Malaria – Prevention is Better Than Cure

The Club has recently faced a number of claims involving crew falling ill due to Malaria.

Malaria is a life threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes.

The mosquito which carries malaria is the female Anopheles.   According to the World Health Organisation (WHO) travellers could be at risk of malaria infection in 91 countries around the world, mainly in Africa, Asia and the Americas. 

Malaria is a preventable disease and although figures provided by WHO suggest that the incidence of malaria has fallen by 21% between 2010 and 2015, it is still a major issue which we face in shipping.  Where there are malaria-like symptoms on board, vessels may be quarantined and denied entry into port until the precise nature of the illness is known and there are likely to be further delays whilst all crew are tested and where necessary treated and possibly even replaced.

Prevention

Malaria can often be avoided using the ABCD approach to prevention, which stands for:

• Awareness of risk – find out whether you’re at risk of getting malaria.
• Bite prevention – avoid mosquito bites by using insect repellent, covering your arms and legs, and using a mosquito net.
• Check whether you need to take malaria prevention tablets – if you do make sure you take the right type and dose.
• Diagnosis – seek immediate medical advice if you have malaria symptoms including up to a year after you return from travelling.

As the anti-malaria medication is not a guarantee in itself of prevention, it is also sensible to use insect repellent on the skin and in sleeping environments, and to wear trousers and long sleeved shirts, particularly during early evening and night time when mosquitoes prefer to feed. If possible sleep under a mosquito net that has been appropriately treated and keep doors and windows closed.

To properly reduce the risk of developing the disease it is essential to take the necessary treatment before, during and after the period of exposure and specialist medical advice should be taken as to which drugs are likely to be the most effective for the areas visited. It is necessary to be open and honest with your doctor about your medical history as taking anti-malaria medication can have an impact on conditions such as epilepsy, psoriasis, psychiatric problems, heart, liver or kidney problems. It is also important to be aware that medication can cause side effects such as nausea, diarrhoea, headache, rash, dizziness and mouth ulcers.

The antimalarial medication you need to take depends on which strain of malaria is carried by the mosquitoes and whether they’re resistant to certain types of antimalarial medication, which is why it is important to seek advice prior to travel.

Some regions have a fairly constant number of cases throughout the year and are termed “malaria endemic”, whereas in other in areas there are “malaria seasons” which usually coincide with the rainy season.

Malaria Symptoms

Typically, the time between being infected and when symptoms start (incubation period) is 7 to 18 days, depending on the specific parasite you’re infected with. However, in some cases it can take up to a year for symptoms to develop.

The initial symptoms of malaria are flu-like and include:

• a high temperature (fever)
• headache
• sweats
• chills
• vomiting

The symptoms are often mild and can sometimes be difficult to identify as malaria. With some types of malaria, the fever occurs in 48 hour cycles. During these cycles, you feel cold at first with shivering. You then develop a fever, accompanied by severe sweating and fatigue. These symptoms usually last between 6 and 12 hours.

Other symptoms of malaria can include:

• muscle pains
• diarrhoea
• generally feeling unwell

The most serious type of malaria is caused by the Plasmodium falciparum parasite. Without prompt treatment, this type could lead to you quickly developing severe and life-threatening complications, such as breathing problems and organ failure.

Travellers from malaria free regions, with little or no immunity, who go to areas with high disease rates are particularly vulnerable, although all seafarers should take necessary preventative action.

Medical advice should always be sought before embarkation.