I caught malaria when I was travelling in Brazil around 5 years ago. I had been staying at the mouth of the Amazon and one evening I looked down and discovered to my horror that my legs were covered in mosquitoes – I had forgotten to put on repellent! A few days later, in an even more remote location, I started to feel rather unwell. Luckily for me, I realized it was malaria quite early on and following a course of antimalarial tablets that I had brought with me the infection was cleared from my system and it never reappeared again. This was fortunate because a malaria infection is actually pretty serious. It’s caused by a parasite called Plasmodium, is transmitted by mosquitoes and is characterized by symptoms such as vomiting, fever, chills, and a flu-like feeling. Although malaria primarily affects people living in developing tropical countries, round 1,700 cases of malaria are diagnosed in the US each year. Most of these cases are either travellers or immigrants who are returning from countries where malaria is found, such as sub-Saharan Africa or South America.1
Unfortunately, malaria during pregnancy is dangerous for both the mother as well for the baby in the weeks immediately before and after birth. Because pregnant women have a dampened immune system in order to protect the fetus from being rejected, they are less able to clear malaria infections. In addition, the malaria parasite collects and replicates in the placenta. As a result, pregnant women are three times more likely to develop severe disease, compared with non-pregnant women and are more likely to miscarry or experience preterm birth. The baby is more likely to suffer from low birth weight and congenital infection and is also more likely to be stillborn or to die shortly after birth.2
Treatment for malaria during pregnancy
For most pregnant women who are diagnosed with malaria treatment usually involves a drug called chloroquine. Although chloroquine has some pretty nasty side effects, such as nausea, diarrhea, itching, and seizures, it is effective in clearing the parasite from your system. And so far it has not been shown to have any harmful effects on the fetus when taken during pregnancy. Small amounts of chloroquine are excreted in breast milk in lactating women; however, as chloroquine has been shown to be safe in infants, the effects are not considered to be dangerous.3 As with non-pregnant women, chloroquine should be taken as soon as possible, as the sooner it is taken the more likely it is that the infection will be cleared. Another drug that is similar to chloroquine called hydroxychloroquine may also be recommended. However, if you are diagnosed with a chloroquine-resistant Plasomodium infection, you will need different drugs.2
Prevention of malaria when traveling
Often it is not possible to completely avoid mosquito bites but the less you are bitten the less likely it is that you will get malaria. The main non-drug methods are:
- Using insect repellent – the most effective repellents contain diethyltolamide (DEET) (which is actually not as toxic as you may have read)4,5 – and applying it frequently (unlike me!)
- Ensuring you sleep under a insecticide-treated net at night or staying somewhere with insect screens on the windows
- Wearing long sleeves instead of T-shirts and trousers instead of shorts or skirts, especially in the evening when mosquitoes are the most active4
Unfortunately there is currently only one vaccine approved against malaria and it is not very effective so if you are travelling to countries where malaria is a problem, it is better to implement other prevention methods.6
Your doctor will more than likely prescribe antimalarial tablets to take everyday while you are away, or, as in my case, you can take a course of them with you and then start taking high doses if you feel the symptoms coming on.
It is important to get a new course of antimalarial pills from your doctor each time you travel to an affected country as your old pills may not be appropriate for the particular strain of malaria in the next country you are visiting.
There’s no evidence to suggest homeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, yeast extract spread (such as Marmite), tea tree oils or bath oils offer any protection against mosquito bites.4