Malaria
Malaria is caused by the Plasmodium parasite spread by the bites of infected mosquitoes. The mosquito makes very little noise and produces very little itching from the bite. There are more than 100 million cases of malaria every year worldwide, resulting in over a million deaths. It is contracted by 2000 residents of the U.K each year . Preventative measures are therefore essential for people travelling to endemic areas.
Many of the tropical
countries have malaria parasites falciparum
strain . which are resistant to some of the
anti-malaria medicines, also side-effects or clinical
criteria may preclude their use in some people.
Therefore it is best to check first with your doctor
or pharmacist which is most suitable for you. It must
be remembered though that any prophylactic measures
taken are not 100%
effective and breakthrough can
still occur with any of the drugs in use.
Personal protection against being
bitten is very important. Use insect
repellents, preferably one containing
DEET(diethyltoluamide) as recommended by the Malaria
Reference Laboratory, at least 50% strength
lotion/spray applied directly to exposed areas of skin
(20% for children). Remember the protective effect
only lasts a few hours so reapply frequently or use a
20-30% long acting DEET cream.
Other alternatives are Bayrepel (Autan) or lemon
eucalyptus (Mosiguard). Clothing treated with 100%
DEET will last for up to 4 days if stored in a plastic
bag and is a good back up to skin applied repellents
in fast sweat off situations (take care with
artificial fibres and plastics) Wear long sleeves and
trousers after sunset. The mosquito attacks you
in your sleep when you are most vulnerable.
Sleep in properly screened rooms and use a 'knockdown'
spray to kill any mosquitoes in the room and inside
the bed net before you go to bed. Studies show that a
Mosquito net impregnated with permethrin is most
effective. Repeltm
mosquito nets are
ready treated with permethrin and are compact and
light to carry for use in any location. Use at night
ensuring it is well tucked in with no holes. Coils,
mats and vaporised insecticides are also useful to
keep rooms free of mosquitoes but are no replacement
for mosquito nets.
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If wearing sunscreen, apply repellent on top. Keep legs and arms covered with clothing, as this will lower the risk of bites. Avoid dark colours as they attract mosquitoes. Avoid strong perfumes, hair sprays or after-shaves as they can attract mosquitoes! Try to avoid evening walks beside rivers and ponds, as this is where mosquitoes breed. If you are likely to be away from medical services for more than a day it is wise to take malaria treatment with you. Malignant malaria (plasmodium falciparum) can develop from just seven days after being bitten, the benign form (Plasmodium vivax) may incubate even longer. So remember that even though you may have taken adequate precautions, if you develop a fever or feel ill while abroad, within one year or especially within 3 months of returning it is essential to seek medical help immediately.The typical symptoms are cyclical bouts of fever lasting a few hours accompanied by severe headache and vomiting, diarrhoea and some abdominal pain. In some cases complications occur affecting the kidneys, liver, brain and blood and in severe cases it can lead to organ failure, delirium or even death. The time taken from developing initial non threatening symptoms to life threatening complications may be only 24 hours in adults. In children the progress of the disease is much more rapid with a greater severity and increased risk of fatality sometimes within a few hours of onset. The World Health Organisation has issued a general recommendation that children do not travel to areas where malaria is endemic if this can be avoided.
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