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Travel Preparation

Malaria

Malaria has caused more deaths worldwide than any other infectious disease: it is the most serious infectious disease hazard to divers traveling to the tropics. The disease is found primarily in subtropical and tropical regions of the world, where environmental conditions favor stable, infected Anopheles mosquito populations.

Malaria occurs in large areas of Central and South America, Hispaniola, sub-Saharan Africa, the Indian subcontinent, southern and southeast Asia, the Middle East, Mexico, Haiti, the Dominican Republic and Oceania. Major cities in Asia and South America are nearly malaria-free, though cities in Africa, India and Pakistan are not. There is less risk of malaria at altitudes above 4,922 feet/1,500 meters.

Malaria Prophylaxis
The serious health risk represented by malaria cannot be overemphasized. Prophylaxis is essential and includes both the prevention of mosquito bites and drug prophylaxis. The malaria parasite, a protozoan, is transmitted to humans by the bite of an infected Anopheles mosquito, usually between dusk and dawn.

Personal protection is the best way to prevent malaria and other insect-transmitted diseases. This means staying in well-screened areas while indoors, wearing clothes that cover most of the body when outdoors, and using mosquito nets when sleeping. Use insect sprays and repellents for clothing, tents and nets as well as personal repellents containing at least 30 percent DEET. Use caution with stronger concentrations.

Drug prophylaxis and measures to prevent mosquito bites are essential for divers. Discuss your travel plans with a physician well before departure, since prophylactic drugs require a prescription. Recommendations may differ from various countries, reflecting the differences in approach and availability of medicines.

Most of the drugs used for prophylaxis are usually safe and well-tolerated by most individuals. However, as with any drug, side effects and toxic reactions may occur. The seriousness of malaria, however, warrants tolerating temporary side effects.

If you are unable to tolerate preventive medications because of side effects, cancel your trip: the risk is too great that you contract malaria and even die.

Regardless of the preventive measures you use, you can still get malaria. Malaria may not develop until long after your trip so you must continue the prophylaxis for its entire course. If you develop flu-like symptoms (any illness with chills, fever and headache) during a trip in malarious areas or within several months after the last exposure, obtain medical attention immediately.

Other Resources:

• Vaccinations and Immunizations
• Diarrhea Management
• Behavioral Counseling