Tropical Travel: do Not Forget Malaria Protection!

Anyone planning a long-distance trip to tropical countries should definitely think about adequate protection against the infectious disease malaria. “In 2006, 566 cases imported to Germany were reported, and 5 travelers died from it,” warns Prof. Thomas Löscher of the Professional Association of German Internists (BDI).

Malaria in the Caribbean

Diseases are not only reported from the known risk areas. Again and again, vacationers also fall ill in travel countries that are not among the classic high-risk areas for malaria.

For example, in early November, two German tourists became infected with malaria during a vacation in the Dominican Republic and were admitted to a clinic in northern Germany with chills, fever, and diarrhea upon their return.

The couple had followed existing malaria recommendations and had not taken prophylaxis before traveling. “The risk of contracting the disease in the Dominican Republic is low, but with the end of the rainy season at the turn of the year, individual cases of malaria occur again and again. Therefore, it is important to inform yourself in advance of such a vacation trip about the risk of infection locally,” advises Prof. Löscher.

Drug prophylaxis

In addition to the cases that have become known, there is a considerable number of unreported introductions and travelers who already have the disease abroad. Globally, 300 to 600 million people contract malaria each year, with 1 to 3 million deaths. “When traveling to malaria areas with a high risk of transmission, preventive medication should be taken to fight the disease,” Löscher said.

In contrast, for people traveling to medium- or low-risk areas, carrying a backup medication for on-site treatment may be sufficient, in addition to consistent mosquito protection. Which medication should be taken depends on the destination, type, duration and timing of the trip. In addition, previous illnesses and the occurrence of side effects influence the choice of the appropriate medication. Vacationers must therefore obtain information about the appropriate prophylaxis well in advance of the start of the trip.

Nets and clothing protect against mosquito bites

The surest protection against infection is to avoid mosquito bites. Mosquito nets treated with a repellent against the disease-carrying Anopheles mosquitoes are best for this purpose. In addition, travelers should wear long clothing and apply mosquito repellent, especially in the early evening hours when mosquitoes are most active.

Anyone who, despite all precautions, becomes ill with a fever, severe feeling of illness, chills, and headache or aching limbs during or after a trip to a malaria area should be sure to see a doctor immediately. “Any fever in the tropics and after return is malaria suspicious,” emphasizes Prof. Löscher.

As a rule of thumb, one should therefore always think of malaria with these symptoms when returning from a risk area. Most malaria attacks after a tropical trip occur within 3 months after return.

If symptoms of illness occur during travel, travelers should take antimalarials carried with them only if a physician cannot be reached in the destination country within 24 hours of the onset of symptoms.