MALARIA.
Advice For Travellers.
MALARIA IS FOUND IN MANY COUNTRIES CLOSE TO AUSTRALIA SUCH AS PNG, VANUATU & SOLOMON ISLANDS.
ANTI-MALARIAL MEDICATION IN A NUTSHELL.
There are two main anti-malarial tablets:
- Malarone tablet – starting 1-2 days before travel and taken until the first week after returning. Cost-effective for short trips.
- Doxycycline – also started 1-2 days before travel but taken until 4 weeks after returning. Cheaper than malarone for longer-term trips.
Side effects of Malarone such as hepatitis are rare. Doxycyline may cause sensitivity to the sun in up to 5% of people – so ensure good sun protection. Take doxycycline with food to avoid Gastro-intestinal side effects.
Most people who get malaria have either not taken it at all, or not taken the medication for the correct length of time. Malaria is very common, so taking anti-malarials is a no-brainer for visits to endemic areas.
There are 6oo to 800 cases of Malaria reported each year in Australia.
Mefloquine is less frequently prescribed because of potential psychiatric side effects.
Immunity wanes within a year of exposure to malaria. People who have grown up in malarial areas and then moved to Australia will also be vulnerable to the disease.
WHY OBSESS OVER THE MOZZIE?
Vaccines are very effective but only cover a limited range of potential infections. The Humble, often painless, Mozzie bite can transmit a large range of infectious diseases.
Around 700 million people each year are infected by mosquito-borne diseases. We’re pretty used to the role of the mozzie spreading diseases within Australia – for example, Ross River Fever, Barmah Forest Virus, Murray Valley Encephalitis & Kunjin virus.
Some of the overseas mosquito-borne infectious diseases include:
- Dengue fever is also common in countries like Bali. The same species of mosquito that carries Dengue fever lives in Northern Queensland. Outbreaks have occurred in Northern Queensland from a person infected overseas.
- Chikungunya fever. There were over 100 cases in Australian travellers in 2013.
- Japanese Encephalitis. Rare but serious and there is a vaccine available.
- Yellow Fever. Vaccine available.
- Elephantiasis
- Malaria
- Zika Virus
Add to that the list of infectious diseases carried by other biting insects (eg. Tsetse, Blackfly, Sandfly, Tick) and the list is truly daunting.
We all know to be careful with food and drink when travelling to developing countries. Fewer people take the same amount of care to avoid mosquito & other insect bites.
What can you do to protect yourself from mozzie bites?
- Wear clothing that covers the forearms (long sleeves) and covers down to the ankles.
- Use insect repellent on both exposed skin and on thin clothing (mozzies may bite through thin clothes)
- Sleep in a mozzie-proofed room or use a mosquito net. Outside, you can use a portable and lightweight mozzie net. The mozzie nets should be impregnated with insecticide.
Which insect repellent is best, and how do I use it?
- Insecticides ideally contain DEET. Use the spray for clothes and nets. The sprays designed to use on clothing have a concentration of up to 100% DEET. The lotions, cream or sticks are used directly on the skin and contain up to 40-50% DEET.
- DEET Concentration of 20 to 50% repels mosquitos effectively for 6 to 13 hours.
- DEET is considered safe in pregnancy (animal studies in early pregnancy, human studies from 12 weeks on) and in children over 2 months of age. This advice is confirmed in a BMJ 2015 review of mosquito repellents.
- Apply the repellent to all exposed skin except the face. Apply before sunscreen the repellant reduces sun protection factor of the sunscreen by around a third.
- Alternatives to DEET are PMD (lasts around 5 hours), Icaridin (up to 6 hours) & IR3535 (shorter proection against the Anopheles species so don’t use in malaria regions).
