How I Naturally Protect Myself From Malaria When Traveling | Travel Health Tips
How to Prevent Malaria When You're Traveling
Malaria is a deadly parasitic blood disease that is transmitted through mosquito bites. There are approximately 200-300 million cases of malaria, and 800,000 malaria-related deaths reported annually throughout the world. This disease is particularly dangerous to young children and pregnant women due to their immature or decreased immune systems. Transmission occurs mostly in tropical and subtropical regions of the world, specifically sub-Saharan Africa, Southeast Asia, the Middle East (up to the Southern tip of Turkey), South and Central America, and as far west as Mexico and as far east as Vanuatu in the western Pacific.Individuals are at risk if they live in, or travel to, a country where there are malaria-infected people and mosquitoes. Therefore, it is imperative that travelers take preventative measures to protect themselves from infection. The following article provides several suggestions on how you can take precautions to prevent from being infected by malaria when you're traveling.
Research all travel destinations prior to departure to check the occurrences of malaria.Malaria can occur even in places not known for it, depending on unusual seasonal changes, influxes of people from other areas, or for other unforeseen reasons, so it is important to check the most up-to-date information for the destinations you're headed to. There are several ways to find out more information:
- Search for government information. Government agencies responsible for keeping an eye on health trends are likely to be the most up-to-date and reliable sources of information, so they should be your first port of call. The sites likely to be most relevant in terms of government include health departments or agencies, health centers sponsored and validated by a government agency, and foreign affairs travel warning sites. In the United States, a good place to begin is with the Centers for Disease Control and Prevention (CDCP).
- Ask your medical practitioner for more information to help determine if your destination is home to malaria.
- If you know people who live in the area, send them an email or telephone them to ask them what they know about the current situation and particular requirements that they've been told.
- Ask the travel agent and airline. These are not going to necessarily be helpful or reliable but they might be your final source for checking independently if needed.
Consult with your physician, pharmacist, or travel health clinic about protective measures.The first line of defense will be the prescription of anti-malarial drugs (also known as malaria prophylaxis medicines).It is helpful to do some research of your own into these drugs so that you can have an informed discussion with your doctor about which drugs are best in your case. Some medication can have severe side-effects, such as violent mood swingsin those who suffer from pre-conditions such as depression in the case of mefloquine,so ask your doctor pertinent questions and ensure that there is plenty of time to notice any negative changesbeforeyou leave your own country so that changes to the drug prescribed can be made if needed (at least three weeks of weekly tablets of mefloquineat homebefore leaving is beneficial). In addition, resistance to some anti-malarial medication is becoming increasingly evident, as in the case of chloroquine, so you may have less choice in the type of medication you take in areas with high resistance levels.Talk to your health practitioner about the options and be sure to specify the exact destination, as even where you're going can impact the type of anti-malarial drugs you'll be given. You will usually have to commence medication for a week or more prior to departure, so be sure to see your doctor early on in your travel plans.
- Follow the recommended dosage and schedule to ensure effectiveness of the drug. Typically, you may expect to take the proper dosage 1-2 weeks before departure, throughout the duration of the trip, and for 4 weeks after leaving the infected locale.
- Children can take anti-mararial drugs but the dosages will be a lot less than those for the adult. Chloroquine and proguanil tend to be prescribed for children, while doxycycline is unsuitable for children under 12.Follow the doctor's advice and be sure to raise any concerns you have at the time of your visit.
- Understand that anti-malarial drugs are not 100 percent effective, and travelers still run the risk of possible malaria transmission if additional preventive measures are not taken.
Don't go.There are some people who should really think twice about going into an area infested with malaria. These are pregnant women, infants, young children (ask your doctor about what age he or she considers "safe"), and anyone who is immuno-compromised, including those who have had their spleen removed.For pregnant women, chloroquine-resistantP. falciparum(see below) can cause abortion, premature birth, still-birth, and maternal death,so pregnant women should not travel to areas where this genus of mosquito is prevalent. WHO advises against taking infants and young children into malarious areas, especially where there isP. falciparum.
- In some cases, it may be possible to travel to an urban part of a malarial country where the mosquito population is under control and to require vulnerable people to remain there while the rest of the party travels into malarious areas. This at least gives the option of traveling part of the way and seeing the sights of at least part of the country.
Be informed.Many malaria deaths are considered to have been preventable if only travelers were more aware.Be absolutely certain that taking anti-malarial medicine isnotenough on its own to protect you. You also need to take the precautions suggested in the following steps for more thorough protection. Some helpful things to understand about mosquito behavior include:
- It is certain species of female mosquitoes of the genusAnophelesthat bite. She usually does so between dusk and dawn.
- The most common malarial parasites that infect humans are:Plasmodium falciparum(life-threatening); and three "benign" malaria strains:P. vivax,P. ovale, andP. malariae.P. falciparumkills an estimated 1 to 2 million people a year and those most vulnerable to it are those who have not grown up in a malarial environment.
Protect yourself against mosquito bites while traveling.There are a number of sensible precautions that you can take to keep mosquitoes (and other unhelpful bugs) at bay when you're traveling.The following sections provide several methods aimed at reducing your risk provided you are consistent, assiduous, and careful at all times. Note that a number of these measures will also decrease the risks of being bitten, burrowed into, chewed on, etc. by other bugs but you should still take appropriate precautions targeted at any particular danger you're aware of. In a nutshell, specialist in travel medicine, Dr Charlie Easmon, recommends that a traveler use the A, B, C, and D prevention method:
- A – for awareness. As already stated, being aware of the risk is your first line of defense.
- B – for bite avoidance. Not getting bitten should be your number one aim.
- C – for chemoprophylaxis. This means taking preventive methods when traveling into a malarious region.
- D – for diagnosis. If you are unfortunate enough to contract malaria, prompt attention and treatment of it is essential.
- E – for remote travel. Dr Easmon adds this because if you're traveling somewhere remote, you'll need to know how to use emergency treatment with safe drugs. Talk to your doctor; at this level you should at least be proficient with first aid and have a basic understanding of responding to symptoms etc.
Use personal insect repellent protection.There are different types of repellent available on the market and some ingredients are stronger than others and may not be available in all countries. Generally, products containing pyrethrum or synthetic pyrethroids are considered safe for personal use.Use of products containing DEET (chemical name, N,N-diethyl-meta-toluamide) is a personal choice, but DEET is highly effective against mosquitoes and other insects and is considered to have an excellent safety profile for adults, pregnant women, and children.Products containing DEET currently are available to the public in a variety of liquids, lotions, sprays, and impregnated materials (for example, wrist bands).DEET products should not applied to babies under two months of age and for children the percentage of DEET should be within the range of 10 to 30 percent.When using DEET, follow the manufacturer's instructions accurately, do not apply to open wounds or cuts, do not applyunderclothing, and wash the DEET off when you are back indoors.
- Apply insect repellent only toexposedskin, not under clothing which is already serving as a barrier. Confirm the effectiveness of your repellent by checking the CDCP web site and follow all label instructions for proper application.
- Non-DEET alternatives for those who dislike DEET include: Jungle Formula, Bayrepel, Mosi-guard, etc.
- Watch for signs of an adverse reaction to any personal insect repellent that has not been used before. Symptoms can include rashes, swelling, redness, etc. Stop using it immediately, wash it off, and contact your local poison center for assistance.
Prepare your sleeping quarters well.Bear in mind that mosquitoes aren't fussed about whether you're indoors or out, so you'll need to take precautions inside places that have not been protected adequately by screens and other barriers against entry. Sleeping measures include:
- Sleep indoors. Insect-proof all sleeping quarters or sleep under a mosquito net. Sleep off the ground. Sleeping outdoors in a malarious region is very dangerous as you are exposed to the mosquitoes. If you need to sleep outdoors, sleep under a properly installed, repellent-treated bed net.
- Windows and any other entry points from outside should have gauze over them.
- The sleeping rooms should be sprayed with an insecticide in the evening to get rid of any mosquitoes that have dropped by during the day. Vaporizing synthetic pyrethroids (Bioallethrin 4.2% w/w) over an electrical heating device or over a spirit burner can help to clear the room of bugs, as can burning mosquito coils.
- The sleeping net , screens, and curtains can be made more protective by soaking it in permethrin (0.2g per m2 of material every six months).These substances are harmless to humans.
- During the daytime, the sleeping net should be rolled up to prevent entry of mosquitoes or other insects.
Wear protective clothing.Both at day and during the night, wear clothing that makes it difficult for mosquitoes to penetrate your skin. The following methods can help:
- Wear long-sleeved shirts, pants, and covered shoes.
- Wear thick socks and tuck pants into them to prevent an entry point for mosquitoes.
- Light colored clothing is less appealing to mosquitoes.
- Consider pre-treating clothing, socks, hats, bandannas, and shoes with pyrethrum or permethrin according the the instructions accompanying the product. Ask about other suitable products as well. Follow the label instructions when applying insecticide and allow adequate time for the items to dry before being used.
- Also treat camping gear, bed nets, and blankets used for camping, expeditions, etc.
Stay in at .Female mosquitoes are out and about between dusk and dawn, feeding at night. Reduce the chances of meeting them by remaining indoors during these peak biting hours.
Take additional precautions for remote locations.If you're planning on heading for a remote malarious area, an additional precaution is to include the use of quinine in case you get a fever.Some anti-malarial drugs can also be taken as stand-by treatments; talk to the expedition doctor for precise details.
Continue to take anti-malarial medication upon your return home, as advised by the manufacturer's directions or your health practitioner's advice.The dosage will have already been determined for you but if you experienced delays in your travel plans, etc., see your doctor as soon as you return for updated advice. Except for Malarone, all anti-malarial drugs need to be continued for four weeks after returning home.
- Failure of travelers to take anti-malarial drugs for the full prescribed cycle, including upon returning home, lessens their effectiveness.Be mindful that vomiting and diarrhea during the trip can also lessen the effectiveness of these drugs.
Seek medical help immediately if you experience symptoms of malaria.Prompt treatment can save your life or reduce the severity of the disease. Symptoms include cycles of chills, fever and sweating every 1-3 days. Nausea, vomiting and diarrhea may also be present during feverish periods.
- If a child contracts a fever after being in a malarious area, do not hesitate; go straight to the doctor as children succumb to malaria extremely quickly.
- Malaria is a tricky disease. TheP. vivaxandP. ovalecan become established in the liver in spite of taking anti-malarial precautions, causing relapse infections months or even years later. Talk to your doctor about taking additional precautions upon coming home from areas where these species are prevalent because you may need to take primaquine to eliminate the liver cycle.
- Long term usage of anti-malarial drugs requires specialist advice; ask your medical practitioner for more information.
- It is recommended that you carry your own net when going to malarious places, as you won't always be assured of having one available for you.
- Avoid ineffective, counterfeit anti-malaria drugs by acquiring a prescription from your personal physician prior to leaving the country.
- Be aware of current international outbreak zones and do your best to avoid them. You can check for regional transmission patterns and outbreak alerts via the CDCP web site.
- Good places to look for more details online include schools of tropical medicine. They will have lots of up-to-date information for you to read, as well as good links to other relevant sites.
- A suitable net for repelling mosquitoes is one that has a small mesh, no holes, and it able to be tucked in under the bottom sheet.
- Malaria parasites can be transmitted through the use of needles or syringes contaminated with the blood of an infected person, or through the transfusion of blood from an infected person.
- If you believe you have contracted malaria, seek treatment immediately even if you believe all active symptoms have passed. Parasites can remain inactive in the liver and cause a reappearance of symptoms months, or even years, later.
- Avoid direct inhalation of insecticide spray or smoke.
- Impregnation of clothes and other products has a use-by date of about 6 months to a year, at which time you'll need to reapply the insecticide barriers if the items are still being used for mosquito repellent purposes.
- Keep all medications, insect repellents, and other dangerous substances being used to ward off mosquitoes locked away from children. Childproof containers are ideal when traveling. Bear in mind that a chloroquine overdose can kill a child.
- Those who have a history of depression or other psychiatric disorders or who suffer from seizures (epilepsy) are advised to avoid mefloquine as an anti-malarial drug.In addition, it may affect young women most.
- Choice of anti-malarial drug by region is as follows:
- Middle East, West Asia, Indian subcontinent, parts of South America (not the Amazon region of Brazil), China: proguanil (Paludrine) plus chloroquine (Nivaquine or Avloclor)
- Mexico, Central America, Haiti, Dominican Republic, parts of South America (not the Amazon region of Brazil: chloroquine
- Africa, Amazon region of Brazil, south-east Asia (not Thai-Cambodian border region): mefloquine (Lariam), doxycycline (Vibramycin), or atovaquone-proguanil (Malarone)
- West Pacific, New Guinea: mefloquine or doxycycline
- Thai-Cambodian border region: doxycycline or Malarone
- Turkey, Egypt, Mauritius (rural, seasonal): chloroquine or proguanil.
Video: How to Help Stop the Spread of Malaria
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