Malaria is on the Rise, but this serious threat to travelers health is easily avoided by following a few precautions

Malaria kills a million people and sickens more than 300 million each year, most of them in Africa. By comparison, only an estimated 30,000 Western travelers are infected with the malaria parasite annually. Still, malaria is among the most serious health issues facing travelers today, and its range is spreading, largely due to drug and insecticide resistance and climate change. A recent outbreak in Kingston, Jamaicathe first in nearly 40 yearsresulted in some 200 confirmed cases by mid-January, leading the Centers for Disease Control and Prevention to recommend anti-malarial drugs for travelers spending the night in that city. "The outbreak is localized in a non-tourist area," said Dr. David O. Freedman, a spokesman for the International Society of Travel Medicine. Another outbreak, in the Indian beach resort of Goa, affected at least nine European travelers.

The four different strains of malaria are all spread through the bite of the Anopheles mosquito. Once the parasite enters the bloodstream, it travels through the liver, infecting the red blood cells. Symptomsheadache, fever, vomitingusually appear within 9 to 14 days of infection but can occur up to a year or more after exposure.

The best way to prevent malaria is to avoid the mosquito bites through which the disease is transmitted by using an insect repellent containing 30 to 50 percent deet, avoiding the outdoors from dusk until dawn, sleeping under a mosquito net, and taking an FDA-approved anti-malarial medication. The following are the most commonly prescribed; consult a travel medicine specialist to choose the one that's right for you:

Atovaquone/proguanil (brand name: Malarone)
Effectiveness: Protects against all strains.
Advantage: Few side effects.
Disadvantage: Expensive (about $6 a day), making it best for trips of two weeks or less.

Chloroquine (brand name Aralen)
Effectiveness: Only efficacious in the Caribbean, Central and South America, the Middle East, and Eastern Europe.

Doxycycline (many brand names)
Effectiveness: Protects against all strains.
Advantage: Inexpensive.
Disadvantage: Can cause gastrointestinal side effects and sun sensitivity.

Mefloquine (brand name: Lariam)
Effectiveness: Protects against all strains.
Advantage: Taken only once a week, rather than daily.
Disadvantages: Has been associated, in rare cases, with adverse psychiatric events; not recommended for certain areas of Southeast Asia.

Always discuss malaria prevention with your doctor or a travel medicine specialist before traveling to an affected region. The CDC cautions against purchasing anti-malarial drugs overseas because they may not be effective. Information about malaria-risk countries is available at: cdc.gov/travel/regionalmalaria/index.htm.
Keep in mind that malaria-prevention drugs are not foolproof and that anyone exhibiting symptoms of malaria should seek treatment within 24 hours. Moreover, anyone experiencing a fever within a year of returning from a malaria-risk area should seek medical attention immediately. When treated, malaria is rarely fatal in travelers.