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Travel Health Advisory

Travelling South? - Malaria Risk For Travellers

Released: December 4, 2008

Travel Health Notice

As the holiday season approaches, people may be planning to travel to popular tourist destinations or home to visit family and friends in areas where there may be a risk of malaria. 

Malaria is a serious and occasionally fatal disease that is spread by the bite of an infected mosquito. There is no vaccine available against malaria.

The Public Health Agency of Canada recommends that travellers consult with a travel health clinic to find out if malaria poses a risk at their destination.  If it does, the Agency recommends travellers:  

  • Protect themselves from mosquito bites.
  • Discuss the benefit of taking anti-malarial medication with a health care professional before departure.
  • Know the symptoms of malaria and see a health care provider if they develop.

About Malaria

Malaria is a disease caused by a parasite that enters the blood of humans by the bite of an infected mosquito.

Symptoms

  • Can take from one week to several months to occur (depends on type of parasite)
  • Usually include flu-like symptoms such as fever, sweats, chills, headache, abdominal pain, muscle and joint pain, nausea and vomiting, diarrhea and feeling generally unwell.
  • In more severe cases may include seizures, coma, kidney and respiratory failure, shock which may lead to death.

Transmission

  • Malaria is spread to humans by the bite of a mosquito infected with the parasite.
  • The mosquito that spreads malaria is usually active during the evening, night and early morning (dusk to dawn).

Geographic Distribution (worldwide)

  • Malaria is widely distributed in tropical areas of the world.
  • Transmission occurs in:
    • most of sub-Saharan Africa and New Guinea;
    • in large areas of Southern Asia and in parts of Southeast Asia, Oceania, Haiti, and Central and South America;
    • in limited areas of Mexico, the Dominican Republic, North Africa and the Middle East.
  • In the last few years, malaria has occurred in areas previously considered to be free of malaria, such as Great Exuma Island of the Bahamas and Jamaica.
  • The following table shows regions of risk for malaria among popular Canadian tourist destinations:

Country

Risk Areas

Belize

All, except no evidence to date of a risk in Belize City.

Costa Rica

In Alajuela, Limón, Guanacaste, and Heredia provinces; no evidence to date of a risk in Limón city (Puerto Limon).

Dominican Republic

The resort areas within the province of La Altagracia (including Punta Cana and Bavaro), as well as all of the rural areas bordering Haiti.

Guatemala

Rural areas at 1,500 metres elevation and below; no evidence to date of a risk in Guatemala City, Antigua or Lake Atitlán.

Jamaica

Very limited risk in Kingston area.

Mexico

There is a risk of malaria to travellers in the southern regions bordering Guatemala and Belize. There is no evidence to date of a risk of malaria in the resort areas along the Pacific and Gulf Coasts or along the border of the United States.

The World Health Organization has a complete map of the areas where malaria transmission occurs New Window.  

Recommendations to Travellers

It is recommended that travellers,

  1. Protect themselves from mosquito bites:
    1. Cover up: wear light-coloured, long-sleeved, tucked-in shirts, long pants, shoes (not sandals), and a hat
    2. Use insect repellent on exposed skin
      1. Of the insect repellents registered in Canada, those containing DEET are the most effective
      2. Use as directed by the manufacturer
      3. Do not apply to cuts, abrasions or irritated skin
      4. Do not spray directly on the face
      5. Wash hands after application, to avoid contact with lips and eyes
      6. When using sunscreen: do not use insect repellent and sunscreen combination products
      7. If application of sunscreen and repellent with DEET is required, apply the sunscreen first and let it soak into the skin for about 20 minutes, then apply repellent with DEET
      8.  Repellent should be washed off at the end of the day, before going to bed.
    3. Sleep under an insecticide-treated bed net
      1. Ensure the net is intact (no tears or large holes)
      2. Tuck it under the mattress
      3. Ensure it is not touching you (or you still may be bitten through the net)
    4. Consider your accommodations: Stay in a well-screened or completely enclosed air-conditioned room
    5. Apply a permethrin insecticide to tents and bed nets for greater protection
      1. Use only products manufactured for clothing and gear and don't use them directly on skin
      2. Permethrin-treated clothing is effective for up to 2 weeks or 6 washings

      More information on precautions to take to avoid mosquito bites while travelling

  2. Discuss the benefits of taking anti-malarial medication with a health care professional before departure
    1. Travellers should visit a travel health clinic at least six weeks before travel.
    2. No anti-malarial medication is 100% effective in preventing the disease.
    3. Discuss your risks with a health care professional to determine whether to take anti-malarial medication and which one to take.
    4. Recommended anti-malarial medication for regions with risk of malaria can be found at the following:
  3. Know the symptoms of malaria and see a health care provider if they develop.

Monitor your health

It is recommended that you seek medical attention if you experience symptoms of malaria especially fever within eight to 12 months of travelling to regions at risk of malaria.

As a reminder...

  • Consult a health care provider or visit a travel health clinic.
    • An appointment at least six weeks prior to international travel is ideal
  • Know your health risks
  • Learn what you can do to stay healthy when travelling
  • Know what vaccines to get and when to get them

Additional information:

Date Modified: 2008-12-04

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