Prevention of mosquito bites between dusk and dawn is the first line of defence against malaria. Measures to prevent mosquito bites include sleeping under long-lasting insecticidal nets, and using protective clothing and insect repellents.
Depending on the malaria risk in the area to be visited, travellers may also need to take preventive medication (malaria pills) prior to, during, and upon return from their travel.
When considering the travel risks of malaria it’s important to:
• Know the malaria-infected areas of any countries to be visited.
• Be familiar with all the insect bite-avoidance measures available, this may include protective clothing, insect repellents, mosquito nets.
• Seek medical advice prior to travel regarding preventive medication options, including how to take medication. For some travellers, malaria treatment medication may be recommended to treat the disease as adequate medical facilities may not always be available.
• Seek medical attention promptly if malaria infection is suspected - even if you have been taking anti-malaria medication.
Determine if malaria transmission occurs at the destinations
Obtain a detailed itinerary including all possible destinations that may be encountered during the trip and check to see if malaria transmission occurs in these locations. The Malaria Information by Country Table (from cdc.gov) provides detailed information about the specific parts of countries where malaria transmission does or does not occur.
It also provides additional information including the species of malaria that occur there, the presence of drug resistance.
Many effective antimalarial medications (malaria pills) are available. Your health-care provider and you will decide on the best drug for you, if any, based on your travel plans, medical history, age, drug allergies, pregnancy status, and other factors.
To allow enough time for some of the drugs to become effective and for a pharmacy to prepare any special doses of medicine (especially doses for children and infants), you may need to visit your health-care provider 4-6 weeks before travel. Other malaria medicines only need to be started the day before travel and so last-minute travelers can still benefit from a visit to their health-care provider before traveling.
What is known about the long-term effects of drugs that are commonly used to prevent malaria?
The drugs used to prevent malaria have been shown to be safe and well-tolerated for long term use.
I was born in a country where malaria is present and had malaria as a child, and then moved to the United States many years ago. Do I need to worry about getting malaria when I return home?
Yes. Anyone who goes to a country where malaria transmission occurs should take precautions against contracting malaria. During the time that you have spent in the United States, you have lost any malaria immunity that you might have had while living in your native country. Without frequent exposure to malaria parasites, your immune system has lost its ability to fight malaria. You are now as much at risk as someone who was born in the United States (a “nonimmune” person). Please consult with your health-care provider or a travel clinic about precautions to take against malaria (preventive drugs and protection against mosquito bites) and against other diseases.
Is it safe to buy my malaria drugs in the country where I will be traveling?
Buying medications abroad has its risks. The drugs could be of poor quality because of the way they are produced. The drugs could contain contaminants or they could be counterfeit drugs and therefore may not provide you the protection you need against malaria. In addition, some medications that are sold overseas are not used anymore in the United States or were never sold here. These drugs may not be safe or their safety has never been evaluated.
It would be best to purchase all the medications that you need before you leave the United States. As a precaution, note the name of the medication(s) and the name of the manufacturer(s). That way, in case of accidental loss, you can replace the drug(s) abroad at a reliable vendor.
Isn’t there a malaria vaccine? And if not, why?
Attempts at producing an effective malaria vaccine and vaccine clinical trials are ongoing. The malaria parasite is a complex organism with a complicated life cycle. The parasite has the ability to evade your immune system by constantly changing its surface, so developing a vaccine against these varying surfaces is very difficult. In addition, scientists do not yet totally understand the complex immune responses that protect humans against malaria. However, many scientists all over the world are working on developing an effective vaccine. Because other methods of fighting malaria, including drugs, insecticides, and insecticide-treated bed nets, have not succeeded in eliminating the disease, the search for a vaccine is considered to be one of the most important research projects in public health.
After Returning from an Area That Has Malaria
How long after returning from an area with malaria could I develop malaria?
Any traveler who becomes ill with a fever or flu-like illness while traveling, and up to 1 year after returning home, should immediately seek professional medical care. You should tell your health-care provider that you have been traveling in an area where malaria transmission occurs and ask to be tested for malaria infection.
Can I give blood if I have been in a country where there is malaria?
It depends on what areas of that country you visited, how long ago you were there, and whether you ever had malaria. In general, most travelers to an area with malaria are deferred from donating blood for 1 year after their return. People who used to live in countries where malaria transmission occurs cannot donate blood for 3 years. People diagnosed with malaria cannot donate blood for 3 years after treatment, during which time they must have remained free of symptoms of malaria.
Blood banks follow strict guidelines for accepting or deferring donors who have been in malaria-endemic areas. They do this to avoid collecting blood for transfusions from an infected donor.