There's no effective vaccine against malaria. In countries where the disease is endemic, prevention involves keeping mosquitoes away from humans. This includes the use of insecticide-treated mosquito netting and spraying indoor walls with insecticide.
See your doctor months before you travel
Most drugs used to treat malaria are also used to prevent it. Two or three months before traveling to an area where malaria is prevalent, talk to your doctor or a tropical disease specialist or visit a travel health clinic to obtain the necessary medications to prevent malaria and to receive travel-related vaccines and information. Explain to your doctor exactly where you're going. The drugs you're prescribed depend on the level of drug resistance within your area of travel.
For preventive treatment, you generally take the prescribed drug one to two weeks before leaving, throughout your trip, and for four weeks after your return. Some medications may slightly differ from this schedule. For example, Malarone is taken one to two days before you leave and throughout your travels, and for only one week after you return, instead of four weeks. Overdosage of antimalarial drugs can be fatal, so follow your prescription carefully. Don't miss doses.
Consider possible adverse effects of medications
In addition, discuss possible and prior adverse reactions to medications. Some have fewer side effects than others. Also, be sure to review your medical history to help identify any possible side effects of taking a medication. For example:
• Mefloquine may infrequently cause nausea, dizziness, insomnia and vivid dreams. In people with past or present psychiatric disorders, mefloquine can worsen symptoms of mental problems.
• Doxycycline can permanently stain the teeth of children younger than 8. It can also cause sun-induced rash. Don't take doxycycline if you're pregnant, because it can harm the fetus.
• Malarone is dangerous for people with severe kidney impairment. It's also generally not prescribed during pregnancy — though, in some cases, it may be — because there is little research on its safety during pregnancy.
If you're pregnant, avoid traveling to malaria-endemic regions. If this isn't possible, your doctor can prescribe an antimalarial drug that's appropriate for you, such as chloroquine or mefloquine (during the second or third trimester). Drug resistance to chloroquine occurs throughout Southeast Asia and Africa, but the drug is still effective for preventing malaria in some areas of Central America, the Middle East and China.
Drug quality varies worldwide
Be careful about purchasing antimalarial drugs in other countries. Quality of drugs varies widely from country to country, depending on the level of regulation and quality control. To avoid questionable products while traveling, the CDC recommends that you:
• Take your medications with you. Purchase medicines in advance in your home country and take them with you.
• Note drug names. Record the generic and brand names of your drugs and the manufacturers, so that if you run out, you can find the correct replacement.
• Inspect packaging. Make sure any drug you purchase is in its original packaging and that the packaging appears authentic.
• Avoid suspicious drugs. Avoid taking tablets that have a strange smell, taste or color, or that are extremely brittle. This may reflect poor storage conditions, which can affect chemical components of the drug.
Tips to prevent malaria
The CDC also recommends the following measures to help prevent malaria:
• Use repellent. Spray DEET insect repellent, in DEET concentrations up to 50 percent, on exposed skin, and use flying-insect spray to kill mosquitoes in your sleeping area. Choose the concentration based on the hours of protection you need — the higher the concentration of DEET, the longer you are protected. A 10 percent concentration protects you for about two hours. Don't use DEET on the hands of young children or on infants younger than age 2 months.
• Wear protective clothing. During active mosquito times, usually from dusk to dawn, wear pants and long-sleeved shirts. Apply permethrin, an insecticide, to your clothing and shoes prior to travel. You can also buy clothing pretreated with permethrin. In addition, some stores carry other anti-mosquito supplies, such as hats with attached mosquito netting that protects your face and neck.
• Use netting. If you're staying in a place that doesn't have screens or air conditioning, sleep under mosquito netting that's been treated with permethrin. This netting is available in many travel and camping supply stores and online.
You can obtain current malaria information by calling the CDC at 877-FYI-TRIP (877-394-8747). You can also get current health information for a particular country by visiting the World Health Organization's Web page on international travel and health.