Malaria is caused by a parasite that is transmitted from person to person by the bite
of an infected "Anopheles" mosquito.
These mosquitoes are present in almost all countries in the tropics and subtropics.
"Anopheles" mosquitoes bite during nighttime hours, from dusk to dawn.
Each of the four different strains of malaria has different symptoms and reacts differently to antimalarial drugs.
The "Falciparum" parasite is the deadliest of the four malaria parasites, but
it is rarely encountered. The "Vivax" parasite is the most common cause of
malaria.
Malaria kills three million people worldwide every year.
Symptoms:
Symptoms include fever, chills, headache, muscle ache, and
malaise. Early stages of malaria may resemble the onset of the flu.
Malaria symptoms can develop as early as 6-8 days after being bitten by an
infected mosquito or as late as several months after departure from a malarious
area, after antimalarial drugs are discontinued.
Prevention:
There is no vaccine for malaria.
The risk of malaria can lowered by the use of antimalarial pills.
Chloroquinine is no longer effective, and Fansidar has dangerous side effects.
Mefloquine ("lariam") is the most widely used anti-malaria drug.
The pills are generally started a week or two before arrival in the risk area.
Malaria pills must be taken regularly (daily or weekly depending on the drug) while you are at risk, and for four to six weeks after you leave a malarious area.
If you stop taking pills too soon, you will increase the chances of getting
full-blown malaria.
A newcomer is Malarone, which can be taken just 24 hours before starting the trip.
Precautions
Avoiding mosquito bites is the only way to be sure of not getting malaria:
spray your face and hands with insect repellent, wear long-sleeve shirts and
long pants, use a mosquito net at night.
Contagiousness
Malaria is not contagious
Duration
Malaria may last for life.
Treatment
Malaria can be treated
effectively in its early stages, but delaying treatment can have
serious consequences.
My advice (very subjective and unprofessional)
I haven't used malaria pills in a long time because i want to avoid mosquitoes
(malarian or not malarian), so i make sure to travel when it's not raining.
If you go in the right season, in most cases you don't need to worry.
When i went to Suriname, every website recommended malaria pills: i don't think
i saw a single mosquito. Ditto when i went to Madagascar, except one park.
That one park had mosquitoes, but not the kind that carries malaria.
That's the other thing: obviously not all mosquitoes carry malaria, otherwise
malaria would be endemic in Europe and the USA too.
The reason why i want to avoid mosquitoes is not only malaria: mosquitoes seem
to be the most dangerous animal in the world.
Some countries have zika and dengue and other diseases
carried by mosquitoes, and much harder to prevent (there are
no vaccines) and harder to cure.
Taking pills is never a good idea: it weakens your immune system, so you are
almost guaranteed to catch some other disease, most likely intestinal.
A friend was sick 2 weeks in Papua and to this day doesn't know what disease
it was. Typical story of western tourist full of vaccinations.
Most malaria pills can make you very sick. A friend had hallucinations when he
was in Uganda and eventually stopped taking them.
Last but not least, no malaria pill is 100% effective.
You can google and find different estimates.
If you do take them, make sure they are the ones that work in the country
that you are visiting.
In Western countries the doctors are extremely incompetent and will recommend the most
expensive brand just because.
There are two very popular ones: lariam (meflouquine) and malarone.
But again you need to ask a local doctor which one works.
Lariam: you need to start taking them two weeks before leaving.
Malarone: you need to start taking them two days before leaving.
So malarone is the preferred one because you can buy it there (what are
the odds that you catch malaria in the first two days of your stay?)
Each one is poison.
So the catch is not to be bitten in the first place: long sleeves, long pants,
even gloves. And lots of DEET-based mosquito repellent on the clothes
(NOT on the skin). And make sure your hotel has a mosquito net over the bed
that doesn't have holes (in some countries it's like asking for trains to arrive
on time). A/C keeps mosquitoes away, but in some countries the A/C may stop working
in the middle of the night even in nice hotels, so the mosquito net is still
essential.
You must have really bad karma if you are bitten by just 10 mosquitoes and one
of them carries the parasite, and that one enters your blood stream, and your
immune system fails on that one. Usually people catch malaria because they
are bitten by thousands of mosquitoes, thousands of times a day.
If you take precautions, you should be ok without pills.
Always put things in perspective. While in India, you are much more likely to
be hit by a car, get a heat stroke or collapse because of pollution than
to catch malaria.
I would only use repellent and long clothes UNLESS you are visiting jungle parks.
A long time ago i did vaccinate against Hepatitis A and Typhoid, the two
diseases that people get from contaminated water (don't count on your
restaurant to wash the dishes with clean water).
Let me reemphasize: malaria pills will NOT save you from dengue, zika
and many other mosquito-born diseases that are much more serious.
