26 October 2007
Malaria advice for travellers to Goa, India
The Health Protection Agency (HPA) Advisory Committee on Malaria Prevention (ACMP) has emphasised to health professionals the importance of malaria prevention tablets for travellers to Goa, India .
In March 2007 the HPA Malaria Reference Laboratory (MRL) reported on a cluster of Plasmodium falciparum malaria cases in travellers from the United Kingdom (UK) who had visited Goa between December 2006 and March 2007 [2,3]. Cases were also seen in other European travellers to Goa . An increase in P. falciparum malaria was subsequently reported in the resident population of Goa in the first six months of 2007 with 788 cases compared to 240 during the same period in 2006 . From 1 January to 31 August 2007 the MRL received reports of 11 cases of P. falciparum malaria imported from India. Six were in individuals known to have visited Goa. Increased rainfall in the region was considered to be a contributing factor to the increase in cases .
Advice for travellers
The ACMP advises that health professionals:
- highlight the risk of malaria
- instruct on the use of insect bite avoidance measures
- recommend malaria prevention tablets for travellers visiting Goa, particularly for those visiting areas north of Panaji and who will be remote from medical care
This advice for travellers to Goa was implemented in March 2007 and was a change to the published ACMP guidelines for India . It remains in effect until further notice. The MRL has undertaken enhanced surveillance of malaria cases imported from India and will monitor carefully any changes in malaria transmission to travellers, with review of this advice as necessary.
The recommended malaria prevention tablets for Goa are chloroquine plus proguanil. Alternatives are mefloquine, atovaquone/proguanil (Malarone®) or doxycycline.
Travellers should seek medical attention promptly if they become unwell and inform their doctor that they have been in a malarious area. Healthcare workers should consider malaria in every ill patient who has recently returned from the tropics.
1. Health Protection Agency. Health professionals are reminded of the need to consider malaria chemoprophylaxis in travellers to Goa, India. Health Protection Report [serial online] 2007: 1; [accessed 26 October 2007]. Available at http://www.hpa.org.uk/hpr/archives/2007/hpr4307.pdf
2. Health Protection Agency. Cluster of malaria cases from northern Goa – update. Health Protection Report [serial online] 2007; 1(10). Available at http://www.hpa.org.uk/hpr/archives/2007/hpr1007.pdf
3. NaTHNaC Clinical Updates. Cluster of malaria cases from northern Goa - update. 9 March 2007. [Accessed 26 October 2007]. Available at http://www.nathnac.org/pro/clinical_updates/malaria_Goa
4. Jelinek T, Behrens R, Bisoffi Z, et al. Recent cases of falciparum malaria imported to Europe from Goa, India, December 2006-January 2007. Eurosurveillance [serial online] 2007 [accessed 26 October 2007];12 (1): E070111.1. Available at http://www.eurosurveillance.org/ew/2007/070111.asp#1
5. Malaria – India (Goa, Rajastan). Promed 16 July 2007. In: ProMED Mail [online]. Boston US: International Society for Infectious Diseases, 16 July 2007 [accessed 26 October 2007]. Available at http://www.promedmail.org/pls/askus/f?p=2400:1202:
6. Chiodini P, Hill D, Lalloo D, et al on behalf of the Advisory Committee for Malaria Prevention in UK Travellers (ACMP). Guidelines for malaria prevention in travellers from the United Kingdom. Health Protection Agency: London; 2007. Available at http://www.hpa.org.uk/infections/topics_az/malaria/guidelines.
NaTHNaC Health Information Sheet – Malaria
NaTHNaC Health Information Sheet – Insect bite avoidance.
ACMP malaria guidelines
NaTHNaC Country Information Pages