Doctor Dang's Insider Tips on Preventing Malaria

by Drdang on October 5, 2010

Doctor Dang's Insider Tips on Preventing Malaria

With blood thirsty mosquitoes swarming the hot tropics, backpackers to malaria endemic areas would naturally be sprayed head-to-toe with mosquito repellent and armed with anti-malaria pills, right? Alas, this is not the case. Most of the 1,298 U.S. cases of malaria reported to the Centers for Disease Control and Prevention (CDC) in 2008 did not take proper preventive precautions.

Malaria is a serious infection that can progress rapidly and kill. Worldwide, there were an estimated 247 million malaria infections in 2006 that resulted in nearly a million deaths. Prevention involving personal protective measures and anti-malarial pills are highly effective and travelers to any of the 109 endemic countries should heed them. Don’t be a statistic. If you plan to backpack the tropics, be travel savvy and protect yourself from malaria.

1. Avoid mosquito bites

* Stay in well-screened rooms.
* Sleep under bed nets and wear clothes treated with insecticide (e.g. permethrin).
* Wear insect repellent. CDC recommends DEET 30−50% (e.g., Off!®, Cutter®, Sawyer®, and Ultrathon™). Picardin 20% (Sawyer™ Insect Repellent) is also an effective alternative. Most repellants are water soluble so reapply frequently if swimming or sweating a lot. For more information on the difference between DEET and picardin, click here for an article from The Medical Letter on Drugs and Therapeutics.
* Wear long pants and long-sleeved shirts to reduce the amount of exposed skin.
* Avoid the outdoors between dusk and dawn when mosquitoes are most active.


2. Take anti-malaria pills

* The type of anti-malaria pill you need depends on the country you visit, local pattern of drug resistance, and personal medical conditions. On the CDC website, you can find malaria information by country along with CDC-recommended medication regimens. Don't forget to check out my tips on buying anti-malaria pills.
* The emergence of drug resistance worldwide has complicated anti-malaria recommendations, and the CDC recommends consulting a travel specialist. Click here for links to U.S. travel medicine clinics. The International Society of Travel Medicine is another great resource.
* Some anti-malaria medications have to be taken at least 1−2 weeks prior to travel and continued for up to a month after leaving the endemic country. You can still get malaria if you do not take the pills consistently or complete the entire course. Make sure you follow your doctor’s advice on how to take the anti-malaria pills.


3. Know the symptoms of malaria

* Malaria causes fever and flu-like symptoms.
* Symptoms can occur within a week of exposure or even several months after leaving an endemic area.


4. Seek medical attention

Malaria can be treated effectively if caught early. The key is to see a doctor as soon as you have symptoms.

* REMEMBER − No anti-malaria medication is 100% effective.
* If you develop a fever during or after travel, you need to see a doctor immediately.
* Tell your doctor that you may have been exposed to malaria. It is important to report your travel history in the first year following exposure to an endemic area.
* If you have general questions about malaria or malaria prevention, you can call the CDC Malaria Hotline at (770) 488-7788.


Dr. Bic Dang specializes in infectious diseases and previously worked as a physician epidemiologist at the CDC. She loves traveling abroad, from scuba diving in Honduras to volunteering at an orphanage in Vietnam to doing HIV/AIDS work in Lesotho.