Clinic: I'm planning a three-week trip to Tanzania. My doctor
recommends that I take medication to prevent malaria. Is this
really necessary? I thought malaria wasn't common anymore. Are
there other things that I can do to protect myself? Is
effective treatment available for malaria?
A: While there
is no vaccine for malaria, it is essential that you receive
medication to prevent malaria before you go to Tanzania.
Although cases of malaria worldwide are decreasing, malaria
continues to be a significant travel-related disease that
carries a risk of serious illness and death. To discuss the
specific malaria medication you need and other travel-related
health precautions you should take, consult with a travel
medicine expert well before your trip.
Malaria is a
disease caused by a parasite that is transmitted to humans
through the bites of infected mosquitoes. People who have
malaria usually get a high fever, headache and shaking chills.
Malaria symptoms typically begin within a few weeks after
being bitten by an infected mosquito. Malaria can be fatal,
particularly when caused by the variety of parasite called
Plasmodium falciparum that's common in tropical parts of
Africa. The risk of death increases in people who have not
been exposed to it previously.
certain parts of the world poses a higher risk of malaria due
to the presence of the more potent type of malaria there,
coupled with a higher density of mosquitoes within those
areas. Its risk is highest for those traveling to countries in
sub-Saharan Africa, followed by developing countries in
Oceania. In the Western hemisphere, malaria risk is highest in
Haiti and the Dominican Republic. There is also a risk in many
countries of Southeast Asia, Central America and South
America. The number of people returning to the U.S. with
malaria has been increasing in past decades, and most cases
have been Plasmodium falciparum.
used to prevent malaria are very effective. It's important
that you get the correct type of medication for the area where
you are traveling, though, and carefully follow the directions
on how to take it. Different parts of the world have different
species of malaria and require different medications for
prevention. U.S. travelers who take preventive medication and
still get malaria or die from the disease are those who take
the wrong medication for their region of travel or take the
to travel to countries that have a risk of malaria should talk
with their health care provider, make an appointment with
their local travel clinic or visit the Centers for Disease
Control and Prevention website to find the best preventive
medication to take for their region of travel.
In addition to
taking the right medication, follow other precautions to
decrease your risk during your trip. That includes wearing
long sleeves and pants while in these areas and applying
insect repellent to exposed skin.
repellents that are most effective contain DEET, icaridin or
lemon eucalyptus extract. Apply repellent to your exposed skin
in the morning after you've put on sunscreen. Reapply it in
the early evening. If you don't have netting for your bed, add
a third layer of repellent before going to bed. For additional
protection, use the insecticide permethrin on your clothing.
If you notice
symptoms of illness after your trip, see a health care
provider right away. Tell your provider of your recent
travels. Effective treatment for malaria is available in the
U.S. Because malaria is so uncommon in this country, however,
providers may not be familiar with diagnosing or treating it,
and malaria could be misdiagnosed as a viral illness.
Treatment for malaria requires infectious disease expertise,
and an infectious disease specialist should be consulted
whenever malaria is suspected. Treatment for malaria involves
IV or oral medications, depending on the severity of the