Malaria remains significant issue for UK travellers
25 April 2008
2007 figures reveal UK travellers continue to be exposed to preventable killer disease
New figures from the Health Protection Agency show that there were 1,548 cases of malaria reported among UK travellers in 2007. Five of these cases were fatal.
This represents a slight fall (12%) in the number of cases reported for 2006 by this time last year (1,758).
The majority of the 2007 cases (1,139) were due to the potentially fatal Plasmodium falciparum which is a major international health risk and kills more than a million people a year in Africa.
There the reason for travel was recorded, 72% of the malaria cases among travellers from the UK last year were in those visiting friends and relatives abroad (549/770). This compares to 14% who were holidaymakers (108/770), a ratio of around 5:1.
Professor Peter Chiodini, who heads up the Agency’s Malaria Reference Laboratory, said: “It is really important that anyone travelling to an area where malaria is a risk seeks medical advice before their trip. This is particularly true for people travelling to visit friends and relatives.
“It seems likely that travellers visiting friends and relatives are either not seeking or unable to access good medical advice on preventing malaria before they travel, or they don’t perceive their risk to be as great as the holidaying public.
“The common misconception that people born in malaria-affected countries but now living in the UK continue to have a natural immunity to malaria is very dangerous.”
Malaria is a parasitic disease transmitted by the Anopheles mosquito that affects Africa, South and Central America, Asia, Oceania and the Middle East. It is potentially life-threatening and, although preventable, many travellers put themselves at risk by not taking the appropriate protective drugs, or not completing the course.
The latest figures reported by the Health Protection Agency’s Malaria Reference Laboratory, show that where the history of preventative measures taken was recorded, 83% of patients (704/844) had not taken malaria prophylaxis and a high proportion of the remainder had taken prophylaxis not recommended for their travel destination by the HPA Advisory Committee on Malaria Prevention for UK Travellers (ACMP).
Professor Chiodini said: “It is clear that some groups are at particular risk of acquiring malaria and are not being reached by health messages about the importance of antimalarial prophylaxis.
“It is essential that travellers to destinations where malaria is present ensure they plan ahead by seeking pre-travel medical advice on which protective drugs and other measures are appropriate for their destination. A course of such drugs should be started prior to travel and be continued for the whole period advised after returning to the UK.
“Equally as important as protective drugs, are measures to prevent mosquito bites which can include applying insect repellent, wearing cover-up clothing and sleeping under an insecticide-treated bed net.
“Without taking the appropriate protective drugs and using other preventative measures to prevent mosquito bites, UK travellers are exposing themselves to a killer disease that is almost completely preventable.
“Talk to your GP or travel health clinic about appropriate measures for your own trip. Despite it being almost completely preventable, many people in the UK are being caught out by malaria. Please don’t be one of them.”
Ends
Notes to Editors
For further information please contact the HPA Centre for Infections press office on 020 8327 7097/ 6690 or 6647.
Global impact of malaria
Malaria has a massive impact on human health; it is the world’s second biggest killer after tuberculosis. Around 300 million clinical cases occur each year resulting in between 1.5 – 2.7 million deaths annually, the majority in sub-saharan Africa. It is estimated that 3,000 children under the age of five years fall victim to malaria each day. Around 40% of the world’s population is at risk and it is not known how this might be affected by possible climate change. The societies and economic development of some of the world's poorest nations are severely affected by malaria.
Symptoms
It is important for travellers to be aware of the symptoms of malaria, which can be very similar to those of flu. The symptoms of malaria include a flu-like illness, fever, shaking, headache, muscle aches and tiredness. Nausea, vomiting and diarrhoea may also occur.
If travellers develop these symptoms whilst abroad or up to one year after returning, they should seek prompt medical advice and tell their doctor they have been in an area where malaria is a hazard.
Seeking advice
Members of the public should seek advice about their specific travel health needs from their GP or local travel clinic.
An information sheet on insect bite avoidance and updates on other travel health issues are available on the National Travel Health Network and Centre (NaTHNaC) website at http://www.nathnac.org/travel/factsheets/iba.htm and http://www.nathnac.org/travel/news/index.htm which deals with queries about patients with complex medical needs or travel itineraries.
Specialist advice
The risks posed by malaria in some countries change over time. Health professionals who require assistance and more specialist advice when advising travellers should contact the HPA Malaria Reference Laboratory (0207 636 3924) or NaTHNaC (0845 602 6712).
Travel guidelines
The Health Protection Agency’s Advisory Committee on Malaria Prevention for UK Travellers (ACMP) has produced guidelines for healthcare workers who advise travellers or prospective travellers who wish to read about the options themselves. Guidelines are available at
http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1195733823080?p=1191942128258
Malaria Reference Laboratory
The Malaria Reference Laboratory provides an integrated service for public health in relation to malaria. It combines reference and diagnostic parasitology of malaria with surveillance of all imported malaria reported in the UK, analysing the results and using these, together with wide consultation to develop national policy on prevention of imported malaria, which it then disseminates widely.
Table 1. Cases of malaria by species of parasite and primary region of travel, United Kingdom: 2007
|
Geographic Area |
P.f. |
P.v. |
P.m. |
P.o. |
Pf/Pv |
Pf/Pm |
Pf/Po |
Pm/Pv |
Total |
|
North Africa |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Central Africa |
23 |
0 |
2 |
2 |
0 |
0 |
0 |
0 |
27 |
|
East Africa |
92 |
8 |
10 |
11 |
0 |
1 |
0 |
1 |
123 |
|
Southern Africa |
31 |
1 |
1 |
1 |
0 |
0 |
0 |
0 |
34 |
|
West Africa |
719 |
2 |
11 |
67 |
1 |
3 |
5 |
0 |
808 |
|
Africa- unspec. |
12 |
1 |
0 |
1 |
0 |
0 |
0 |
0 |
14 |
|
Middle East |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
1 |
|
Asia |
22 |
168 |
0 |
1 |
2 |
0 |
0 |
0 |
193 |
|
Asia-unspecified |
0 |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
1 |
|
Far East/SE Asia |
1 |
3 |
0 |
0 |
0 |
0 |
0 |
0 |
4 |
|
Far East- unspec. |
0 |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
1 |
|
Central/S America |
2 |
11 |
0 |
1 |
0 |
0 |
0 |
0 |
14 |
|
Oceania |
1 |
14 |
0 |
0 |
0 |
0 |
0 |
0 |
15 |
|
Not given |
235 |
46 |
6 |
24 |
1 |
1 |
0 |
0 |
313 |
|
Total |
1139 |
256 |
30 |
108 |
4 |
5 |
5 |
1 |
1548 |
Table 2. Cases of malaria by stated reason for travel, United Kingdom: 2007
|
Population group |
P.f. |
P.v. |
P.m. |
P.o. |
Pf/Pv |
Pf/Pm |
Pf/Po |
Pm/Pv |
Total |
|
New entrant |
40 |
25 |
2 |
10 |
0 |
0 |
0 |
1 |
78 |
|
Visiting family in country of origin |
455 |
51 |
10 |
29 |
0 |
1 |
3 |
0 |
549 |
|
UK citizen living broad |
14 |
4 |
0 |
1 |
1 |
0 |
0 |
0 |
20 |
|
Civilian sea/air crew |
2 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
2 |
|
British armed services |
0 |
4 |
0 |
1 |
0 |
0 |
0 |
0 |
5 |
|
Business/professional travel |
35 |
8 |
2 |
5 |
0 |
0 |
0 |
0 |
50 |
|
Foreign student studying in the UK |
24 |
6 |
1 |
3 |
0 |
0 |
1 |
0 |
35 |
|
Holiday travel |
58 |
41 |
2 |
7 |
0 |
0 |
0 |
0 |
108 |
|
Foreign visitor ill while in UK |
56 |
27 |
4 |
7 |
1 |
1 |
0 |
0 |
96 |
|
Children visiting parents living abroad |
0 |
0 |
0 |
1 |
0 |
0 |
0 |
0 |
1 |
|
Not stated |
455 |
90 |
9 |
44 |
2 |
3 |
1 |
0 |
604 |
Last reviewed: 11 August 2008
