As the threat from the disease grows, here is everything the modern traveller needs to know about malaria.

What is malaria?

Malaria is an infection caused by a tiny, blood-borne parasite, transmitted by the bites of infected female Anopheles mosquitoes. Symptoms can often be delayed until sometime after exposure (a minimum of seven days but often four weeks or much longer), meaning the connection with travel may be forgotten, delaying diagnosis. 

Returning from a tropical holiday should come with a suntan and sense of relaxation – not a tropical disease. However, the number of British travellers catching malaria abroad is rising, and scientists are warning it could get worse. 

The UK Health Security Agency (UKHSA) has just published its latest data on malaria in travellers returning to the UK, and the numbers are troubling. Over 2,000 cases were reported in 2023, the highest total in over two decades. Globally, the number of cases of malaria has risen by 16 million, compared with pre-pandemic levels. 

No less worrying is the potential impact of climate change. Warmer temperatures can extend malaria transmission season, as well as extend the disease’s geographical range to higher altitudes and cooler places where transmission was previously uncommon. Flooding and extreme weather events create perfect conditions for mosquitoes to thrive, resulting in outbreaks of the disease. 

In tropical countries where malaria is widely prevalent, the disease takes a huge toll. In 2022, there were 249 million cases, 94 per cent of which were in Africa. These led to at least 608,000 deaths, mostly in children. 

But research recently presented at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Spain suggested that if the world’s carbon emissions and population growth remain on the current trajectory, the populations at risk of malaria and other mosquito-borne diseases could increase by an additional 4.7 billion people by 2100, relative to 1970-1999. 

Diagnosing malaria depends on knowing that a person has been in a destination with a risk of the disease, since early symptoms can be non-specific, and malaria has a remarkable ability to be mistaken for other conditions. 

The most common symptoms of malaria:  

• Fever, usually above 38C and often intermittent 
• Fatigue 
• Aching muscles and joints 
• Headache 
• Chills (often with sweating and shivering) 
• Abdominal pains and diarrhoea 
• Sometimes jaundice (yellowing of the skin and whites of eyes) 

Severe malaria can result in headache, fits and even death. Suspected malaria is therefore a medical emergency, and prompt treatment is effective and lifesaving. 

The bottom line 

If you develop a fever or become unwell on returning home from travelling abroad, seek medical advice promptly and make sure you doctor know that you have been away. 

What areas have risks of malaria?  

Risk areas for malaria include many parts of Africa, Asia, Central and South America, the Caribbean and Oceania – including holiday destinations in parts of Thailand, India and Peru. 

How to prevent malaria on your travels

Medical prevention

Four to six weeks before your holiday begins, book a travel consultation regarding antimalarials – a travel nurse can advise on where and whether they are needed, and the options likely to suit you best.  

Malarone and doxycycline are the two most-commonly prescribed medications, usually tablets or capsules taken once a day. They need to be commenced before travel, taken while you are away and continued on your return home.  

For now, there are no suitable malaria vaccines for travellers. However, promisingly, two important vaccines have recently become available to combat malaria as part of public health campaigns in parts of Africa. 

Avoiding insects

Bite prevention measures dramatically reduce the risk of disease, with insect repellents containing DEET, plug-in insect killers, mosquito bed nets and a wide range of other options. Our expert travel nurses can recommend suitable products during your travel consultation. 

Other mosquito-borne diseases

Malaria is not the only disease on the rise due to climate change. Other mosquito-borne diseases include Dengue Fever (currently causing a large outbreak in South America), Japanese encephalitis, Chikungunya, Yellow Fever and Zika. The Zika outbreak in 2016 demonstrated how quickly mosquito-borne diseases can turn into an international health emergency. Climate change is expanding the range of mosquitoes capable of spreading them, and constant vigilance will be needed to combat them. 

If you’re travelling to areas that are at risk for Malaria, book a travel consultation for a stress-free holiday. 

Find more travel health information at fitfortravel.nhs.uk and travelhealthpro.org.uk. 

Related services at Fleet Street Clinic

Specialist Travel Clinic 

Antimalarials 

Travel Vaccinations 

Dengue Fever
 

Continued Reading about “Why malaria is on the rise – and how to protect yourself on holiday”

Read – Why malaria is on the rise – and how to protect yourself on holiday 

Read – Britons catching Malaria at highest number in over 20 years 

Read – Climate change drives deadly malaria surge as elimination efforts reach ‘crunch point’ 

Read – Vaccines are a glimmer of hope against malaria, but the battle has only just begun