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So summer is finally here, and judging by the adverts on TV and social media, and various emails that keep landing in my inbox, virtually the entire population of the UK is plotting some kind of mass exodus to pastures warm as millions of us jump the nearest plane to anywhere with a few rays and some sand/sea/sightseeing, whatever floats each individual’s boat. Family K did this at Easter, so we are currently very excited about some camping and our latest pilgrimage to Center Parcs next month, but most of us in the UK do enjoy our big adventure at this time of year.

As we all know, there’s a lot of ‘stuff’ to sort out when planning these most precious of times; along with all the excitement of quality time and pure, uninterrupted fun for a prolonged period with those we value most, there are the mundane practicalities to deal with – passports, tickets, packing luggage according to whatever rules have been imposed by that airline at that time, getting local currency and travel vaccines in plenty of time etc etc – but one that, in my experience, is frequently a very last minute panic, is thinking about whether or not you need to worry about malaria during your date with paradise.

Malaria is an infection caused by the Plasmodium parasite and humans catch it when bitten by a mosquito carrying the parasite in their blood. There are different types of Plasmodium – the falciparum species results in the most severe form of malaria, with the others carrying less of a risk – although the disease they carry is still well worth avoiding. While we have little to worry about in the UK it is a huge worldwide issue causing approximately 1 million deaths in total in 2008 according to the World Health Organisation. Britons are only at risk of being infected while abroad in the so-called malaria zones including areas of Africa and Asia, Central and South America, Haiti and the Dominican Republic, parts of the Middle and Far East and some Pacific islands. In 2008 about 1300 people returned to the UK with malaria following their travels and there were 6 confirmed deaths here.

As with every other condition prevention of malaria is far better than cure, and there is much that can be done to avoid infection. The first thing to discover when planning your travels is what sort of malaria risk there is at your destination –ask your GP or consult a reputable travel website – and to get clued up on bite prevention, for example:

Remember that malaria bearing mosquitos bite at night, so this is the crucial time
Use effective air conditioning or screened doors and windows,
Sleep under insecticide treated mosquito nets if there is no air conditioning
Use insect repellent (DEET is best) on your skin and bed, reapply this frequently
Wear loose fitting trousers and long sleeves to cover your extremities

You also need to consider taking antimalarial medication, you need to visit your GP to arrange a prescription for this as it is not available over the counter. You will need to pay for it – and it can be quite expensive – but it will be a fraction of the overall cost of your travels and well worth it. Different medications are recommended for the various areas, and your doctor will have up to date information in order to advise you which is best for you.

Essentially there are three main medications. Doxycycline is an antibiotic also used for many other infections in the UK – it is the student’s favourite, being cheap and cheerful, but it can make skin sensitive to the sun; not good in a destination with a malaria problem as sun and malaria are inextricably linked! Another alternative is mefloquine which is convenient to take, reasonably priced and comes with few side effects – unfortunately, this is the one that gets a bad press from time to time because it makes a very small minority of people who take it extremely depressed to the extent that some have harmed themselves as a result. Very rare, but a disaster if you are the one in a (pick a big number) that it happens to .

The last choice is malarone, which is essentially expensive but lovely. Based on a two week package holiday, the cost is a very small percentage of the overall holiday but enough to make most people wince – if you’re ‘going travelling’, and expect to take it for a prolonged period, it’s a significant but ‘well worth it’ chunk of your money.

Please be guided by your local travel clinic/GP surgery regarding the best choice for you, but it doesn’t hurt to do some research of your own before your appointment so that you can have an informed discussion. Make sure you take it as directed, particularly upon your return as all antimalarial medication must be taken for a number of weeks after arriving safely back in the UK and it can be very easy to forget to take it once normal life resumes.

All of this will greatly reduce your chances of becoming infected, but never be overconfident – remember our national treasure Cheryl Cole being struck down with the illness in 2010? She was taking the right antimalarial medication and undoubtedly following bite prevention advice when she became the latest malaria statistic, so it is very important to be vigilant at all the appropriate times. And if you do think that you may have malaria then early treatment can make a huge difference to the severity of your experience so contacting a doctor immediately is vital. The symptoms of malaria are:

a high temperature (fever) of 38°C (100.4F) or above
sweats and chills
generally feeling unwell
muscle pains

Typically the illness runs in cycles because once the infection is in your body new parasites are released into your bloodstream every 48 hours. This causes all of the symptoms above for several hours, followed by a less severe period before the next cycle begins 2 days later. If you have any of these while travelling in a malaria zone please seek medical advice as a matter of urgency, falciparal malaria in particular can develop rapidly into a life threatening illness.

Symptoms can occur anything from 8 days to several months following a bite so it is important to report any fever to a doctor once back in the UK even if it has been quite some time since your travels. Complications can include severe anaemia and brain and liver damage to name a few, and your doctor will not think that you are wasting their time if malaria is a possibility.

So if you are planning a trip to one of the many beautiful areas of the world that carry a malaria risk then I hope you have an absolutely awesome time and please do not let the very real threat of malaria spoil your fun – if you follow the above advice and any other tips from your own surgery then you should be fine! And while we are on the subject of travels, don’t forget your other vaccines, sunscreen, plenty of fluids and so on…..

Here’s to an awesome summer – whether your main concern is exotic malaria, or British campsite mud prevention, have a wonderful time!


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