Preventing Malaria

Travel Clinics of America - how to prevent malariaMalaria is a serious disease transmitted by infected mosquitoes. Although there is no vaccine for malaria, travelers should avoid infection by repelling mosquitoes and using preventive medicines.

Malaria can develop days or weeks after an infected mosquito bite. If you develop unexplained fever during your trip, or any time in the year after you return home, then seek prompt medical care. Inform the treating physician about your travel history, including malaria prophylaxis medications you have taken.

Malaria risks in specific regions depend upon many factors, including mosquito population levels, weather conditions and local infection rates. Therefore, travelers must seek advice from medical professionals who have current knowledge of the malaria risk in your destinations.

Repelling Mosquitoes

  • Use insect repellent containing 30-50% DEET on all exposed skin except eyes, lips and open wounds.. Wash off with soap when you return indoors.

  • Apply sunscreen before applying insect repellent.

  • Pre-treat clothes, tents, netting and shoes with permethrin, which repels mosquitoes.

  • Read the product labels of repellent products carefully for proper use.

  • Minimize exposed skin when hiking. Wear long pants tucked into socks and long sleeve shirts tucked in.

  • Avoid perfumes and scented products which serve as mosquito magnets.

  • Choose accommodations with screens in all windows.

  • Use permethrin pre-treated mosquito bed netting with an elastic edge for a tight fit while sleeping.

  • Try to remain indoors between dusk and dawn when mosquitoes are most active.

Medications to Prevent Malaria

  • Anti-malarial medicines are taken before, during and after the trip. It is extremely important to take these medications as prescribed.

  • There are several medications available to prevent malaria. Some of these medicines work better in certain destinations, depending upon local malaria resistance patterns. Each of them has unique advantages and side-effects. Children and pregnant travelers require special considerations.

    Chloroquine

    • Used only for travel to areas where there is no chloroquine-resistant malaria.

    • Take once weekly.

    • Take with food for better tolerability.

    • Begin taking 1-2 weeks before travel to malaria-risk area..

    • Continue taking weekly while traveling in malaria-risk area and for 4 weeks after leaving the area..

    • Headache, dizziness, blurred vision, insomnia and itching are the most frequent side effects.

    Atovaquone/proguanil (Malarone)

    • Take daily.

    • Take at the same time every day.

    • Begin taking 1-2 days before travel to malaria-risk area.

    • Continue taking daily while in malaria-risk area and for 7 days after leaving the region.

    • Abdominal pain, nausea, vomiting and headache are the most frequent side effects.

    Mefloquin (Lariam)

    • Used only for travel to areas where there is no mefloquine-resistant malaria.

    • Take once weekly.

    • Continue taking weekly while in malaria-risk area and for 4 weeks after leaving the region.

    • Rarely associated with serious adverse reactions (e.g. psychosis or seizures) at prophylactic doses.

    • Upset stomach, headache, insomnia, abnormal dreams, depression, anxiety and dizziness are the most frequent side effects.

    Doxycycline

    • Take daily.

    • Take with food for better tolerability.

    • Do not take before going to bed.

    • Take at the same time every day.

    • Begin taking 1-2 days before travel to malaria-risk area.

    • Continue taking daily while in malaria-risk area and for 4 weeks after leaving the area.

    • Can cause photosensitivity (sensitivity to sunlight). Decrease the risk by avoiding sun exposure and using sunscreens.

    • Can cause vaginal yeast infection

Before you travel, see your travel medicine provider

  • Review your specific itinerary and determine your risk of malaria exposure.

  • Review your personal medical history and medications.

  • Discuss anti-malarial medication options.

  • Prepare an alternate plan in the event that you develop significant side effects to medication while abroad.

  • Discuss treatment options if you develop malaria while abroad.

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