INTRODUCTION
Pregnant women, babies, and young
children should not travel to those parts of the world
where there is transmission of chloroquine-resistant
malaria - World Health Organization, 2000
Most Americans know very little about
malaria because it was eradicated in this country
in the 1940s. Despite the fact that the World Health
Organization (WHO) mounted an international malaria-eradication
campaign in 1956, the worldwide incidence of malaria
has increased. An estimated 40% of the world's population
is at risk for malaria each year. There are now more
than 300 million cases of malaria annually, and more
than 1.5 million people die of this disease every
year. Approximately 230 Americans are diagnosed each
year with malaria that they have acquired abroad.
Malaria occurs in large areas of Central
and South America, sub-Saharan Africa, the Indian
subcontinent, Southeast Asia, the Middle East, and
Oceania. The risk of getting malaria increases as
a traveler spends more time outdoors at low altitudes,
especially in the evening in rural areas. Information
on malaria risks in various countries changes frequently
and is dependent day to day on local conditions.
Malaria is caused by a parasite that
is transmitted by mosquitoes. You can contract the
disease if you are bitten (inoculated) by a female
Anopheles mosquito that is carrying the malaria
(Plasmodium) organism. Anopheles mosquitoes
bite during the evening and at night, from dusk to
dawn. Malaria is also transmitted from person to person,
and cases have been reported from blood transfusions
or congenitally from mother to child.
Because malaria is caused by a parasite
that lives in red blood cells, blood banks put restrictions
on blood donations from travelers. Many blood centers
defer donors for as long as 3 years if they have taken
antimalarial drugs and have visited a malarious area,
or for 6 months if they have visited a malarious area
without taking antimalarial drugs. The Centers for
Disease Control and Prevention (CDC) operates a voice
information service (877-394-8747) on international
travelers' health that provides specific recommendations
regarding malaria prevention around the world and
also a fax service (888-232-3299). The CDC web site
for malaria information is www.cdc.gov/travel/index.htm.
Another excellent web site for malaria information
is www.geocities.com/aaadeel/malaria.html.
Based
on CDC,
Health Information for International Travel 2000-2001,
DHHS, Atlanta, GA, 2001; WHO,
International Travel and Health, 2002, Geneva;
and Dr. Richard Thompson's book
Well on the Road -
A Practical Guide for the International Traveler,
2002.
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