Travel Medicine Clinic at Hartshorn Health Service (970)-491-7121

Malaria is a life-threatening, parasitic disease transmitted to humans by the bite of an infected mosquito. It was once thought to be caused by marsh areas, hence the name malaria (bad air). In 1880, scientists discovered it was caused by a parasite. There are four types of malaria that threaten over 40% of the world=s population.

Where does malaria exist?

Malaria exists in over 100 countries around the world. Large areas of Central and South America, Haiti and the Dominican Republic, Africa, the Indian Sub-continent, Southeast Asia, the Middle East, and Oceania are considered malaria-risk areas. In countries where malaria occurs, the highest rates of transmission occur in low-lying areas during, and just after, the rainy season. In some countries malaria transmission may be high year-round, even in urban areas.

How common is it?

The World Health Organization estimates that 300-500 million acute cases of malaria occur and more than 1 million people die of malaria annually. Most of the deaths occur in children in Sub-Saharan Africa. Each year 1000-1500 cases of malaria are diagnosed in the United States in immigrants and travelers returning from malaria-risk areas.

How do you get malaria?

If a person is bit by an infected mosquito the parasite will go from the mosquito into the persons blood. The parasite then travels to the liver where it grows and multiplies. The parasite leaves the liver after a period as short as 8 days or as long as several months and enters the blood where it bursts the red blood cells and releases toxins which make the person feel sick.

What are the signs and symptoms of malaria?

Most people will begin with symptoms 10 days to 4 weeks after infection although a person may feel ill as early as 8 days or up to one year later. Symptoms of malaria include fever and flu-like illness, including chills, headache, muscle aches, and fatigue. Nausea, vomiting, and diarrhea may also occur. Malaria can cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells.

One form of malaria, P. Falciparum, can kill by infecting and destroying red blood cells (anemia) and clogging the capillaries that carry blood to the brain or other vital organs. If not treated promptly it can cause kidney failure, seizures, mental confusion, coma and death.

Two kinds of malaria, P. Vivax and P. Ovale, can relapse. These parasites can stay in the liver for several months up to 4 years after initial infection and then invade the red blood cells causing symptoms.

How do they diagnose and treat malaria?

Malaria is diagnosed by looking at a drop of blood under a microscope. Malaria can be treated with prescription medications. The type of medication depends on the kind of malaria diagnosed, where the person was infected, their age, and how ill they are.

Can malaria be prevented? YES!!!!

- Visit your health care provider 6-8 weeks before foreign travel to obtain a prescription for antimalarial drugs.
- Ways to prevent mosquito and other insect bites include:

1. Avoid being outside from dusk until dawn when mosquitoes come out to feed.
2. Wear long pants and long-sleeved shirts, especially between dusk and dawn. Avoid wearing tight fitting clothing because mosquitoes can bite through the fabric. Never leave clothes lying on the ground.
3. Always wear shoes and socks and use a repellent on the skin above your socks, even when wearing pants.
4. Use DEET insect repellent on exposed skin. Concentrations between 30% to 35% provide effective protection on adults. Concentrations of 6% to 10% can be used on children. Do not inhale or use on wounds or irritated skin.
5. Premetherin can be used on clothes, nets, tents, curtains and gear. When applied to clothing it will repel or kill mosquitoes, ticks, chiggers, and mites.
6. Sleep under a mosquito bednet that has been dipped in premethrin insecticide if you are not staying in well screened housing.
7. Consider carrying duct tape to patch tears in window screens and spaces between screens and window frames.
8. Use fans where available because the air currents help keep mosquitoes away.

- Be sure to take your anti-malarial pills during and after your trip as prescribed.

What do I do if I become sick with a fever?

Fever in the first week of travel in a malaria risk area is unlikely to be malaria but any fever should be evaluated.

Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to 1 year after returning home should seek prompt medical attention and should tell the physician their travel history.