What Is Malaria, and Where Are You Most at Risk?
Keep this in mind if you're traveling this summer.
For decades, malaria has been seen as a treatable disease—at least in the United States. But new research in the The Lancet Infectious Diseases warns that the disease could "become a potential global health emergency" as soon as the next decade.
The two new scientific articles, published Monday, warn that multi-drug-resistant strains of malaria are currently spreading across Southeast Asia, including places like Thailand, Cambodia, Laos, and Vietnam. According to researchers, the drug-resistant strains of malaria have already had "disastrous consequences," rendering a widely-used drug known as dihydroartemisinin-piperaquine (DHA-PPQ) ineffective.
Unfortunately, this rise in malaria isn't necessarily new. According to a 2018 report from the World Health Organization, malaria cases have risen significantly in 13 countries, and increased by two million cases—from 217 million to 219 million—between 2016 and 2017.
Basically, it all sounds pretty damn scary. Luckily, Health spoke with an infectious disease expert to find out what you need to know about malaria—including where you're most at risk and how you can prevent it.
What is malaria?
For the most part, malaria isn’t a problem for people living in the US. But if you travel outside of the US, you can quickly be exposed to the potentially deadly disease—and worldwide, 3.2 billion people (so about half the world’s population) are at risk of contracting malaria, per the National Institute of Allergy and Infectious Diseases (NIAID).
It’s important to know the facts about malaria if you travel a lot, since malaria is still prevalent in Asia, Africa, and South America, Frank Esper, MD, an infectious disease specialist at Cleveland Clinic, tells Health
Malaria is a serious and possibly fatal disease, caused by a parasite that typically infects a certain type of mosquito, according to the Centers for Disease Control and Prevention (CDC). In the US, the disease was eradicated in the 1940s (to do that, the government actually had millions of homes sprayed with the pesticide, DDT, per the CDC. But “in a nutshell, malaria is still prevalent in multiple areas around the world,” Dr. Esper says.
Malaria is transmitted from mosquitos to humans through mosquito bites, says Dr. Esper. “A mosquito that is infected bites an individual, transmits that parasite into this new person’s body, that person get[s] sick,” he explains.
The parasite that causes malaria is Plasmodium. There are five types: Plasmodium falciparum, Plasmodium malariae, Plasmodium vivax, Plasmodium ovale, and Plasmodium knowlesi. But Plasmodium falciparum is the most worrisome, Dr. Esper says.
What are malaria symptoms?
One of the dangers of malaria is that it can look like a more common illness, such as the flu, at first. Chills, fever, sweats, fatigue, headache, vomiting, nausea, and body aches are all symptoms of malaria. If the disease persists without treatment, it an cause anemia and jaundice (a yellowing of the skin and eyes) because of the loss of red blood cells, per the CDC, and can lead to kidney failure, seizures, mental confusion, coma, and even death.
The CDC says that symptoms can appear as soon as 10 days or as late as one year after being exposed to the disease. You should be on the lookout for those flu-like symptoms if you have traveled to a country in which malaria is present, and if you experience them, it's time to see a doctor right away, since malaria can very rapidly turn into something serious, per the CDC.
What is the treatment for malaria?
Your first line of defense in malaria is prevention, so if you know you’ll be traveling to a region in which malaria is prevalent, it’s crucial to prepare ahead of time. You need to pick up malaria pills and start taking them before you land in the region, to give your time body to prepare. Once you’ve started taking the pills “the parasite will die as soon as it hits your blood,” Dr. Esper explains.
To assess your risk of contracting malaria before traveling abroad, consult your GP. Or, better yet, talk to a travel medicine specialist. How far in advance of your trip you need to take malaria medication depends on the specific medication you decide to take. Some need to be taken just one to two days ahead of time, while some should be started one to two weeks ahead of time. Some malaria medications are not advised for pregnant women, the CDC says. Additionally, not all malaria medications are safe for everyone. For example, people with certain psychiatric conditions aren’t advised to take a common malaria medication. Talking with a travel medicine specialist can help you decide what the best course of action for you is.
And then, when you do have your malaria pills in hand, it's essential that you actually follow through with the entire course of medication. Make sure you take all your pills, even if you’re about to leave town and don’t think you’ll likely get bitten again. Dr. Esper warns, “People boarding the plane [can get] bitten by a mosquito.”
But let’s say, hypothetically speaking, you don’t take your malaria pills and you wind up developing those flulike symptoms while traveling or when you get back home. That’s when you have to call your doctor immediately, Dr. Esper says.
“They can do a blood test,” he says. This can confirm whether or not you have malaria. If you do, you can be treated with a medication called artesunate, given intravenously (via IV). The CDC says the artesunate treatment can last up to two days. But again, this is a last line of defense—you really need to be on malaria meds the whole time you’re traveling in a risky region.
The good news in all of this? Malaria is really only a concern if you're traveling to a region in which the disease is prevalent±and even then, if you take your malaria pills the way they're prescribed, you should be fine.