An infectious disease typically transmitted by a female Anapheles mosquito infected with a parasite, malaria can kill fast.
The World Health Organization estimates that 429,000 people died from the infectious disease in 2015. Prevention and treatment efforts the world over have, fortunately, decreased the number who contract the mosquito-borne illness that first surfaces with often overlooked symptoms like fever, and which can rapidly lead to life-threatening complications like kidney failure.
In many developed countries, the disease has been eliminated — as it was here in the United States in the 1950s. However, researchers say that since the 1970s the number of imported cases of malaria has risen steadily. Those in harm’s way include travelers seeking adventure abroad in locations from West Africa to South America, and those who previously lived in countries where malaria is present and return for longer visits.
[See: 10 Classic Health and Safety Risks Among First-Time Campers.]
In the Hospital With Malaria
According to a study published last month in the American Journal of Tropical Medicine and Hygiene there were an estimated 22,029 malaria-related hospitalizations — averaging 1,469 each year — in the U.S. from 2000 to 2014. That included 182 in-hospital deaths and 4,823 severe malaria cases. While representing a little less than 5 hospitalizations for malaria for every 1 million people in the U.S., researchers point out that hospitalizations for malaria far outnumbered those for other travel-associated diseases like dengue fever.
Based on Centers for Disease Control and Prevention surveillance data, about 69 percent of all malaria cases reported in the U.S. involve hospitalization. So given the 1,469 hospitalizations a year cited in the tropical medicine journal, the total number of malaria cases would be higher, or on average about 2,128 each year, says study lead author Diana Khuu, an epidemiologist at the University of California, Los Angeles. (By comparison, the CDC says about 1,500 to 2,000 cases are reported annually in the United States.) “This means that about 659 cases are outpatient or untreated cases each year,” Khuu says.
Though there wasn’t a significant increase in hospitalizations from malaria during the study period, experts speculate factors including increased ease of international travel and many people not taking measures to prevent contracting malaria have contributed to a rise in recent decades of imported cases of malaria treated in the U.S.
Mapping Out a Prevention Strategy
In the vast majority of cases, experts say it’s possible to prevent contracting malaria, starting by getting a view of the risk in the area where you’re traveling.
Go online and check out CDC guidance for travelers’ health, recommends Dr. Patricia Walker, president of American Society of Tropical Medicine & Hygiene, and medical director of HealthPartners Travel and Tropical Medicine Center, which is based in St. Paul, Minnesota. “Look up your country and see if there’s malaria in that country,” she says, adding that it’s important to check, rather than making assumptions. She also cautions against relying on friends or people you casually encounter in travels to provide accurate information on malaria risk in a given area.
“Consider seeing a travel medicine expert,” she adds. The ASTMH provides a directory of clinicians who consult on tropical medicine and travelers’ health, as does the International Society of Travel Medicine. Doctors and clinicians specializing in this area can help outgoing travelers assess their risk for a range of diseases while abroad, from malaria to Ebola, and advise on the best ways to prevent transmission.
For those traveling to places where malaria may be present — or may be contracted by people living or traveling there — antimalarial medications are typically recommended for travelers. “There are several really good medications to prevent malaria if you take them properly,” Walker says. Medicines commonly used to prevent malaria include Malarone, taken daily (which, in higher doses, is also used to treat malaria); doxycycline (daily) and mefloquine (taken weekly) — with drugs started before traveling, and taken during and then for a time after the trip.
Care should also be taken to avoid getting bitten by mosquitoes to protect against malaria transmission. Mosquitoes carry so many other diseases besides malaria as well, Walker says — like the Zika virus, which can raise the risk for a pregnant woman of having a baby with microcephaly and other birth defects.
Walker advises getting a long-acting insect repellant that lasts 10 or 12 hours, she says, rather than a shorter acting repellant you’re less likely to reapply frequently enough. And use it. “Let’s say you’re on safari, and you’re hot and sweaty and you take a shower and you smell good and feel good, and you don’t want to put a repellant back on. You have to put it back on because those mosquitoes bite at dawn, at dusk and at night,” Walker stresses.
For whose who anticipate more intensive mosquito exposure, such as while backpacking or going on safari, she recommends considering soaking clothes with the insecticide permethrin. This can be purchased as a spray or liquid and used to treat bed nets (or you can purchase bed nets already treated with permethrin), the CDC notes.
Be resourceful in prevention, too, for instance carrying duct tape — really. “Every inveterate traveler will have some duct tape with them,” Walker says. Here’s why: You can cover a rip in a window screen — like to Spartan accommodations in a developing area — or a hole in mosquito netting to keep the bugs out, along with any disease they might be carrying.
[See: Which Medical Screenings Should You Have in 2017?]
Back Home: Treat Suspect Symptoms as a Medical Emergency
After a person has been infected with a parasite that causes malaria, it can take time for symptoms to emerge. Those symptoms from high fever to shaking chills, headache and nausea can mimic the flu. So if you have a fever after traveling to an area where malaria was present, “you should consider it a medical emergency, and be seen even if it’s 2 in the morning; don’t wait until it’s 8 the next morning,” Walker says. That means going to the emergency room even if it’s the middle of the night or, if symptoms arise during the day, at the very least making sure you can see your doctor that day, she adds.
Let the medical provider know if you’ve been to a country with malaria, says Dr. William Schaffner, an infectious disease specialist and a professor of preventive medicine and infectious diseases of Vanderbilt University Medical Center.
As global outbreaks are of growing concern in domestic medicine, increasingly patients are being asked if they’ve traveled internationally recently when they seek treatment at emergency rooms, as is done at Vanderbilt, Schaffner says. But experts say doctors frequently still don’t think to ask (many have never treated malaria), and a simple delay in treatment — because malaria is initially mistaken for the flu, for example — can prove deadly.
“You can die from malaria within 24 to 48 hours [of when your symptoms begin],” Walker says. “The parasite infects your red blood cells … especially the Plasmonium falciparum — the most common cause of severe malaria and the most common cause of death. It’s one of those rapidly fatal diseases.”
[See: 11 Ways Rural Life Is Hazardous to Your Health.]
Fortunately, medicines used today to treat malaria in the U.S. are highly effective, particularly if given early on. So let a health provider know immediately where you’ve been and ask to get tested for malaria if you have any concerns that you might have contracted it while traveling.
“I really think if the patient has the forethought not only to talk about their illness but to talk about their recent travel history, that ought to trigger in the minds of doctors to consider an array of infections that they might have acquired during their travel in the tropics, and malaria always should be at the top of that list,” Schaffner says.
More from U.S. News
5 Solid Lifestyle Changes to Help Prevent Cancer
9 Ways to Boost Your Immune System
How to Prevent Malaria While Traveling Abroad — and Treating It at Home originally appeared on usnews.com
