection you may have had is quickly lost when you move out of a risk area...
It’s not possible to avoid mosquito bites completely, but the less you’re bitten, the less likely you are to get malaria.
To avoid being bitten:
- Stay somewhere that has effective air conditioning and screening on doors and windows. If this isn’t possible, make sure doors and windows close properly.
- If you’re not sleeping in an air-conditioned room, sleep under an intact mosquito net that’s been treated with insecticide.
- Use insect repellent on your skin and in sleeping environments. Remember to reapply it frequently. The most effective repellents contain diethyltoluamide (DEET) and are available in sprays, roll-ons, sticks and creams.
- Wear light, loose-fitting trousers rather than shorts, and wear shirts with long sleeves. This is particularly important during the early evening and at night, when mosquitoes prefer to feed.
There’s no evidence to suggest homoeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, yeast extract spread (such as Marmite), tea tree oils or bath oils offer any protection against mosquito bites.
Anti malarial tablets
There’s currently no vaccine available that offers protection against malaria, so it’s very important to take antimalarial medication to reduce your chances of getting the disease.
However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid bites is also important.
When taking antimalarial medication:
- make sure you get the right antimalarial tablets before you go – check with your GP or pharmacist if you’re unsure
- follow the instructions included with your tablets carefully
- depending on the type you’re taking, continue to take your tablets for up to 4 weeks after returning from your trip to cover the incubation period of the disease
Check with your GP to make sure you’ve prescribed a medication you can tolerate. You may be more at risk from side effects if you:
- have epilepsy or any type of seizure condition
- are depressed or have another mental health condition
- have heart, liver or kidney problems
- take medicine, such as warfarin, to prevent blood clots
- use combined hormonal contraception, such as the contraceptive pill or contraceptive patches
If you’ve taken the antimalarial medication in the past, don’t assume it’s suitable for future trips. The antimalarial you need to take depends on which strain of malaria is carried by the mosquitoes and whether they’re resistant to certain types of antimalarial medication.
In the UK, chloroquine and proguanil can be bought over-the-counter from local pharmacies. However, you should seek medical advice before buying it as it’s rarely recommended nowadays. For all other antimalarial tablets, you’ll need a prescription from your GP.
Read more about antimalarial medication, including the main types and when to take them.
Get immediate medical advice
You must seek medical help straight away if you become ill while travelling in an area where malaria is found, or after returning from travelling, even if you’ve been taking antimalarial tablets.
Malaria can get worse very quickly, so it’s important that it’s diagnosed and treated as soon as possible.
If you develop symptoms of malaria while still taking antimalarial tablets, either while you’re travelling or in the days and weeks after you return, remember to tell the doctor which type you have been taking. The same type of antimalarial shouldn’t be used to treat you as well.
If you develop symptoms after returning home, visit your GP or a hospital doctor and tell them which countries you’ve travelled to in the last 12 months, including any brief stopovers.
DEET insect repellents
The chemical DEET is often used in insect repellents. It’s not recommended for babies who are less than 2 months old.
DEET is safe for older children, adults and pregnant women if you follow the manufacturer’s instructions:
- don’t spray directly on to your face – spray into your hands and pat on to your face
- avoid contact with lips and eyes
- wash your hands after applying
- don’t apply to broken or irritated skin
- make sure you apply DEET after applying sunscreen, not before [malaria symptoms and treatment]