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MALARIA PREVENTION
People returning from holiday may develop malaria, which can be fatal. Over
much of Asia, India, Africa and South America there is a high risk of malaria
infection. Travellers to moderate- or high-risk areas should start appropriate
medication one week prior to departure on holiday and continue for four weeks
after their return.
Advice about malaria prevention varies according to the area and time of
year. Up-to-date advice should be sought from your doctor, and the latest
information can also be obtained from the Malaria Reference Centre (Telephone
0891 600350 - continuous 24-hour tape) or from the Hospital for Tropical
Diseases Healthline (Telephone 0839 337733).
However, no medication is completely effective in preventing infection, and
it is extremely important to avoid being bitten by the mosquitoes which
transmit malaria.
Protection against mosquito bites
- If possible, avoid going out between dusk and dawn when malarial mosquitoes
commonly bite. Wear long-sleeved clothing and long trousers when going out at
night, and avoid dark colours, which attract mosquitoes.
- Apply insect repellent to exposed skin, choosing one containing either DEET
or dimethyl phthalate. The manufacturers' recommendations for use must not be
exceeded, especially with small children. Insect repellents which contain DEET
include Autan, Ultrathion and Jungle Formula. (A new preparation, Mosiguard,
does not contain DEET but is useful for small children and those with skins
sensitive to DEET.)
- Use an efficient air-conditioner at night, if available. Use screens over
doors and windows; if no screens are available, windows and doors should be
closed at night.
- If accommodation allows entry of mosquitoes, use a mosquito net over the
bed, with edges tucked in under the mattress, and ensure that the net is not
torn and that there are no mosquitoes inside. Protection is increased by
impregnating the net with permethrin or deltamethrin.
- Use anti-mosquito sprays or insecticide dispensers (mains or battery
operated) that contain tablets impregnated with pyrethroids, or burn pyrethroid
mosquito coils in bedrooms at night.
- If possible, stay in a well-constructed and well-maintained building in the
most developed part of town.
- Even transient visits of an hour or two to infected areas can result in
infection. People in transit stops on air journeys have been infected in
airports.
- If you develop a fever, seek medical attention promptly.
This paper first appeared in Travel Clinics - A primary care manual
It was sponsored by SmithKline Beecham Vaccines Group
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