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Travel Health Advisory

Travelling South? - Malaria Risk for Travellers

This travel health notice is NO LONGER IN EFFECT. Click here for a list of current travel health notices.

Released: November 26, 2009

Travel Health Notice

As the holiday season approaches, people may be planning to travel to popular tourist destinations, or home to visit family and friends in areas where there may be a risk of malaria.

Malaria is a serious and occasionally fatal disease. It is caused by a parasite which is spread to humans by infected mosquitoes. There is no vaccine available against malaria.

All travellers are at risk if going to a destination where malaria occurs. 

Travellers can reduce their risk by following four principles of malaria prevention, called the “ABCD” of malaria:

  1. be Aware of malaria risks and symptoms
  2. know how to prevent mosquito Bites
  3. take anti-malarial drugs or "Chemoprophylaxis", if appropriate
  4. seek medical help early for Diagnosis, if malaria-like symptoms develop

About Malaria

Malaria is a serious disease caused by one of five different parasites in the Plasmodium family. The parasites are transmitted to humans by the bite of an infected mosquito. One species of the malaria parasite, Plasmodium falciparum, can cause very severe illness and occasionally lead to death.

Symptoms

  • Can take from one week to several months to occur (depending on the type of malaria parasite).
  • Are often flu-like, including: fever, sweats, chills, headache, abdominal pain, muscle and joint pain, nausea and vomiting, diarrhea and feeling generally unwell.
  • In more severe cases may include seizures, coma, kidney and respiratory failure, and shock, which may lead to death.

Transmission

  • Malaria is spread to humans by the bite of a mosquito infected with malaria parasites.
  • The mosquito that spreads malaria is usually active during the evening, night and early morning (dusk to dawn).
  • The risk for malaria transmission increases in rural areas and during and after rainy seasons.

Where Malaria a Concern?

  • The following table shows regions of risk for malaria among popular Canadian tourist destinations:

Country

Risk Areas

Belize

All; except no evidence to date of risk in Belize City.

Costa Rica

Alajuela, Limón, Guanacaste, and Heredia provinces; no evidence to date of risk in Limón city (Puerto Limon). No risk in Playa Bejuco.

Dominican Republic

All, except no evidence to date of risk in the cities of San Domingo and Santiago. Note: risk is present in resort areas. 

Guatemala

Rural areas at 1,500 metres elevation and below; no evidence to date of risk in Guatemala City, Antigua or Lake Atitlán.

Jamaica

Very limited risk in Kingston area.

Mexico

There is risk of malaria to travellers in the southern regions bordering Guatemala and Belize. Some risk present in rural areas in the states of Nayarit, Oaxaca, Sinaloa; and in parts of Sonora, Chihuahua, and Durango. There is no evidence to date of risk of malaria in the resort areas along the Pacific and Gulf Coasts or along the border of the United States.
  • Most malaria cases and deaths occur in sub-Saharan Africa.
  • Malaria transmission occurs in
    • most of sub-Saharan Africa and limited areas in Northern Africa;
    • large areas of Southern Asia, Southeast Asia, and some parts of East Asia;
    • areas in Central America including the Dominican Republic, Haiti, parts of Mexico and much of South America;
    • Papua New Guinea and other small islands in the South Pacific / Oceania region; and
    • limited areas in the Middle East and Eastern Europe.
  • A list of countries Opens in a PDF document and a Link to external site map of the areas where malaria transmission occurs are available from the World Health Organization.

Recommendations for Travellers

It is recommended that travellers,

  1. Protect themselves from mosquito bites:
    1. Cover up: wear light-coloured, long-sleeved, tucked-in shirts, long pants, shoes (not sandals), and a hat
    2. Use insect repellent on exposed skin:
      1. Of the insect repellents registered in Canada, those containing DEET are the most effective
      2. Use as directed by the manufacturer
      3. Do not apply to cuts, abrasions or irritated skin
      4. Do not spray directly on the face
      5. Wash hands after application, to avoid contact with lips and eyes
      6. When using sunscreen: do not use insect repellent and sunscreen combination products
      7. If application of sunscreen and repellent with DEET is required, apply the sunscreen first and let it soak into the skin for about 20 minutes, then apply repellent with DEET
      8.  After returning indoors, wash off repellent.
    3. Sleep under a bed net, preferably treated with insecticide:
      1. Ensure the net is intact (no tears or large holes)
      2. Tuck it under the mattress
      3. Ensure it is not touching you (or you still may be bitten through the net)
    4. Consider your accommodations: Stay in a well-screened or completely enclosed air-conditioned room
    5. Apply a permethrin insecticide to tents and clothing and other travel gear for greater protection
      1. Permethrin-treated clothing is effective for up to 2 weeks or 6 washings
      2. Although permethrin is not available in Canada, travel health clinics can advise you how to purchase permethrin and pre-treated gear before or during your trip
      3. This could be considered for playpens, crib, or strollers to protect young children

        More information on precautions to take to avoid mosquito bites while travelling…
  2. Discuss the benefits of taking anti-malarial medication with a health care professional before departure
    1. Travellers should visit a travel health clinic at least six weeks before travel.
    2. No anti-malarial medication is 100% effective in preventing the disease.
    3. Discuss your risks with a health care professional to determine whether to take anti-malarial medication and which one to take.
    4. Recommended anti-malarial medication for regions with risk of malaria can be found at the following:
  3. Know the symptoms of malaria and see a health care provider if they develop.
    1. Seek medical attention immediately if a fever arises during or after travel (for up to three months or longer) to regions at risk of malaria
    2. Be sure to tell your healthcare provider that you have travelled to a region where malaria is present.

Don’t Forget...

  1. Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.
  2. What to do if you get sick when you are travelling.
  3. What to do if you get sick after you return to Canada.
  4. Know what vaccines to get and when to get them.

Additional information:

Date Modified: 2009-11-26

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