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MALARIA & DENGUE FEVER
Many of the serious illnesses experienced by travellers are transmitted by the bites of mosquitoes in tropical regions. Malaria, for instance, is one of the leading causes of death in the world each year. In areas such as lowland areas of tropical Africa and parts of Papua New Guinea transmission rates are extremely high and a significant percentage of the local population live with active parasites in their blood. Major epidemics of serious viral illness including Dengue Fever and Chikungunya result from bites by mosquitoes. 

An extremely important aspect of illness prevention while abroad involves avoiding or minimising bites by mosquitoes. Although specific species of mosquito transmit illnesses, different mosquitoes often co-exist in the same region. Their specific biting habits may be different. Knowledge of the habits of mosquitoes helps to devise strategies to reduce the number of bites. Reduce the number of mosquito bites on your trip and you are well on the way to remaining in good health. Some of the most important strategies to reduce mosquito bites are listed below.

  • Wear protective clothing with long sleeves to provide a physical barrier against bites.
  • Where possible, wear light-coloured clothing
  • Use high quality insect repellents containing diethyltolumide (DEET) 20-30 %
  • Choose an air-conditioned room if available
  • Use a permethrin-impregnated mosquito net if malaria is present in that area.
  • Avoid perfumes and strongly scented cosmetic products.
  • Only sleep in accommodation with adequate insect screening.
  • Spray insecticide inside your room towards dusk paying particular attention to door and window frames and under furniture. 
  • Choose accommodation on higher floors of buildings.
  • Impregnate some items of clothing or bed linen with permethrin, an insecticidal fabric treatment available from our clinic.

If you are bitten by a mosquito, do not panic but seek medical advice if you start to develop symptoms such as fever or a rash. Some people appear hypersensitive to mosquito bites and they may find anti-histamines or special anti-bite creams useful to reduce discomfort.

MALARIA
According to some authorities, Malaria is the leading cause of death in the world each year.  In some localities such as parts of Papua New Guinea and West Africa the malarial risk is so extreme that almost the entire population carries parasites in their blood. Local people who are repeatedly infected will often develop some tolerance to Malaria. Travellers who have no immunity to Malaria are at risk of serious illness or even death if infected from the bite of the mosquito vector – the Anopheles mosquito. Fortunately, Malaria can normally be effectively prevented. Even if you develop malaria, treatment is usually effective if started early. The key to prevention of malaria and minimising its danger is a basic understanding of the illness and practical issues to manage the risk. 

Anti-Malarial Drugs 
At the time of your consultation in our clinic, a doctor will make a specific recommendation regarding medications to prevent malarial infection. Not all travellers require anti-malarial drugs. Sometimes you may be visiting a malaria-free area. Perhaps your trip is a short one. Our experienced staff will discuss all the options involved and help you to make an informed choice. Benefits and risks of each medication need to be specifically discussed. Other factors such as your age, sex, past medical history, other medications and resistance patterns of malaria all need to be taken into account. At the present time, there are several different options available for malarial prevention (prophylaxis) drugs.

  • Chloroquine alone
  • Chloroquine plus Proguanil (Paludrine)
  • Mefloquine
  • Doxycycline
  • Malarone

Each of these drugs has advantages and disadvantages. Both Chloroquine and Mefloquine are taken weekly. The other drugs are required on a daily basis. Our doctor will discuss the correct way to take each of these medications and their individual side effects, benefits and interactions. You must tell the doctor if you have any medical conditions, allergies or if you are on other medications. Also inform the doctor if you are pregnant. You will discover more detailed information on anti-malarial drugs in the medications section in the final pages of this book. Some drugs are also used for emergency self treatment of malaria – if appropriate our doctor will discuss these medications (Malarone or Riamet).

DENGUE FEVER
Dengue Fever is a common viral illness which occurs widely throughout tropical regions throughout the world. Dengue Fever is transmitted from the bite of the Aedes mosquito and results in a flu-like illness commencing a few days after the bite. Dengue fever is often found even in metropolitan areas of cities such as Djakarta, Rio de Janeiro, Kuala Lumpur, Bangkok and Singapore where the mosquitoes often proliferate in water containers left out in the open. Cases of dengue fever even occur in Northern Queensland. Major epidemics of dengue with thousands of cases occur each year and the illness poses a significant risk to travellers.

Typical symptoms of dengue fever include a fever, severe headache, body aches and pains and a characteristic rash. In a small percentage of dengue fever, there is a more severe and complicated illness where haemorrhages may occur. Dengue can be fatal if untreated but death is rare if appropriate medical care is sought. Travellers will need to be aware of a number of important facts about dengue fever.

  • Malaria pills offer no protection against dengue fever. Dengue is prevented by avoiding mosquito bites.
  • The Dengue fever mosquito, Aedes, normally bites during the daytime.
  • If you suspect you have dengue fever you must not take aspirin because it may cause bleeding. Seek medical advice as soon as possible.
  • Treatment is entirely symptomatic but may involve intravenous fluids or even a blood transfusion in severe cases.

If you have suffered dengue fever before you need to be extra careful because there is an increased risk of a more severe illness. 


Phone  (02) 9891 4850
Travel Health, Medical and Vaccines
   Sydney Travel Vaccines