For malaria, there are now several drugs approved here, the prescription of which is individually adapted to the needs of the traveler: e.g. Resochin®, Paludrin®, Lariam®, Malarone®, Riamet® and, in exceptional cases, the antibiotic doxycycline *.
Depending on the incidence of malaria in the destination country, the length of stay, the individual’s health status and the type of travel, there are the following options for dealing with the problem of malaria:
Do nothing and rely on local health systems
Taking an emergency remedy with you
Prophylactic use of medication
Prophylactic taking of medication and additional carrying of an emergency medication
Carrying an emergency drug alone to treat an outbreak of malaria (stand-by) may be considered if:
the probability of contracting malaria is very low
the stay in the malaria area is only short or very long
Contraindications for prophylaxis drugs exist.
You should discuss this in detail with the doctor.
After taking an antimalarial drug for self-treatment, you should seek medical treatment as soon as possible, but no later than after returning home.
In general, a tropical physician should be consulted for all illnesses during and after travel to the tropics and subtropics.
If fever occurs for more than 2 days, see a doctor immediately.
If no doctor is available, start emergency therapy immediately.
If fever persists, always consult a doctor or clinic immediately
* Please refer to the package inserts of the medications. The brand names are given as examples. Regarding the dosage and other recommendations for taking antimalarial drugs for prophylaxis and therapy or stand-by use, we refer to our corresponding patient information, which you can obtain from us at any time. Pati0311
The malaria pathogen:
There are three different types of malaria, which are caused by different pathogens:
Malaria tertiana Plasmodium vivax/ovale
Malaria quartana Plasmodium malariae
Malaria tropica Plasmodium falciparum
The pathogens are transmitted by the mosquito species Anopheles. The risk of being stung is particularly high in the evening and at night. The pathogens undergo a development cycle first in the mosquito and then in humans. There, after a so-called liver phase, they multiply in the red blood cells. These are destroyed in the process, leading to the febrile seizure.
The diagnosis of malaria:
Malaria can be diagnosed relatively quickly and reliably from a blood smear or the so-called “thick drop”. However, the evaluation of the stained preparation requires some practice. However, doctors in malaria regions are usually well versed in diagnostics. Self-testing for malaria is relatively difficult to perform and not absolutely safe.
The spread of malaria:
Malaria is widespread in most tropical and subtropical regions of our world. Worldwide 200 million fall ill every year, more than 1 million die from this disease. Affected is in more than 100 countries of our world mainly the population there and less the tourists.
About 1000 cases are brought into Germany every year, most of which could be avoided through sensible prevention.
The main symptom of malaria is fever, at the earliest 5 days after possible infection in the malaria area (incubation period). However, only in malaria tertiana and quartana do the febrile episodes occur at regular two- and three-day intervals, respectively. Malaria tropica, on the other hand, can also feign only flu-like symptoms with continuous fever. Initially, symptoms may be mild.
Thus, during and after a stay in the tropics, any unexplained febrile illness is suspicious of malaria until it is safely ruled out.
In most cases, malaria appears no later than 6 weeks after the stay. In malaria tertiana, much later outbreaks are also possible, but rare.
Always give your doctor a hint about previous travels and especially tropical stays if you fall ill with a fever.
While malaria tertiana and malaria quartana are very unpleasant but usually benign, malaria tropica can lead to death from day 5 of the outbreak if left untreated.
However, it is still true that any malaria is treatable and curable if you just think about it in time and treat it properly.
Unfortunately, malaria cannot be confirmed or ruled out with certainty based on the clinical picture alone. Malaria is generally perceived as a serious illness. So if you get vaguely feverish in the tropics, feel very bad without any apparent cause such as a cold or diarrhea, you need to think about the possibility of malaria.
If in doubt, see a doctor as soon as possible. Caution is advised, especially in the case of unusual courses of the disease.
Malaria prophylaxis and therapy:
It is best to avoid getting malaria in the first place. Insects can transmit other unpleasant diseases besides malaria.
By consistently protecting yourself from bites, you can reduce the risk of malaria to one-tenth.
Application of mosquito repellent, if necessary also on the clothing
Wearing covering clothing, light-colored, stitch-proof if necessary.
Use of a mosquito net (if necessary, soak with mosquito repellent).
No light in the room with the window open
If necessary, mosquito repellent spray in the bedroom
By taking preventive medication, you can avoid contracting malaria with a high probability, but unfortunately not with absolute certainty. It is important to take it reliably and especially for 1 or 4 weeks after leaving the malaria area.
Any malaria illness on vacation means a risk to the traveler and a significant impairment of the recreational value. According to these guidelines and taking into account possible side effects of antimalarial drugs, the prophylaxis recommendation should be adjusted quite individually.