Malaria in the Dominican Republic

Updated: February 6, 2008

The Public Health Agency of Canada (PHAC) reminds travellers that anti-malarial medication and the use of personal protective measures against mosquito bites are recommended to prevent getting malaria while visiting certain areas in the Dominican Republic.

There is a risk of getting malaria in the resort areas within the province of La Altagracia, as well as all rural areas of the Dominican Republic especially in areas bordering Haiti. The tourist resort destinations of Punta Cana and Bavaro are located within the province La Altagracia.

Malaria

Malaria is caused by a parasite (Plasmodium).  There are four species of the parasite:   Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. Infection with P. falciparum can be fatal.

Symptoms of malaria include fever, headache, nausea, vomiting, muscle pain and malaise. Rigors (severe shakes or muscle spasms) and chills often occur.

Transmission

Malaria is most commonly transmitted to humans through mosquito bites.  The mosquito that transmits malaria is typically active during the evening, night and early morning.   

Geographic Distribution

Malaria is endemic (i.e., constantly present) in most of sub-Saharan Africa; in large areas of the Middle East, South Asia, South East Asia, Oceania, Haiti, Dominican Republic, Central and South America; and in parts of Mexico and North Africa.

Recommendations

The Public Health Agency of Canada recommends that travellers use personal protective measures against mosquito bites and use appropriate anti-malarial medication when travelling to destinations where malaria occurs.

Chloroquine is the anti-malarial drug of choice for travel to areas at risk of malaria transmission in the Dominican Republic. Alternative effective medications are atovaquone/progranil (Malarone®), doxycycline and mefloquine.

Personal Protective Measures

Two important measures can help you prevent malaria infection: avoid mosquito bites and use effective anti-malarial medications. 

1. Prevent Mosquito Bites

   • Take the following personal protective measures to reduce the risk of exposure to mosquitos that bite from dusk to dawn (evening, night and early morning time).
   • Apply insect repellent to exposed skin. Use DEET-based products only on exposed areas of skin. Remove the repellent with soap and water when it is no longer required.
   • Cover up! The less exposed skin you have, the less likely you are to be bitten. Wear light-coloured, long-sleeved shirts and long pants.
   • Sleep under a mosquito net. Mosquito nets protect you when you're sleeping. Permethrin-treated nets are much more effective than untreated nets and are safe for children and pregnant women. 
   • Consider your accommodations. When possible, remain in well-screened or completely enclosed, air-conditioned areas.

More detailed information on preventing mosquito bites can be found at: 
Statement on Personal Protective Measures to Prevent Arthropod Bites
Canada Communicable Disease Report Volume 31 ACS-4, 15 May 2005

2. Take Antimalarial Medication (Prophylaxis)

   Antimalarial medications decrease the risk of developing symptomatic malaria. Your individual need for antimalarial medications should be discussed with your physician or travel medicine professional at least 6 weeks before travel.

   If your physician or travel medicine clinic prescribes an antimalarial medication, it is important that you take it as directed in order to maximize the protective effect.  Each drug has its own dosing regime that should be strictly followed. 

A traveller must seek medical attention as soon as possible for unexplained fever that arises during or after travel to an area where malaria occurs.

If identified early and treated appropriately, almost all malaria can be completely cured. However, even short delays in the diagnosis of malaria can make treatment more difficult and less successful.

Consult with your health care provider or travel health clinic before travelling to better understand your health risks and to learn what personal preventative measures you may need while travelling.

Monitor your health

If you have been taking medication to prevent malaria while travelling, you must continue to take it for the full course prescribed, even if that means after your return to Canada. If you have been to an area where malaria occurs and you develop fever within a year of returning home (especially in the first three months), inform your doctor immediately. Anti-malarial medication doesn't guarantee absolute protection against malaria. If you become ill on your return and malaria is suspected, a blood test is recommended.

As a reminder…

PHAC strongly recommends that Canadian travellers consult their personal physician or a travel clinic at least six weeks prior to international travel regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.

PHAC recommends, as well, that travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician, without being asked, that they have been travelling or living outside of Canada, and where they have been.

Additional information:

• External Sources of Information

  World Health Organization: Malaria Page

  Centers for Disease Control and Prevention: Malaria Page