 Malaria is a potentially fatal parasitic disease that is transmitted through the bite of mosquitoes infected with single-celled organisms called plasmodia. While malaria is uncommon in the United States, it is a concern in much of the tropics, including many countries in Central or South America, Asia, Africa, and the Middle East. Your risk for malaria depends on what country you are traveling to, your accommodations, the length of your visit, and the time of year you are traveling. Check with the Centers for Disease Control and Prevention (CDC) (www.cdc.gov/travel/) for information about your destination. If you’re traveling in countries where malaria is a concern, you can reduce your risk of malaria by using mosquito repellent, wearing protective clothing, and taking certain prescription medicines. The CDC recommends that you: Use insect repellent that contains at least 20-35 percent DEET (N,N-diethyl-m-toluamide) such as Off! Deep Woods Insect Repellent. Wear protective clothing such as long pants and long-sleeved shirts when sleeping outdoors. Use a mosquito net treated with permethrin (an insecticide) over your bed. Spray your clothing with insect repellent, and also spray your bedroom with permethrin. The choice of antimalaria medicine depends on the timing of your travels, your destination, and the area's risk of malaria. The most commonly recommended drugs for malaria prevention are mefloquine (brand name >Lariam), chloroquine (>Aralen), and >doxycyline (Vibramycin). A new medicine containing atovaquone and proguanil (Malarone) was recently approved for the prevention and treatment of malaria. Malarone will be particularly useful for people traveling to regions with malaria strains that are resistant to traditional medications. Start taking antimalaria medicines before arriving at your destination, take them throughout your trip, and continue for four weeks after you return. Mefloquine and chloroquine should be taken once a week, beginning a week before you travel and ending four weeks after your return. If your doctor recommends doxycycline, take it once a day, starting one to two days before your trip, and continue taking it for four weeks after you return home. Malarone therapy is generally shorter. Treatment begins 1 to 2 days before departure and finishes 7 days after returning. If you are planning a trip to a malaria-prone area, talk to your doctor about protective measures that are right for you. Sources:
National Center for Infectious Diseases Travelers' Health. CDC Web site: www.cdc.gov/travel/, last accessed 6/1/00.
Principles and Practice of Infectious Diseases. Churchill Livingstone, Inc., 2000.
Kain KC. "Travel Medicine. Malaria in travelers: Epidemiology, Disease, and Prevention," Infectious Disease Clinics of North America 12 (1998).
"Prevention of Malaria," The Medical Letter on Drugs and Therapeutics 42 (2000).
Baird JK. "Prevention of malaria in travelers." Medical Clinics of North America 83, 1999.
Pharmacist’s Letter, Infectious Diseases, Vol. 16, No. 8, August 2000.
Center for Drug Evaluation and Research News Along the Pike, July 2000 Issue 7, www.fda.gov/cder/pike, last visited 8/15/2000.
This answer prepared 8/15/00.
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