by Returning from a tropical holiday should bring sunshine and relaxation – not tropical disease. However, the number of British travelers catching malaria abroad is increasing, and scientists are warning that it could get worse.
The UK Health Security Agency (UKHSA) has just published the latest figures on malaria among travelers returning to the UK, and the numbers are worrying. Over 2,000 cases were reported in 2023, the highest total in the last twenty years.
Although the increase partly reflects a return to “normal” numbers of people traveling, there are more alarming factors at play. Worldwide, the number of malaria cases has increased by 16 million, compared to pre-pandemic levels.
There is no less concern over the potential impact of climate change. Warmer temperatures can extend the malaria transmission season, as well as expand the geographic range of the disease to higher altitudes and cooler areas where transmission was previously uncommon. Flooding and extreme weather events create perfect conditions for mosquitoes to thrive, leading to outbreaks of the disease.
In tropical countries where malaria is widespread, the disease takes a huge toll. In 2022, there were 249 million cases, 94 percent of which were in Africa. At least 608,000 of these were killed, mostly children.
But research presented recently at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) World Congress in Spain suggested that if world carbon emissions and population growth remain on current levels, populations at risk of malaria and other diseases could another mosquito-borne. an increase of 4.7 billion additional people by 2100, compared to 1970-1999.
Mosquitoes are versatile and are able to change their habits and biting behavior in response to efforts to control them, making them a complex health challenge. In fact, the United States recently saw its first cases of local transmission of malaria in 20 years, an important warning of what may lie ahead.
So, as risks of this deadly disease emerge, here’s what travelers need to know to stay safe abroad.
What is malaria?
Malaria is an infection caused by a tiny blood-borne parasite, which is transmitted through the bites of an infected female Anopheles mosquitoes. Symptoms are often delayed until some time after exposure (at least seven days but often four weeks or much longer), meaning that the travel link may be missed, delaying on diagnosis.
Diagnosing malaria depends on knowing that a person is in a destination at risk of the disease, since early symptoms can be non-specific, and malaria has a great potential to be mistaken for other conditions.
The most common symptoms of malaria are: fever, usually above 38C and often chills; tiredness ; painful muscles and joints; headache ; chills (often with sweating and shivering); abdominal pains and diarrhea; sometimes jaundice (yellowing of the skin and the whites of the eyes). Severe malaria can lead to headaches, seizures and even death. Suspected malaria is therefore a medical emergency, and prompt treatment is effective and life-saving.
The bottom line
If you develop a fever or become ill after returning home from traveling abroad, seek medical advice promptly and make sure your doctor knows you have been away.
What areas are at risk of malaria?
Malaria risk areas include many places in Africa, Asia, Central and South America, the Caribbean and Oceania – including holiday destinations in parts of Thailand, India and Peru.
How to prevent malaria on your travels
Medical prevention
Four to six weeks before your holiday starts, seek advice from a travel clinic about anti-malarial medication – a doctor can advise where and whether they are needed, and which options are likely to suit you.
Malarone and doxycycline are the two most commonly prescribed medications, tablets or capsules that are usually taken once a day. They must be started before travelling, taken while you are away and continued on your return home.
Currently, there are no suitable malaria vaccines for travellers. However, it is noteworthy that two important vaccines have recently become available to combat malaria as part of public health campaigns in parts of Africa.
Avoid insects
Bite prevention measures greatly reduce the risk of disease, with insect repellents containing DEET, plug-in insect killers, mosquito bed 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 outbreak in South America), Japanese encephalitis, chikungunya, yellow fever and Zika. The Zika outbreak in 2016 showed how quickly mosquito-borne diseases can turn into an international health emergency. Climate change is expanding the range of mosquitoes that can spread them, and constant vigilance will be needed to combat them.
Find more travel health information at fitfortravel.nhs.uk and travelhealthpro.org.uk.
Dr Richard Dawood is a specialist in Travel Medicine at Navy Street Clinic. Fleetstreetclinic.com 020 7353 5678
