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Malaria is a very serious infection caused by a parasite called plasmodium, which you can catch from the bite of an infected mosquito. It can occur even up to a year after travelling in an area in where there is malaria.
Where is malaria found?Malaria is widespread in many tropical and subtropical countries including parts of Africa, Asia and South America.
The most common symptoms are fever and a flu-like illness between one to four weeks after the initial mosquito bite. People can also develop headaches, migraines, muscle pains, abdominal pains, cough, tiredness and sometimes diarrhoea and/or vomiting. In severe cases, Malaria can be fatal. You cannot be vaccinated against malaria, but you can protect yourself in two ways.
1. Avoiding mosquito bites: particularly during the hours of sunrise and sunset which is when the mosquito is most active. Use of insect repellents, appropriate clothing and mosquito nets should also be considered. The risk of getting malaria is greatest if you do not take your anti-malarial medication or do not take it properly. 2: Anti-malarial tablets: It is important to start the tablets before travel as guided by your travel nurse (with some tablets you should start three weeks before). The tablets must be taken regularly, preferably with or after a meal. It is extremely important to continue to take them for four weeks after you have returned, to cover the incubation period of the disease. Atovaquone/proguanil (Malarone®) requires only 7 days post-travel).
Urgent medical attention is required if a person has contracted malaria. It is normally treated using anti-malarial medicines but may require hospitalisation.
Travellers must always make sure they use a medication which they can tolerate (only the more common side effects are given here) and one which is appropriate for their entire trip. It is advised for people travelling to high risk places where malaria may occur and at Cosmopolitan Medical Clinic, our doctor or nurse will advise which vaccine is suitable. Some tablets may cause side effects, which we will discuss with you during the consultation. Women who are either pregnant or breastfeeding should discuss their itinerary and risk profile with our travel nurse. In Britain, chloroquine and proguanil can be purchased from local pharmacies or chemists. All other drugs require a doctor's prescription. CHLOROQUINE (LICENSED FOR PROPHYLAXIS IN UK) Preparations available: Avloclor® (Zeneca) and Nivaquine® (Rhône-Poulenc Rorer). Adult dose is 2 tablets (each containing 150mg chloroquine as base) taken once a week. Nivaquine is available in syrup form. Consider a trial course before departure, if using this regime for the first time, to make sure you do not develop any side effects (e.g. for two weeks). Otherwise, chloroquine is recommended to be started one week before travel (to ensure adequate blood levels), throughout travel in high risk areas and for 4 weeks afterwards. PROGUANIL (LICENSED FOR PROPHYLAXIS IN UK) Preparations available: Paludrine® (Zeneca). Adult dose is 200mg daily. This can be used continuously for a period of up to 5 years. One or two doses should be taken before departure and continued throughout travel in high risk areas and for 4 weeks afterwards. MEFLOQUINE® (LICENSED FOR PROPHYLAXIS IN UK) Preparations available: Lariam® (Roche). Adult dose is 250mg weekly. One dose should be taken a week before departure and it should be continued throughout exposure and for 4 weeks afterwards. However 3 doses at weekly intervals prior to departure are advised if the drug has not been used before — this can often detect, in advance, those likely to get side effects so that an alternative can be prescribed. DOXYCYCLINE (LICENSED FOR PROPHYLAXIS IN UK) Preparations available: Doxycycline (non-proprietary), Vibramycin® (Invicta). Adult dose is 100mg daily. It can normally be used continuously for a period of at least 6 months — be guided by your doctor. A trial course should be started at least one week before travelling, to ensure you do not develop any side effects. Otherwise doxycycline need only be started a few days just before travel, continued through travelling in high risk areas and for 4 weeks afterwards. ATOVAQUONE PLUS PROGUANIL (LICENSED FOR PROPHYLAXIS IN UK) Preparations available: Malarone®. Adult dose is one tablet daily - each tablet contains 250mg atovaquone plus 100mg proguanil. Child doses will be based on the weight of the child but will be once daily also. The course should start 2 days before entering the malaria high risk area, throughout exposure, and for 7 days after leaving the infected area. Licensed for trips of up to 28 days but there is no evidence of increased side-effects if used for longer. At Cosmopolitan Medical Clinic, our doctor or nurse will advise which vaccine is suitable based on your destination, itinerary, length of stay and any current medical conditions.