While insect bites are common, you can minimize the risk of insect-borne diseases (malaria, sleeping sickness, Chagas' disease, filariasis and others) by using simple self-protection measures.
- Wear clothing that cover the arms and legs.
- Spray or soak clothes, mosquito nets and tents in permethrin.
- Apply a 30-to-50 percent DEET-containing insect repellant at three-to-six-hour intervals to exposed skin (if using with sunscreen, apply sunscreen first and DEET second), and taking antimalarial medications.
Malaria is a mosquito-borne disease caused by a parasite. People with malaria often experience fever, chills and flu-like illness. Left untreated, they may develop severe complications and possibly die. Bed nets, insecticides and antimalarial drugs are effective tools for fighting malaria in areas where it is transmitted.
Travelers to a malaria-risk area should avoid mosquito bites and take a preventive antimalarial medication.
Travelers whose itinerary includes tropical countries where malaria exists will need to take antimalarial prophylactic medication.
Any fever in the first two months after returning from malaria-prone areas should be urgently evaluated.
Medications for Malaria Prevention
We recommend one or more of the following oral medications for malaria prevention. Please note that none are 100 percent effective.
- Atovaquone/Proguanil (Malarone®) — Take one tablet daily starting one to two days before arrival, continuing daily during exposure and for seven days after leaving the malarial area. Side effects are infrequent and equal to those caused by placebos, and have similar symptoms to jet lag.
- Mefloquine (Lariam®) 250 mg — Take one tablet weekly, starting two weeks before the trip, continuing weekly during the trip, and weekly for four weeks after returning from a malarial area. Mefloquine is generally effective against all types of malaria, including chloroquine-resistant plasmodium falciparum. Uncommon adverse reactions include vivid dreams, lightheadedness, vomiting in young children and occasional but rarely permanent neuropsychiatric adverse reactions including anxiety and depression, which can be severe.
- Chloroquine phosphate or Aralen® (500 mg) or Hydroxychloroquine (200 mg/twice a day) — Use same schedule as mefloquine above. Side effects include stomach upset and, rarely, an itchy skin rash. This medication is not effective against chloroquine.
- Doxycycline 100 mg — Take one tablet daily, starting two days before arrival, and continuing daily for the duration of the trip and for four weeks after leaving the malarial area. Always use sunscreen with an SPF of at least 30 when taking doxycycline, as severe sunburn can result in persons exposed to frequent, direct sunlight. Do not take doxycycline with Pepto-Bismol, antacid or calcium tablets. Side effects include upset stomach, vomiting or diarrhea and sun sensitivity.
- We advise pregnant women to avoid travel to chloroquine-resistant malarial areas, and non-pregnant women of childbearing age to avoid becoming pregnant while taking malaria treatment.
- Malaria may occur several months or years after leaving a malarial area, even in travelers who have taken the recommended malarial treatment. Should you develop an unexplained illness characterized by spiking fever, notify your physician of previous travel in a malarial area.