However, the figures, compiled by the Agency’s Malaria Reference Laboratory (MRL), which contributes to the National Travel Health Network and Centre (NaTHNaC), show that the failure to take preventative medication remains the key risk factor for both contracting and possible death from malaria.

In 2003, 16 people died of malaria, 11 of whom did not take any preventative medicine before travelling, compared to 9 deaths in 2002. Although the number of deaths varies each year these deaths highlight the need to reinforce messages the importance of taking preventive medication. Half of those who died in 2003 were over 55 years of age.

Malaria is commonplace in Africa, parts of Asia and the Middle East and Central and South America. The risk is particularly great in Africa where the most lethal form of malaria caused by Plasmodium falciparum is common. All of the fatal cases were contracted in Africa; one in India. Half of all cases of malaria were in people visiting friends and relations abroad, with a further 20% of cases occurring in those travelling for holiday or business.

Professor Peter Chiodini, Director of the Agency’s Malaria Reference Laboratory said, “It is vital that travellers take the appropriate preventative medication to decrease the chances of contracting malaria. This means taking medication prior to travelling, during their stay abroad and for a period after returning. In addition, simple measures to avoid mosquito bites, such as wearing insect repellent and suitable clothing and sleeping under an insecticide-treated net are also highly effective and add enormously to the benefits of drug protection. These measures are also important because there are other diseases spread by insects for which there is no preventive medication.”

The Health Protection Agency is urging health professionals providing advice on malaria to travellers to pay particular attention to those groups at high risk of contracting malaria such as those who are visiting friends and relatives and older travellers, who need to be sure to take appropriate prophylaxis. The Agency would also like to remind those health professionals reporting cases to the MRL to record the travel history and reason for travel on their reports since this information is vital to target pre-travel advice and for public health action.

Notes to Editors:

1. Malaria is a preventable parasitic disease transmitted by mosquitoes. It is predominantly a disease affecting Africa, South and Central America, Asia, Oceania and the Middle East. The symptoms include a flu-like illness, fever, shaking, headache, muscle aches and tiredness. Nausea, vomiting and diarrhoea may also occur. If travellers develop these symptoms whilst abroad or up to one year after returning, they should seek prompt medical advice and tell their doctor they have been in an area where malaria is a hazard.

2. The risk is particularly great in Africa, south of the Sahara, where over 95% of the potentially lethal falciparum malaria seen in the UK is contracted. The appropriate preventative medicines for most of Africa require a doctor’s prescription and cannot be bought over the counter at a pharmacy.

3. The risks posed by malaria in some countries change over time so the treatment used in the past for these countries may not be the most appropriate today.

4. The HPA has recently published new guidelines on the prevention of malaria in travellers at http://www.hpa.org.uk/infections/topics_az/malaria/guidelines.htm

5. Advice on travel medication and vaccinations is available from NHS Direct on 0845 4647. Information sheets on insect bite avoidance is available on the National Travel Health Network and Centre (NaTHNaC) website http://www.nathnac.org/travellers/iba.html

6. Health professionals who require assistance and more specialist advice when advising travellers should contact the HPA Malaria Reference Laboratory or the National Travel Health Network and Centre. A telephone number with information for the public about malaria prevention (recorded message) is available on 09065 508 908.

7. To see a copy of the latest CDR Weekly report, please go to: http://www.hpa.org.uk/cdr

Health Protection Agency, UK