The World Health Organization (WHO) has received numerous reports in recent weeks of holiday makers to Africa, in particular, returning home with malaria. In light of these reports, WHO is warning travellers to take all possible precautions in order to prevent malaria.

"The risk of malaria for travellers is real: each year thousands of travellers fall ill with malaria, and a proportion of these die. Most of these deaths could be prevented by using repellents and taking other measures to prevent mosquito bites in combination with the regular use of the right antimalarial drugs for prophylaxis," said Dr David Heymann, WHO Executive Director for Communicable Diseases and Programme Manager, a.i., of Roll Back Malaria (RBM).

Reports have reached WHO from Spain and Germany of travellers falling ill after returning from last minute package holidays to destinations such as Senegal and Gambia. Similar reports have come from the United Kingdom, Sweden and Denmark.

In Southern Africa, there is a special need for vigilance over the coming months as above-normal rainfall is forecast from December 2000 to March 2001, with a corresponding increase in malaria transmission over most of the region up to May 2001.

WHO recommends weekly mefloquine prophylaxis for most African countries. Mefloquine prophylaxis should be started 2-3 weeks before travel. For travellers who failed to start prophylaxis in time, daily doxycycline offers an alternative, as it can be started the day before travel. Both drugs should be continued during the stay and for four weeks after leaving the endemic area, to cover the incubation period of the disease. All antimalarial drugs have contra-indications and unwanted side-effects, and should be prescribed by a qualified physician or travel health clinic.

Travellers are advised to seek advice on the presence of malaria risk and the best drugs to take to help prevent malaria, and protect themselves from mosquito bites on holiday by using repellents between dusk and dawn and insecticide-treated mosquito nets where necessary. No antimalarial prophylactic regimen gives complete protection, and if travellers fall ill during or after the holiday they should seek medical attention quickly.

Initial symptoms of malaria may be mild and include fever, malaise and flu-like symptoms. Malaria must always be suspected if fever -- with or without other symptoms such as headache, muscular aching and weakness, vomiting, diarrhoea and cough -- develops at any time between one week after the first possible exposure and two months (or even later in rare cases) after the last possible exposure. If they get a fever, travellers should get immediate medical care and insist on a laboratory test for malaria. Malaria is a curable disease if treated immediately. If untreated, sufferers can lapse into coma and die. A proper travel history given to the health provider can be life-saving.

WHO estimates that more than one million people, primarily African children, die of malaria annually, while there are an estimated 300 million cases of malaria in over 100 countries around the world.

Roll Back Malaria – a global partnership movement seeking to halve the malaria burden by the year 2010 - with its secretariat at WHO – counsels travellers to take all necessary precautions against contracting malaria.

"People should not be complacent - without prevention malaria risk is very serious: people can die very quickly once they have malaria," said Dr Heymann. "We urge travellers and tourists to enquire whether malaria transmission occurs in the places they are going to visit."

___________________________________