Malaria: symptoms, causes, treatment and prevention for travellers

The NHS says malaria can be hard to spot. NHS inform describes symptoms similar to flu that can start mild and be difficult to identify as malaria. The NHS lists the symptoms as follows.

• A high temperature, or feeling hot, cold or shivery.

• Sweating.

• Headaches and feeling confused.

• Feeling very tired and sleepy, especially in children.

• Feeling or being sick, tummy pain and diarrhoea.

• Loss of appetite and muscle pains.

• Yellow whites of the eyes or skin (jaundice), which may be less noticeable on brown or black skin.

• A sore throat, cough and difficulty breathing.

The NHS says symptoms usually appear between 7 and 18 days after you have been bitten by an infected mosquito, but sometimes you may not have symptoms for months after travel, and rarely years. NHS inform says they usually appear 6 to 30 days after the bite but can take up to a year.

This is why any fever after being in a malaria area, even weeks or months later, should be treated as possible malaria until a doctor says otherwise. NHS inform says to tell the healthcare professional that you have been in a country with a risk of malaria, including any brief stopovers.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have malaria symptoms and you have travelled to a country where malaria is found in the last 12 months. You should also tell anyone you travelled with to get help straight away.

NHS inform says malaria can get worse very quickly and can be fatal if not treated, and advises phoning 111 or going to A&E if you or your child develop symptoms during or after a visit to an area where the disease is found, even if it is several weeks, months or a year after you return. If you have symptoms while travelling, the NHS says not to wait until you get home to seek advice.

NHS inform says malaria is caused by the Plasmodium parasite, which is spread to people through the bites of infected mosquitoes, and that it can take just 1 bite. There are 5 types of Plasmodium parasite that cause malaria in humans, found in different parts of the world and varying in severity.

No, not in the usual sense. The NHS says malaria is not found in the UK and you cannot usually catch it from another person. NHS inform says malaria cannot be spread directly from person to person, and the parasite is spread by night-biting mosquitoes that bite most commonly between sunset and sunrise.

Rarely, the NHS says it can be passed from a mother to her unborn baby during pregnancy or by a needlestick injury. NHS inform adds that it is very rare for it to be spread through blood transfusions and sharing needles.

The NHS says malaria is an emergency and needs to be treated quickly with antimalarial medicines, and that some people may need to stay in hospital to have specialist care. It can sometimes come back and need to be treated again.

NHS inform says that if malaria is diagnosed and treated quickly you should fully recover. Treatment begins in hospital to make sure complications do not develop suddenly. It is with tablets or capsules, or through a drip into a vein if someone is very ill. The medicine and how long you take it depends on the type of malaria, how severe symptoms are, whether you took preventive tablets, your age and whether you are pregnant. Treatment can leave you very tired and weak for several weeks.

NHS inform says severe complications can occur within hours or days of the first symptoms. They include severe anaemia from destruction of red blood cells, cerebral malaria (which can cause the brain to swell, fits or coma), liver failure and jaundice, shock, fluid on the lungs, acute respiratory distress syndrome, low blood sugar, kidney failure, swelling and rupture of the spleen and dehydration.

The effects are usually more severe in babies, young children, pregnant women and older people. The NHS says people who are pregnant, young children, people over 65, people with a weak immune system and people who do not have a spleen are at higher risk of serious illness.

NHS inform says that if you get malaria while pregnant, you and your baby have an increased risk of serious complications such as premature birth, low birth weight, restricted growth of the baby, stillbirth, miscarriage and death of the mother. Pregnant women are advised to avoid travelling to regions with a risk of malaria and to discuss any plans with a GP, midwife, obstetrician or travel health adviser, because not all antimalarial tablets are safe in pregnancy.

The NHS lists feeling very tired and sleepy as a symptom that is especially seen in children, and young children are among those at higher risk of becoming seriously ill. Anyone travelling with a baby or child to a malaria area should get advice well before travelling.

NHS inform describes the ABCD approach: Awareness of risk, Bite prevention, Check whether you need antimalarial tablets, and Diagnosis, which means seeking immediate advice if you have symptoms, including up to a year after you return. The NHS says to get advice from a GP, nurse, pharmacist or travel clinic at least 4 to 6 weeks before you travel, though you can still get advice at the last minute.

The NHS recommends taking any prescribed antimalarial medicine, which you usually start a few days or weeks before travel and continue for a few weeks after you get back, using insect repellent that is 50% DEET-based, sleeping under insecticide-treated mosquito nets, and wearing long sleeves and trousers in the evening. NHS inform says there is no evidence that homeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, Marmite, tea tree oil or bath oils protect against malaria.

NHS inform says there is currently no vaccine that protects against malaria, and that antimalarial tablets do not stop the parasite entering your body but stop the infection developing. If you stop them early, you could still become ill. The NHS adds that if you now live in the UK but were born or used to live in a high-risk country you are no longer immune and should take precautions.

Travel health advice and antimalarial prescriptions may be provided by your GP practice, a pharmacist or a travel clinic, as the NHS suggests. The UK Malaria Expert Advisory Group publishes annual guidelines for UK travellers that clinicians use to choose a suitable option for each destination.

If you develop a fever after travel, the NHS route is an urgent GP appointment or NHS 111, with emergency departments for those who are very unwell. Private travel clinics and doctors can also see you, but malaria is an emergency, so do not delay seeking assessment while arranging an appointment.