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Conquering a killer

By Kim O’Hare

Today, the UAE is officially free of indigenous malaria, but only 30 years or so ago, it had a significant problem with the mosquito-borne disease.

During one particularly bad season in 1978, one major hospital was treating 30 patients a week and the country was in the midst of a campaign to fight malaria. pictureThe public was warned to empty buckets that caught water dripping from air-conditioners. Residents were advised to take anti-malaria medicine once a week, and people living on the east coast were told to take it twice weekly.

Sharjah Municipality distributed free malaria pills to hotels, large companies and residents, while the Dubai Public Health Department sprayed labour accommodation with insecticide.

Malaria-control activities started in the UAE in 1970 when the prevalence rate was between 30 to 60 per cent in some areas, according to a Ministry of Health report.

Seven years later, a more comprehensive strategy for the control of malaria was adopted with the objective of preventing indigenous transmission of the disease and the UAE reported its last case of indigenous malaria in 2000. Today, it has been declared officially malaria-free by the UN.

However, the risks of this deadly disease are still very real if you’re travelling abroad for business or on holiday.

Every 30 seconds, somewhere in the world, a child dies from Malaria. More than a million people, mostly infants, young children and pregnant women perish from the disease each year.

According to the World Health Organisation, Malaria is endemic or “constantly occurring” in more than 100 countries around the world. Most cases are reported in Africa but significant numbers are also reported in Asia, the Middle East, Latin America and Europe.

If you are travelling to a malaria hotspot it is particularly important to be prepared. While there is no vaccine for malaria, there are anti-malaria medications that can reduce the risk of developing symptoms of the disease, although they will not provide 100 per cent protection. 

The anti-malarial medications are important because you likely don’t have the malaria antibodies in your system. To make things worse, when travelers return to their home country, where malaria is quite rare, they’re often misdiagnosed.

The UN recently held World Malaria Day to get the word out. One of the most effective means of preventing malaria is the use of bed nets, but only two per cent of African children sleep under insecticide-treated bed nets.

The most common means of transmission is the mosquito. Infected female mosquitoes carry the spores of the parasite, transferring them when they bite humans. The spores collect in the victims’ liver and multiply.

Adding to the difficulty of diagnosis is the fact that some spores can remain dormant for several months. 

Symptoms of malaria include: headache, fever, chills, muscle and joint pain, nausea and vomiting, and convulsions. The symptoms can be mistaken for those of several other diseases, so a diagnosis requires a blood test.  Symptoms normally begin showing up 10 to 15 days after infection. If the person is not treated promptly, the disease can rapidly worsen, turning into severe illness that can be fatal.

If you unexpectedly develop fever within three months of returning from a malaria-endemic area, see a doctor immediately. Consider yourself a medical emergency. Get your blood tested and repeat those tests within 12 to 24 hours if your symptoms persist.

While malaria tends to be seasonal in many parts of the world you are always in a risk situation in certain tropical countries, especially in sub-Saharan Africa.

The treatment of malaria depends on the species of parasite, the severity of the infection and the age of the person infected. In some parts of the world, parasites have become resistant to some of the drugs used in treatment.

The good news is that almost all malaria can be completely cured if identified and treated early. But if left untreated, you can go from being asymptomatic to severely ill very quickly. Death can occur within 36 to 48 hours. The types of drugs used will vary, depending on where you’ve been, which parasite has infected you and how sick you are.

The best way to avoid being infected is to avoid being bitten by malaria-carrying mosquitoes. Stay indoors from dusk to dawn, when mosquitoes are biting most. If you are out between dusk and dawn, wear light-coloured long-sleeved shirts, long pants, socks and shoes.

Minimize the amount of exposed skin. Impregnate all clothing with an insecticide such as 0.5% permethrin to make them repellant. Sleep under a mosquito net impregnated with permethrin. Use DEET-based insect repellents.

When travelling in areas where malaria is endemic, children are at higher risk of infection than adults. For children, sparingly apply DEET in a concentration of not more than 10 per cent to exposed surfaces only. Wash it off after your child comes indoors.

The Centres for Disease Control has up to date information on Malaria outbreaks and other health risks for travelers.

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