Every year not less than 300 million people come down with malaria, one of the most common tropical diseases. The number of actual deaths is estimated at 2 million per annum. 90% of all malaria cases account for Africa.

But also "non-malaria-countries" increasingly have to contend with malaria: 1,040 cases, including 8 deaths, were reported for 2001 in Germany, 1,337 cases were diagnosed in the United States in 2002 (8 dead), 1,722 cases were reported in the UK for 2003, 16 people died - the statistics show an upward tendency. And - almost all of these patients didn't take proper precautions.

Medicine differentiates between 3 forms of malaria:

1) Malaria quartana:

This is the mildest form of malaria. While its symptoms are similar to those of malaria tertiana, they are less pronounced. As the name implies, the attacks of fever recur around every four days, although the episodes can recur for months or years.

2) Malaria tertiana:
The symptoms of this form of malaria manifest themselves around two to three weeks after infection. Here, too, very high fever sets in, along with chills, headache, joint pain and back pain. Although the symptoms initially subside, they return in three-day cycles. While malaria tertiana also destroys red blood cells, this doesn't happen as quickly or as aggressively as in the case of malaria tropica. Only rarely is this form of malaria fatal. However even months after treatment, malaria attacks can repeatedly occur.

3) Malaria tropica:
Around one to two weeks after being infected with malaria tropica, very high fever (40 °C) sets in. Further symptoms include diarrhea, vomiting, headache and muscle pain. The fever then subsides, only to return at irregular intervals. Since this does not result in regular episodes of fever, as in the case of the other types of malaria, malaria tropica is often confused with a flu. Malaria tropica is the most dangerous form of malaria. If treated too late or not treated at all, it will lead to death in around 30 percent of all cases. Every hour counts here. Because after only a few days, the parasites have destroyed so many red blood cells that anemia (an extreme lack of red blood cells) sets in. The potential fatal consequences consist of cerebral and cardiac damage or circulatory collapse through shock. If the patient survives the disease, he or she is considered to be cured after around a year.

These are the facts. On account of this it's astonishing as much more that many people are treating this sensitive topic very lightly. Buzzing off to Kenia, harum-scarum, last minute and without appropriate medication - of course. Enjoying a sundowner at the open-air beach bar, dressed with a spaghetti strap top and shorts, without applying protecting repellents - of course. All that is more than careless and contravenes two elementary rules of malaria prophylaxis at the same time: expositon prophylaxis and chemoprophylaxis.

Exposition prophylaxis means:
- to wear skin-covering, bright-coloured, loose-fitting clothes as soon as dawn begins
- to apply a repellent. Repellents are available as natural- and chemical-based ones, as spray, gel, creme or roll-on. Most of them are to be applied to the skin, some are solely suitable for textiles. Visitors to high risk Malaria areas should prefer chemical-based repellents containing DEET (Diethyl-M-Toluamide) which is much more effective than e. g. citronella oil or pyrethrum (extracted from Chrysanthemum cinerariaefolium)
- to use mosquito nets with small-sized meshes. It's an advantage to carry along an own mosquito net; not every accomodation provides a net. Furthermore it's convenient to have a sewing kit, some tape or plaster with you to be able to repair wholes in the net.

Concerning this subject you should prefer to appeal to a tropical institute or a travel clinic which are always up-to-date in terms of changing resistances and the areas of circulation. Alternatively you can consult a doctor specialized in travel and/or tropical medicine. Visitors to tropical high risk areas will often be recommended a medicament called "Lariam" which is renowned for it's numerous and strong side-effects. For years Lariam has been the most effective medicament but meanwhile there is also an alternative with a higher compatibility (Malarone). This product is quite new and therefore more expensive than Lariam. But please don't try to save in this case, it's a matter of your health.

Following you will find more detailled information about malaria and travel clinics

www.traveldoctor.co.uk MALARIA
www.traveldoctor.co.uk TRAVEL CLINICS

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