3 December 2007

Malaria risk for travellers

Two German tourists have recently been diagnosed with malaria following a holiday to the Dominican Republic [1]. They spent two weeks in Punta Cana a popular resort area on the east coast and in accordance with German advice, did not take malaria prevention tablets. United Kingdom (UK) guidelines recommend malaria prevention tablets for travellers to the Dominican Republic.

With the upcoming holiday season people may be travelling to popular tourist destinations or returning home to visit family in malaria risk areas. These cases highlight the risk of malaria and emphasise the importance of being aware of the risk and taking the appropriate precautions.

Malaria

Malaria is a serious disease transmitted via the bite of infected Anopheles mosquitoes. Approximately 1,750 cases of malaria are imported into the UK each year. Of these, there are between five and 15 deaths each year. In 2006, there were 1,758 malaria cases reported, with eight deaths [2]. In 2005, a series of malaria cases were reported amongst travellers to The Gambia, all of whom had either taken inadequate or no malaria prevention tablets [3].

Advice for travellers

Malaria is widely distributed throughout the tropical areas of the world. This includes popular winter sun destinations for travellers from the UK such as the Dominican Republic, The Gambia, and Goa in India, as well as regions such as West Africa that are visited by persons who return to see family members.

Travellers should discuss their travel plans with their practice nurse or specialist travel clinic. Health advice for specific destinations can be found in the NaTHNaC Country Information page. Malaria prevention tablets are recommended in accordance with the Health Protection Agency Advisory Committee on Malaria Prevention (ACMP) guidelines. No malaria tablet is completely effective; it is therefore important to take insect bite avoidance measures. Travellers who fall ill following a visit to a malarious area should seek prompt medical attention informing their physician of their travel history. Travellers should be aware that malaria can present up to a year or more after return.

References

1. ProMED-mail. Malaria – Germany ex Dominican Republic: Punta Cana. ProMED-mail 2007; 26 Nov: 20071126.3826. http://www.promedmail.org/pls/promed/f?p=2400:1001:

6820872000863726140::NO::F2400_P1001_BACK_PAGE,F24

00_P1001_PUB_MAIL_ID:1000,40226. Accessed 3 December 2007.

2. Health Protection Agency Malaria Reference Laboratory. Imported malaria cases and deaths, United Kingdom 1987-2006. [online resource, accessed 3 December 2007.] Available at http://www.hpa.org.uk/infections/topics_az/malaria/cases_

deaths.htm

3. HPA. Malaria deaths in travellers returning from The Gambia. Commun Dis Rep CDR Wkly [serial online] 2005 [accessed 3 December 2007]; 16: 51. Available at http://www.hpa.org.uk/cdr/archives/archive05/News/news4905.

htm#mal

Links

NaTHNaC Health Information Sheet on Malaria

http://www.nathnac.org/pro/factsheets/malaria.htm

NaTHNaC Health Information Sheet on Insect Bite Avoidance

http://www.nathnac.org/pro/factsheets/iba.htm

NaTHNaC Country Information Page

http://www.nathnac.org/ds/map_world.aspx

HPA ACMP Malaria guidelines

http://www.hpa.org.uk/infections/topics_az/malaria/guidelines

htm