COVID-19 and travel

Travelling safely

Travel the globe safely during COVID-19. What other risks are there for the adventurous traveller?

We focus on the worlds biggest killer …..Malaria

Malaria prevention during COVID-19

Malaria is a tropical disease spread by mosquitoes that causes a fever, chills, sweating, nausea, vomiting, and aches and pains. In serious cases it can lead to life-threatening complications, which means malaria prevention techniques are crucial when travelling to high-risk areas.

Reducing deaths from malaria relies on:

• A – Seeking good malaria prevention advice and adherence to prophylactic malaria treatment
• B – Febrile travellers returning home, seeking prompt healthcare

During the current COVID-19 pandemic, many travellers may present with a fever. Some will have contracted Plasmodium falciparum malaria, which could prove fatal if it is not diagnosed and treated early.

As we start to control the transmission rate of the COVID-19 virus, travel restrictions are slowly being lifted. Travellers are being told to adhere to local and regional COVID related travel advice, but should not forget that the threat of malaria is still ever present.

Ensure that you follow all the important steps for malaria prevention:

• A – Awareness of the malaria risk at your chosen destination
• B – Bite prevention
• C – Chemoprophylaxis (appropriate choice of antimalarial medication and compliance with the regime)
• D – Diagnosis (prompt diagnosis and treatment without delay)

In the current climate, please be aware that if you have returned from a malaria risk area in the last six months and have fever, you will need a malaria test the same day that you develop fever.

Travellers returning from malaria risk areas who are ill should seek urgent medical advice and inform the health professional that they have travelled to a malaria risk area in the last six months.

How to protect yourself from malaria

If you are planning on travelling to a malaria zone within the next few months, it’s a good idea to familiarise yourself with malaria prophylaxis techniques. It’s recommended that, before leaving the country, you get malaria advice from your GP, travel nurse or pharmacist.

Bite avoidance

A key element of malaria prophylaxis is mosquito bite avoidance. When visiting a country affected by malaria, bite prevention techniques should be your top priority.

This is for two reasons:

• Antimalarial tablets cannot provide 100% protection
• Mosquitoes can carry other dangerous diseases such as dengue fever

You can avoid getting bitten by following these tips:

• Wear long, loose trousers and long-sleeved tops to keep your skin covered, particularly between dusk and dawn when the mosquitoes that carry malaria are most active
• Apply insect repellent to areas of exposed skin; repellents containing 20-50% DEET are the most effective.
• Book accommodation with insect screens on the windows and doors, and air conditioning
• When sleeping in more basic accommodation, sleep under a mosquito net sprayed with insecticide/mosquito repellent
• Use plug-in insecticides

Chemoprophylaxis

Chemoprophylaxis is a term that describes medical treatments taken to prevent illness. Malaria chemoprophylaxis refers to antimalarial tablets, which should be taken in particularly high-risk areas.

Usually you have to obtain antimalarials with a prescription. One of the most common malaria tablets prescribed in the UK is atovaquone and proguanil (malarone), due to its relatively low risk of serious side effects and simple dosage regime. You can obtain this from your own GP, nurse, or by visiting an online GP such as accessdoctor.co.uk after completing a simple online consultation.

The symptoms of malaria include:

• Fever
• Chills and shivering
• Sweating
• Headache
• Nausea and vomiting
• Aches and pains
• Diarrhoea

Sometimes the symptoms of malaria occur in cycles. You may experience bouts of fever, chills, and sweating every two or three days. Not all people infected with malaria experience these cyclical bouts of symptoms. For that reason, it’s advised that you seek medical advice regarding malaria as soon as you experience any of the symptoms described above (provided you have been in a malaria zone for at least one week).

How long can you take malaria prophylaxis?

Malaria prophylaxis includes antimalarials and bite avoidance and the length of time you need to take your tablets will depend on the type of antimalarial you have. Malarone should be started 1-2 days before travelling, one tablet a day while you are in a malaria risk zone, and then 7-days after returning.