Travel, Mosquitoes & Malaria... Know Before You Go!

Travelling can be an adventure, a chance to open your mind to new parts of the world, enjoy spectacular sights first hand, experience different cultures and have fun.

However, world travel comes with risk.. in previous posts I have covered sun risks and risks of traveller's diarrhoea from consuming contaminated food and water.

Today for that other significant threat... mosquitoes and the bites we might endure when travelling...

At best a few mosquito bites will be a bit itchy and annoying for a few days, but at worse, a bite from a mosquito could leave you very unwell.

From malaria to yellow fever, mosquito bites when travelling can provide souvenirs you really did not want from your travels.

Luckily, there are steps you can take to prevent bites and to protect yourself in case you are bitten.

This post will share all you need to know about travel and mosquitoes - what the risks are and how to avoid them.

(**Disclaimer before I continue - I did work as a nurse for many years, in which travel health was a large part of my role so feel reasonably informed to write this post... However, always take the advice of your own health care provider over the information I am offering here!)....

MOSQUITOES AND THE DISEASES THEY CAN SPREAD

When you travel, a bite from a mosquito can have a range of consequences - the majority will merely cause local irritation whilst some might result in allergic reaction or skin infection.

For the very unlucky, a bite from a mosquito will be the source of transmission of an infectious disease (also known as vector borne disease).

In the world today vector borne disease accounts for more than 17% of infectious diseases and has a significant mortality rate.

The greatest proportion of the affected parts of the world are tropical and subtropical regions and often areas where poverty is greater.

The most common diseases spread by mosquitoes are:

- malaria

- yellow fever

- zika virus

- dengue fever

- japanese encephalitis

(there are also many others).

There are vaccines or medications that can hep reduce the risk of contracting some of these diseases when you travel but for others bite avoidance measures are your only option.

To provide information on all the diseases spread by mosquitoes would be too much for one post, so in this post I will concentrate on malaria.

However, some of the general principles here about risk assessment and bite avoidance measures apply to any mosquito spread illness.

MALARIA

Malaria is a very significant and potentially life threatening illness that remains a high risk to travellers in some parts of the world.

Malaria is contracted through the bite of a female Anopheles mosquito.

Preventing malaria is a possibility with the right measures and it is curable if recognised and treated quickly.

MALARIAL REGIONS

Areas of the world that carry the most significant risk of malaria include the tropical and subtropical regions of:

- Africa

- Central and South America

- Asia

- The Middle East

- Hispaniola

- Oceania

Every year the World Health Organisation re-evaluate the risks in given locations and advice on the need for prevention measures at a destination might change based on this. Therefore, whenever you are due to travel to a potentially risky part of the world, ensure you get the latest advice from a travel health expert.

SIGNS AND SYMPTOMS OF MALARIA

Malaria usually manifests with fever, headache, abdominal pain, lethargy and general body aches.

For some, cough or diarrhoea may also be present.

Symptoms might be mild but can progress to severe in time.

In certain types of malaria, symptoms can develop quickly and become life threatening, with resulting coma and death if left untreated.

First symptoms of malaria appear most typically 7-14 days after being bitten.

In other types of malarial infection the illness onset might be 12-18 days but in some cases symptoms do not manifest for months (and occasionally years) following the bite.

It is important you know the signs and symptoms of malaria and seek medical help if they occur when travelling or on return home (for up to a year afterwards).

Always ensure if you do have unexplained fever illness after travelling that you advise the health professional you see that you have been to a malarial part of the world and they can test (and treat) accordingly.

When malarial illness is suspected you will require blood tests to confirm the diagnosis and the sub-type of malaria you have.

Treatment should not be delayed, should be based on the results of your investigations and the latest global advice your health professionals will have access to.

THE ABCD MALARIA PREVENTION APPROACH

Following the recommended ABCD approach to malaria when you travel will ensure you are at the lowest possible risk of developing malaria or if you do become unwell, that you will get treatment fast.

Risk Awareness

Well before you travel visit a travel health clinic locally to you (or many GP / primary care practices offer this service) where they will have the latest advice on malarial risk at your destination and what is necessary to reduce it.

Know the risks and ensure you follow the advice you are provided!

If you are a person who is planning to return to visit friends and family in a destination in which you were born or have previously lived and think you do not need malarial preventative measures as you have natural immunity... think again!

The greatest proportion of malarial diagnosis from returning travellers comes from people visiting friends and family without taking necessary precautions. Natural immunity fades fast when you are away from a risk area.

Bite Prevention

The most effective methods of avoiding malaria in risk areas is to ensure you are taking enough measures to prevent being bitten by a mosquito in the first instance!

Bite prevention will not only protect you against malaria but also other diseases mosquitoes can spread.

The main general measures to take when travelling to avoid mosquito bites are:

- Use a good insect repellent... The main type of repellent that is advised is one that contains DEET as it covers a broad spectrum and has few reported side effects.

The stronger the DEET concentration (given as a %), the longer the protection lasts before you need to reapply.

If applying sun cream and DEET ensure you apply the DEET after you have applied the sunscreen and use a minimum SPF of 30-50 (for more on sun safety see my earlier post).

- Wear long, loose clothing to reduce exposed areas of skin, particularly at times of day when mosquitoes are most prevalent.

Mosquitoes can bite through very tight or thin clothing layers so dress appropriately.

- Clothing can be sprayed with an insecticide, such as permethrin, that will kill mosquitoes on contact so might be worth doing.

- Mosquito nets can be necessary and helpful. These are used around your bed at night and impregnated with an insecticide (such as permethrin).

- Keep doors and windows closed, or if they are open then use mosquito screens. Utilise air conditioning to keep the room cool and the air circulating without the added risk of mosquito entry.

- Avoid areas of stagnant or standing water as these are key breeding grounds for mosquitoes.

Chemoprophylaxis (Anti-malarial medication)

If you are travelling to an area with a significant risk of being bitten by mosquitoes who transmit malaria, you will need to ensure you take 'prophylaxis'... medicine to reduce the chances of contracting malaria if you are bitten.

Anti malarial medications are available from travel health professionals or primary care doctors, so once again ensure you are being seen by a relevant expert in good time before you are due to depart.

Anti malarial medication comes in different forms, with some types only being appropriate for certain destinations and not others.

The different types of anti-malarials also have differing potential side effects and their dosing schedules will vary greatly (some taken daily, some just once a week).

For some destinations there might be more than one appropriate drug type that you could take as prophylaxis. In this instance your travel health professional will be able to discuss with you the pros and cons of each and what will fit your requirements best.

The costs of anti-malarial medication is often not insignificant, with some of the drugs that have the best cover, least side effects and easiest dosing schedule being the most expensive (of course!).

However, don't try to save a few bucks and forego these drugs...

Contracting malaria when you are away will be a much greater price to pay than the extra budget needed to keep you well.

Diagnosis

The final point in the ABCD approach to malaria is Diagnosis...

You have taken all the above steps to prevent contracting malaria but nothing is 100% fail safe and you are incredibly unlucky to develop symptoms after a mosquito bite.

The key now is to act fast -

Know the signs and symptoms of malarial illness (described above) and if you do develop them when you are travelling or for up to a year after being in a malarial region then seek medical help fast.

With quick intervention malaria can be treated very effectively.

So, there is a round up of the essential points to know about mosquitoes and malaria before you travel to a malarial part of the world.

Don't take malaria risk lightly when you travel... having worked as a nurse for many years in the UK the cases I saw of malaria in returning travellers were not infrequent.

Make sure you enjoy visiting the tropics and subtropics of this world and stay healthy when you do so!

Other information:

World Health Organisation Factsheets

Amazon USA Links for: Insect Repellent, Mosquito Nets & Clothing Insecticide Spray

Amazon UK Links for: Insect Repellent, Mosquito Nets & Clothing Insecticide Spray

**To make my travels possible and affordable I do so through international house-sitting, using both Trusted Housesitters and Kiwi Housesitters**