Malaria Prevention

Malaria parasites are picked up by the female Anopheles mosquitoes from people who are already infected with malaria. Female Anopheles mosquitoes bite people in order to get the blood they require for nurturing their eggs.

Once inside the mosquito’s body, the parasite reproduces rapidly. When a mosquito with the parasite in its saliva bites someone, the parasite is transmitted into the host’s blood.

The parasite then moves on to the host’s liver and reproduces there, causing fever, chills, and in extreme cases, coma and death.

The malaria parasite is only carried by the female anopheles mosquito therefore not all mosquito bites will result in malaria. The male anopheles mosquito does not bite and the other species of mosquito do not carry the parasite at all. This is not a reason for a casual approach to bite avoidance – all mosquito bites should be avoided- but anti-malaria tablets will help to prevent malaria if you do get bitten.

Mosquitos are most active from dusk through to early sunrise. Use bite avoidance measures such as insect repellents, mosquito coils, and nets as well as wearing long, loose fitting clothes to prevent bites. Higher concentrations of DEET (the active ingredient in repellents) are recommended for wet conditions, hot environments or if you suffer from excessive perspiration (when there is a greater chance of it being washed away).

Malaria is most common in the tropical and subtropical parts of the world, where rainfall and warm temperatures provide an ideal breeding ground for mosquitoes. The Anopheles mosquito needs a hot, humid climate to reproduce and is found in South-East Asia, Pacific Islands, Africa, Central and South America and the Caribbean.

Malaria is a disease that can be caused by 4 different types of plasmodium parasite. Some antimalarials are more effective at treating one type of malaria than another. Therefore the required malaria tablets will differ depending on the country you are visiting. This information is updated regularly and we recommended you check on fitfortravel.nhs.uk for the most up to date travel health information.

Malaria is a blood-bourne disease that is only transmitted through mosquito bites, dirty needles, blood transfusions and during delivery in pregnancy. It is not contagious and cannot be passed on like the common cold.

Once bitten by an infected female Anopheles mosquito, the symptoms of malaria can take 1 to 4 weeks to develop. The parasites that cause malaria can lie dormant in the liver and not produce symptoms for up to a year and sometimes this can cause re-infection of the disease. It is therefore important to see your GP urgently if you develop the symptoms of malaria within a year (especially within 3 months) of returning from a country where there is a malaria risk.

You need to have a blood test to know if you have malaria. The parasite will be visible in the red blood cells under a microscope. This is the only definitive way to diagnose malaria.

If you are suffering with any symptoms that may be due to malaria, it is extremely important to seek urgent medical attention.

Antimalarial tablets have been shown to be tolerated for a year or more. If you require treatment for a year or more you should see your GP for specialist advice.

When travelling abroad to a malaria zone, you need to start taking the malaria tablets before you enter to ensure you have sufficient medication in your system to give you protection against the malaria parasite. It is advisable to get them before you travel.

Additionally, medicines and pharmacies are heavily regulated in the UK. There is an audit trail of the manufacture, their storage conditions and their supply to ensure your safety. The medicines you buy abroad may not be as well controlled and you may purchase inferior quality medication that can be out of date, counterfeit or simply may not work.

Unfortunately there is not currently a vaccine against malaria but this is being researched and scientists are making progress in development. At present the only way to prevent malaria is by antimalarial tablets, eradication of mosquitoes and prevention of mosquito bites.

Travel to malaria zones is best avoided in pregnancy as the disease can cause still-birth, premature birth or miscarriage. If travelling to a malaria zone cannot be avoided then antimalarial medication is recommended. Pregnant women should see their GP to discuss the most appropriate regime of antimalarials.

Some medications pass through the baby via breast milk but the amount will be too small to protect against the disease. Breastfeeding mothers with young children should consult their GP regarding antimalarial requirements.

Malaria is curable with the right treatment in a timely manner. Different strains are prevalent in different parts of the world meaning different options are used for its treatment and prevention. Delaying treatment or using the wrong treatment can prolong the disease and can be dangerous. The strain P. falciparum is the most dangerous as it may have fatal consequences. P. vivax and P. ovale are not as dangerous as P. falciparum but can lie dormant for long periods of time in the liver and may cause relapses of the disease. P. malariae can be in the blood of untreated individuals for many years sometimes decades.

No matter the strain of malaria, it has potential to be cured with fast, effective treatment administered by a medical professional. It is extremely important to seek urgent medical attention if you suffer with any of the malaria symptoms when travelling or after return.

Yes, malaria is treatable but the process can be quite long and the disease can be fatal. Prevention is always better than cure.

Use the recommended antimalarial medicine for your destination and using effective bite avoidance measures such as insect repellents containing DEET, sleeping under mosquito nets and covering up between dusk and dawn will all help to significantly reduce the risk of contracting malaria. See our 'Prevention' section for more detailed advice.

The medicines that are available to prevent malaria include Malarone (and generic atovaquone/proguanil), doxycycline, mefloquine (Lariam), chloroquine (Avloclor) and proguanil (Paludrine).

Yes, as long as you are buying from a website that is a legally operating and regulated pharmacy it is perfectly safe to buy malaria tablets online. The Independent Pharmacy is an NHS Online Pharmacy based in Bristol and has all the necessary regulation to be able to safely provide convenient access to genuine prescription malaria tablets through our Online Pharmacy.

There are 4 different types of parasite that cause malaria in different parts of the world; hence the medication used to prevent malaria varies according to you destination. The treatments may change according to the updated information depending on current levels of resistance. It always best to check first before purchasing your antimalarials, even if you have used them for your destination previously. Use fitfortravel.nhs.uk for up to date information on the right medication to take for the area that you will be travelling to.

Each antimalarial has its own pros and cons; Malarone is the most expensive but tends to have the least side effects whilst doxycycline is the cheapest but can make you burn very easily in the sun. Once you have found which antimalarial(s) are suitable for your trip, you should read the information on each individual product carefully before making your decision.

This varies on the medication you are taking. All malaria tablets start at least two days before you enter the malaria zones, whilst you are there and for at least a week after you leave the area. It is important to take the tablets at regular intervals as directed and to finish the course.

• Malarone (and generic atovaquone/proguanil) is taken once daily starting only 2 days before you travel, during your travel and for 1 week after you return.
• Doxycycline is taken one capsule daily, starting 2 days before your trip, during your trip and continuing for 4 weeks after you get back.
• Mefloquine (Lariam) only needs to be taken one tablet weekly, starting 3 weeks before the trip, continuing during your travel and for 4 weeks after you return.
• Chloroqine tablets are taken 2 tablets weekly starting 1 week before travel, whilst you are in the malaria zone for 4 weeks after exiting the malaria zone.
• Chloroquine/Paludrine travel pack is taken as 2 chloroquine tablets weekly and 2 paludrine tablets daily. It should be started 1 week before travel, continued for the time you are there and for 4 weeks after returning.

Malarone (atovaquone/proguanil) is very well tolerated and usually the side effects are rare. If you do experience any unwanted effects they can include stomach upset, headache skin rash and mouth ulcers. Side effects can sometimes be reduced by taking Malarone with food.

Doxycycline treatment can cause your skin to show increased sensitivity to UV sunlight. This means that you will burn much quicker on exposure to the sun than normal. Most malaria zones exist in warmer climates, as this is where mosquitoes thrive. To counteract this you should wear a high factor sun block (SPF 50), try to cover exposed skin and stay out of the sun when it is strongest between 11am-3pm. Other mild side effects that are reported with doxycycline treatment include stomach upset, indigestion and thrush.

Mefloquine (Lariam) needs to be avoided by those who have suffered from (or have a close family member who suffers from) mental illness and those who are epileptic because it can cause vivid dreams and sleep disturbance, mood changes and anxiety.

Atovaquone/proguanil are the two ingredients contained in Malarone tablets. When the exclusive patent expired for Malarone tablets, other manufacturers could also produce tablets containing atovaquone/proguanil without the brand name Malarone. This means you can get the medically identical, unbranded medicine at a significant reduction of the branded price.

People who live in areas where malaria is prevalent can acquire some partial level of immunity. This usually happens from a young age however, there is no way to tell or guarantees. Partial immunity to malaria can wear off; those born in a malaria-risk area who leave for a significant period should not assume that they still have a level of immunity.

You should never assume you are immune to malaria, it is always best to take antimalarials and avoid bites as a precaution.

If a level of immunity has been acquired since an early age this diminishes quickly when the person no longer lives in the malaria area. People returning to countries of their birth that carry a malaria risk should not assume they have immunity. Antimalarial tablets are always required in these cases.

Malaria destroys red blood cells and clogs the capillaries (blood vessels) that supply blood to the brain and other major body organs. If not treated in a timely manner, this may prove fatal.

There are 4 major types of malaria. These are:

• Plasmodium vivax
• Plasmodium malariae
• Plasmodium ovale
• Plasmodium falciparum

Plasmodium falciparum is the most dangerous and fatal type of malaria. Each type of malaria occurs in different parts of the world requires different preventative medicines, therefore it is important to check which malaria tablets you require for your trip.

Malaria that is not severe or complicated in nature can be treated through oral medications. Artemisinins in combination with other antimalarial medication, such as amodiaquine, lumefantrine, mefloquine, etc. are an effective treatment against malaria.

In case of severe malaria, doctors prescribe intravenous administration of antimalarial treatments, including artesunate administration in a critical care unit, where the patient may be monitored for other manifestations of the disease such as low blood potassium and seizures.

No, malaria and yellow fever are not the same illness, though they are spread in a similar way. Malaria is caused by a parasite that gets inside your bloodstream and causes illness. This disease can be fatal if medical attention is not sought fast enough.

Yellow Fever is a virus, also spread by mosquitos, which is of typically short duration. Symptoms usually include fever, chills, loss of appetite, nausea, muscle pains and headaches. They usually improve within five days.

Malaria outbreaks can happen, with little warning, in many countries. Some countries regularly pose a risk of contracting malaria, including Ghana, Nigeria, Tanzania, Thailand, Ethiopia, Uganda, Kenya, Zambia, Zimbabwe, Vietnam, Honduras and parts of southern and eastern India. However, you should double check with a trained travel nurse, or view the latest travel map to find out about recent endemics before deciding whether or not you need anti-malarial treatment for your travels.

There is no link between the two viruses, though they are both spread by mosquitos. There are four types of dengue virus, and it spreads easily in tropical areas. Dengue can also be spread from human to human, by blood transfusions, organ donations or contact with bodily fluids. One of the main symptoms of dengue, other than flu-like symptoms, is a severe pain behind the eyes and in the head, and sensitivity to light.

In high-transmission areas of the world, children under the age of five (including infants, babies and toddlers) are one of the most vulnerable groups. A large proportion of malaria deaths worldwide occur in children.

The majority of malaria cases are associated with a degree of anemia, and the severity of the anemia depends on the patient’s characteristics, including age, resistance, comorbid features) and parasite-specific characteristics, such as species and drug-resistance. Malarial anemia can cause severe morbidity and mortality, especially in vulnerable groups like pregnant women and children.