Summer, Travel and Medication – Part 5 – Malaria

Prevention of malaria.

The anopheles mosquito only bites between sunset and sunrise. There are some very effective precautions you can take to avoid being bitten by the mosquitoes: wear light-colored clothing that covers the arms and legs; sleeping under a mosquito net impregnated with special substances such as permethrin or deltamethrin; cover the exposed areas of the body every four to six hours with an insect repellent, preferably one based on DEET (Diethyltoluamide). The optimal concentration of DEET is between 20 and 50%. Pregnant women and children are advised to use the 20% concentration. It is also advisable, especially for pregnant women and children, to wash off any remaining repellents once protection is no longer needed.


Antimalarial drugs have many contraindications and many side effects. Preventing malaria through medication is not easy as resistance has developed to the chloroquine and proguanil medications. No fabric, no matter how effective, has a 100% protection level.

It is extremely dangerous for pregnant women to become infected with malaria: dangerous for both the mother and the unborn child. In very small infants, a malaria infection can be fatal. Therefore, the WHO advises against travel to regions where malaria is endemic and thus the transmission risk is very high for pregnant women and families with young children.

When antimalarial drugs are taken, they are not passed on through breastfeeding: this means that the newborn needs to receive their own dose of antimalarial drugs.

One can develop a natural immunity, but only after repeated infections, for several years to come. Immunity disappears very quickly (usually within six months) when there is no more exposure to the malaria infectors. Therefore, any traveler, even those visiting their own country of origin, should be considered non-immune.

One should be very aware of possible malaria when a high fever develops up to three months after returning from the tropics. It is a fact that deaths have to be counted every year because people do not react in time.

Travelers coming from tropical areas where malaria is endemic must wait a minimum of six months before they can donate blood, ie as total or for some blood components. Diagnosed malaria patients have to wait three years. However, this limitation does not apply to plasma donation.

This was part 5 of a series of 6 articles on travel and medication. The other parts are: Part 1 Vaccinations – Part 2 Traveler’s diarrhea – Part 3 Lyme disease – Part 4 mountain sickness and heat stroke – Part 5 Malaria – Part 6 motion sickness and jet lag.