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Malaria and International Travel
What's the Problem?
Malaria was eradicated from the United States in the 1950's; however, each year, approximately 1500 cases are reported annually, the vast majority in immigrants and overseas travelers returning from malaria-risk areas, many from sub-Saharan Africa and South Asia. 1
Malaria is a major health problem globally. In fact approximately one million people die of malaria annually, mostly children in Africa. Between 350 and 500 million cases of malaria occur around the world every year. 2
Malaria is caused by a parasite that is transmitted to humans through the bite of an infective female Anopheles mosquito. Malaria symptoms include fever and flu-like symptoms, such as shaking chills, muscle aches, headache, fatigue, cough and vomiting. Untreated malaria can lead to seizures, kidney failure, coma, and death. Some species of malaria can remain dormant in the liver and cause a reappearance of symptoms months or even years after the initial onset of symptoms.
Who's at Risk?
Anyone who lives or travels to malaria-endemic areas in sub-Saharan Africa, Asia, Central and South America, the Caribbean, the Middle East, and Oceania. People who grow up in areas where malaria is endemic develop a partial immunity with repeated attacks resulting in milder infections. However, young children do not have this protection and adults soon lose it if they move from a high-risk area.
Can It Be Prevented?
Yes. For the traveler, malaria can be prevented by taking antimalarial drugs and by avoiding mosquito bites. No drug is 100% effective, but in most cases, early diagnosis and treatment can prevent serious illness.
For those who live in malaria-endemic areas, several prevention methods exist: insecticide-treated bed nets, indoor insecticide spraying, and medications to prevent the consequences of malaria infection in pregnant women in high transmission areas, who, because of their pregnancy, are no longer as well protected by their immune systems. Because the Anopheles mosquito is most active between dusk and dawn, the use of insecticide-treated bed nets are an effective preventative measure. Effective drugs exist to treat malaria illness, but unfortunately, access to these drugs can be inadequate in some countries.
Prevention is becoming increasingly important as malaria parasites resistant to the newest forms of treatment have been detected.3Scientists are working on anti-malarial vaccines and recent developments in the field show great promise.4
The Bottom Line
Although rare in the US, over one million people die annually due to malaria. Simple interventions such as insecticide-treated bednets and insecticide spraying in homes can have a dramatic effect on malaria prevention by decreasing the risk of mosquito bites. Improved access to effective drugs is essential to prevent malaria-related deaths. Despite some encouraging recent progress, much remains to be done to eliminate malaria.
Safia Mohamed lives in Kenya and has a six year old daughter. In the past, malaria would send her daughter to the hospital two to three times a year. That is until insecticide-treated bed nets were distributed throughout the community, courtesy of the Global Fund. Since Safia has put the nets up, her daughter has not suffered from malaria and Safia has saved money to focus on her child's nutrition.5
- 1 US Centers for Disease Control and Prevention
- 2 Global Malaria Action Plan
- 3 Enserink, M. Signs of Drug Resistance Rattle Experts, Trigger Bold Plan. Science. 2008;322:1776.
- 4 Collins, W.E., Barnwell, J.W. A Hopeful Beginning for Malarial Vaccines. The New England Journal of Medicine. 2008;359:2599-2601.
- 5 Noor, A.M., Mutheu, J.J., Tatem, A. J., Hay, S.I., Snow, R. W. Insecticide-treated net coverage in Africa: mapping progress in 2000-07. Lancet. 2009;373:58-67
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