Malaria: Symptoms, Risk Areas and How to Prevent It
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Malaria: Symptoms, Risk Areas and How to Prevent It
What malaria is, where you can catch it, the symptoms to watch for after travel, and how to protect yourself.
Feeling ill during or after a trip? A fever, chills, sweats, headache or flu-like illness during or up to a year after visiting a malaria area needs medical help the same day: call NHS 111, see a GP urgently or go to A&E, and say where you've travelled. Call 999 if someone is confused, very drowsy or having a fit. Malaria tablets are for prevention only.
Key fact: Most UK malaria cases are in travellers who didn't take malaria tablets. Bite prevention plus the right tablets, started on time and finished after you leave, greatly reduces the risk.
Travelling to a malaria area?
Tell us where you're going and when, and a UK pharmacist prescriber will check which malaria tablets are recommended for your trip. Adults 18 and over, trips up to 12 weeks. Order at least a week before you travel. Approved before 3pm, Monday to Friday? Dispatched the same day by Royal Mail Tracked 48, Tracked 24 or Special Delivery.
Start Malaria Tablets Consultation →What is malaria?
Malaria is a serious infection caused by a parasite (Plasmodium) that's spread by the bite of an infected Anopheles mosquito. These mosquitoes mostly bite between dusk and dawn. Once in your body, the parasites travel to your liver, multiply, then infect your red blood cells.
There are several types. Plasmodium falciparum, the most common type in Africa, is the most dangerous: it can become life-threatening quickly if it isn't treated. Other types, such as *P. vivax*, can hide in the liver and cause illness months or even years after a trip.
Spread by mosquitoes
Infected mosquitoes bite mainly from dusk to dawn.
Can be fatal
Falciparum malaria can become severe quickly without treatment.
Preventable
Bite avoidance plus the right tablets greatly reduces your risk.
Curable
Malaria can be cured if it's diagnosed and treated promptly.
Can you get malaria in the UK?
Not from mosquitoes in the UK. Almost every case diagnosed in the UK was caught abroad. Malaria doesn't spread from person to person through everyday contact, although very rarely it can pass through blood transfusions or from a mother to her baby.
Malaria in UK travellers
Malaria is one of the most important health risks for UK travellers to tropical countries. In 2023, the UK Health Security Agency recorded:
Most cases were caught in West Africa, most often in Nigeria, Sierra Leone and Ghana, and around 3 in 4 UK residents who caught malaria had been visiting friends and relatives. Many people who grew up in a malaria country assume they're immune, but that protection fades quickly after living in the UK.
Where is malaria a risk?
Malaria is found in parts of more than 80 countries, mainly in:
- Sub-Saharan Africa: the highest-risk region, accounting for most UK cases.
- South and South-East Asia: risk varies widely, and is low in many popular tourist areas.
- Central and South America, including parts of the Amazon.
- Parts of the Middle East and Oceania, such as Papua New Guinea.
Risk can differ within one country, between cities and rural areas, by altitude and by season. As a general guide, UK guidelines recommend malaria tablets for most of sub-Saharan Africa, while many popular tourist areas of South-East Asia only need bite avoidance. Always check the advice for every place you're visiting: the UKHSA country recommendations and TravelHealthPro are the official UK sources.
Symptoms of malaria
Malaria can feel like flu at first. Symptoms include:
- A high temperature (fever), which may come and go
- Sweats and chills, or feeling hot and shivery
- Headache and aching muscles
- Feeling generally unwell, tired or weak
- Being sick, diarrhoea or tummy pain
- A cough or loss of appetite
When symptoms start
Symptoms usually start from about a week after an infected bite, and most falciparum malaria appears within 3 months of returning. But malaria can appear up to a year or more after a trip, even if you took tablets. If you're ill during or after travel, always tell the doctor where you've been.
Call 999 if someone who has travelled to a malaria area is confused, very drowsy, having a fit, struggling to breathe, has yellow skin or eyes, or is passing very little or dark urine. These are signs of severe malaria.
How malaria is diagnosed and treated
Malaria is diagnosed with a blood test, which should be done the same day. If you're abroad, see a doctor straight away and ask for a malaria test. Malaria is treated with antimalarial medicines chosen by a doctor, often in hospital for falciparum malaria. Treated promptly, most people recover fully.
Malaria can't be treated online. Our service supplies prevention tablets for healthy travellers only. If you think you might have malaria, get medical help the same day.
How to prevent malaria: the ABCD
UK guidelines use four steps, known as the ABCD of malaria prevention:
Awareness of risk
Find out whether there's malaria where you're going, including the specific regions, and how high the risk is.
Bite prevention
Use an insect repellent containing DEET (20% to 50%), wear long sleeves and trousers from dusk, and sleep under an insecticide-treated mosquito net unless your room is screened or air-conditioned.
Chemoprophylaxis (tablets)
Take the malaria tablets recommended for your destination, start them on time, and finish the course after you leave.
Diagnosis
Get medical help the same day if you have a fever or flu-like illness during or up to a year after your trip.
No tablet gives 100% protection, so bite prevention matters even when you take tablets.
Malaria tablets
The main malaria prevention tablets used in the UK are:
| Tablet | How you take it | After you leave |
|---|---|---|
| Atovaquone/proguanil (Maloff Protect, Malarone or generic) | Once a day, starting 1 to 2 days before | 7 days |
| Doxycycline | Once a day, starting 1 to 2 days before | 4 weeks |
| Mefloquine (Lariam) | Once a week, starting 2 to 3 weeks before | 4 weeks |
Which is best depends on your destination, your health and your trip. Our guide to the best malaria tablets in the UK compares them, how to take malaria tablets explains when to start and stop, and Malarone side effects covers what to expect. Chloroquine and proguanil, once widely used, are no longer recommended for most destinations, and the combination pack is discontinued in the UK.
Who is at higher risk?
- People visiting friends and relatives in their country of origin, who often stay longer and assume they're immune.
- Pregnant women: malaria is more dangerous for mother and baby. UK advice is to avoid travel to malaria areas in pregnancy if possible.
- Young children and older adults.
- People without a working spleen, with sickle cell disease or a weakened immune system.
- Long-stay travellers and people on last-minute trips who don't get advice in time.
These groups need specialist advice from a travel clinic or GP, ideally 6 to 8 weeks before travel.
Common malaria myths
- "I grew up there, so I'm immune." Any immunity fades within months of living in the UK.
- "It's a short trip, I don't need tablets." One bite is enough. Short trips still need protection where it's recommended.
- "I took my tablets, so a fever can't be malaria." Tablets greatly reduce the risk but don't remove it.
- "I can buy tablets cheaply when I get there." UK guidelines warn that antimalarials bought abroad may be fake or substandard.
Getting malaria tablets
If you're an adult travelling to a malaria area for up to 12 weeks, our pharmacist prescribers can check your destinations against UK guidelines and supply the right tablets. See our malaria tablets page for who the service is for and how it works. Order at least a week before you travel. Also travelling long-haul? See our jet lag treatment and travel sickness tablets.
UK safety and reporting side effects
In the UK, Malarone, generic atovaquone/proguanil and doxycycline are prescription-only medicines, and Maloff Protect is a pharmacy medicine. Before any malaria tablets are supplied, a GPhC-registered pharmacist prescriber reviews your consultation, including every destination, your dates, your health and the other medicines you take, and checks the UK malaria guidelines for your trip. Always read the patient information leaflet in the pack.
Buy malaria tablets in the UK before you travel. UK guidelines warn that antimalarials bought abroad may be fake or substandard. Only buy medicines from a registered UK pharmacy: you can check any online pharmacy on the GPhC register.
If you think you've had a side effect from a medicine, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme, which helps keep medicines safe for everyone.
Malaria tablets are one part of travel health. Before you go, check FCDO travel advice for your destination and TravelHealthPro for vaccines and other health risks. We don't provide vaccinations, so book a travel clinic or speak to your GP practice if you need them.
Frequently Asked Questions
Can you get malaria in the UK?
Not from UK mosquitoes. Almost all malaria diagnosed in the UK is caught abroad, most often in West Africa. Very rarely, it can be passed on through a blood transfusion or from a mother to her baby.
Is malaria contagious?
No. Malaria doesn't spread from person to person through coughs, touch or everyday contact. It's spread by the bite of an infected mosquito.
How long after travel can malaria symptoms appear?
Usually from about a week after an infected bite, and most falciparum malaria appears within 3 months of returning. But symptoms can appear up to a year or more later, so always tell a doctor you've travelled.
What does malaria feel like?
At first it can feel like flu: a high temperature, sweats and chills, headache, aching muscles and feeling very unwell. Some people also have vomiting, diarrhoea or a cough.
Is there a malaria vaccine for travellers?
No. Malaria vaccines are used for young children living in parts of Africa, but there's no malaria vaccine for UK travellers. Bite prevention and malaria tablets are the way to protect yourself.
Can malaria be cured?
Yes, if it's diagnosed and treated promptly. Falciparum malaria can become life-threatening quickly, which is why a fever after travel needs a same-day blood test.
Do I need malaria tablets if I grew up in a malaria country?
Yes, if they're recommended for your destination. Any immunity fades within months of living in the UK, and most UK malaria cases are in people visiting friends and relatives.
Which countries need malaria tablets?
Tablets are recommended for most of sub-Saharan Africa and some parts of Asia, Central and South America and Oceania. Many popular tourist areas of South-East Asia only need bite avoidance. Advice can differ within a country, so check every place you're visiting.
What is the ABCD of malaria prevention?
Awareness of the risk, Bite prevention, Chemoprophylaxis (taking the right tablets) and prompt Diagnosis if you feel unwell. All four together give the best protection.
When should I see a doctor?
The same day if you have a fever, chills, sweats or flu-like illness during or up to a year after visiting a malaria area. Call 999 for confusion, drowsiness, a fit or difficulty breathing.
References
- UK Health Security Agency. Malaria prevention guidelines for travellers from the UK 2026. gov.uk
- UK Health Security Agency. Malaria prevention guidelines 2026: chemoprophylaxis. gov.uk
- UK Health Security Agency. Malaria prevention guidelines 2026: country recommendations. gov.uk
- UK Health Security Agency. Malaria imported into the UK: 2023. gov.uk
- NHS. Malaria. nhs.uk
- National Travel Health Network and Centre. TravelHealthPro. travelhealthpro.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Malaria tablets need a clinical consultation before they can be supplied, and recommendations depend on your destination. If you feel unwell during or after travel to a malaria area, get medical help the same day. In a medical emergency, call 999.
