Returning from a tropical vacation should bring with it a feeling of sunbathing and relaxation, not a tropical illness. But the number of British travelers catching malaria abroad is rising and scientists warn the situation could get worse.
The UK Health Safety Agency (UKHSA) has published its latest data on malaria in travelers returning to the UK and the figures are worrying. More than 2,000 cases were reported in 2023; this was the highest total in more than two decades.
While the increase partly reflects a return to “normal” in the volume of people traveling, there are more worrying factors at play. Globally, the number of malaria cases has increased by 16 million compared to pre-pandemic levels.
The potential impact of climate change is no less worrying. Higher temperatures may prolong the transmission season of malaria and expand the geographic range of the disease to higher altitudes and cooler locations where transmission was previously rare. Floods and extreme weather events create perfect conditions for mosquitoes to thrive, causing outbreaks of the disease.
In tropical countries where malaria is common, the disease causes great harm. There were 249 million cases in 2022, 94 percent of which were in Africa. These led to at least 608,000 deaths, mostly in children.
But research recently presented at the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Spain suggested that if world carbon emissions and population growth continue on their current trajectory, populations at risk of malaria and other mosquito-borne diseases could increase. Compared to 1970-1999, there will be an additional 4.7 billion people by 2100.
Mosquitoes are versatile and can change their habits and biting behavior in response to efforts to control them, thus posing a complex health problem. In fact, the United States recently saw its first case of local malaria transmission in 20 years; This is an important warning of what may lie ahead.
As the risks of this deadly disease increase, here’s what travelers need to know to stay safe abroad.
What is malaria?
Malaria is an infection caused by a small blood-borne parasite that is transmitted through the bites of an infected female. Anopheles mosquitoes. Symptoms can often be delayed until some time after exposure (at least seven days, but often four weeks or longer), meaning the connection to travel may be forgotten and diagnosis may be delayed.
Diagnosing malaria depends on knowing that a person is in an area at risk of the disease, as early symptoms can be non-specific and malaria has a remarkable ability to be confused with other conditions.
The most common symptoms of malaria are: fever, usually above 38°C and often intermittent; burnout; aching muscles and joints; headache; chills (often with sweating and shivering); abdominal pains and diarrhea; sometimes jaundice (yellowing of the skin and whites of the eyes). Severe malaria can cause headaches, seizures, and even death. Therefore, suspected malaria is a medical emergency and prompt treatment is effective and life-saving.
Underline
If you develop a fever or feel unwell when you return home from a trip abroad, seek medical attention immediately and make sure your doctor knows you are away.
In which regions is there a risk of malaria?
Areas at risk for malaria include many parts of Africa, Asia, Central and South America, the Caribbean and Oceania, including resorts in Thailand, India and parts of Peru.
How can you prevent malaria when you travel?
medical prevention
Four to six weeks before your holiday starts, seek advice from a travel clinic regarding anti-malarial medications; A doctor can advise where and whether these are necessary and what options are best for you.
Malarone and doxycycline are the two most commonly prescribed medications; They are usually tablets or capsules taken once a day. It should be started before travelling, taken while you are away and continued when you return home.
There is currently no malaria vaccine available for travelers. However, it is encouraging that two important vaccines to combat malaria have recently become available in some parts of Africa as part of public health campaigns.
avoiding insects
Bite prevention measures significantly reduce the risk of disease with insect repellents containing DEET, plug-in insecticides, mosquito nets, and a wide variety of other options.
Other mosquito-borne diseases
Malaria is not the only disease on the rise due to climate change. Other mosquito-borne diseases include dengue fever (currently causing a major epidemic in South America), Japanese encephalitis, chikungunya, yellow fever, and Zika. The Zika outbreak in 2016 demonstrated how quickly mosquito-borne diseases can become an international health emergency. Climate change is expanding the range of mosquitoes, and constant vigilance will be required to combat them.
You can find more travel health information at fitfortravel.nhs.uk and travelhealthpro.org.uk.
Dr Richard Dawood is a Travel Medicine specialist at Fleet Street Clinic. fleetstreetclinic.com 020 7353 5678