Have you traveled to an area where malaria is endemic? Do you think you are in the clear once you get home? Wrong. Malaria symptoms can emerge up to 25 days after initial infection. In other words, you could find yourself coming down with malaria a few weeks removed from your vacation.
There are several reasons why post-trip Malaria is particularly dangerous. For one, medical centers and doctors in your home country may not be familiar with tropical disease treatment. There is a serious risk of misdiagnosis when it comes to post-trip malaria cases. And in many cases of correct diagnosis, the wrong medication is prescribed, resulting in unnecessarily complex cases of malaria.
Recently, a friend traveled to Mali and came down with malaria after she returned home. Initially, she was misdiagnosed and when they finally got it right, she was treated with Chloroquine, a medication that is traditionally used to treat malaria, but one that has lost much of its efficacy in recent years (doubly true for the particular strain that she had). She ended up temporarily losing her hearing and spending nearly a week in the hospital.
Here are a few guidelines to keep in mind if you return home from a trip to an area where malaria is endemic:
Continue taking your prophylactics as prescribed
When you were prescribed to your malaria prophylactics, your doctor gave you important instructions to follow. Continue to follow them even after you get home. Most prophylactics require dosage even after your arrival at home, because as we noted earlier, malaria infection can manifest several weeks after the initial transmission.
If you come down with malaria symptoms, go to a doctor immediately and explain that you have recently traveled
For information on symptoms, please see this post. If you start experiencing symptoms, it is imperative that you go to a clinic and have a diagnosis. Tell the doctor where you recently traveled and explain what measures you took to prevent malaria. If possible, see if the doctor can refer you to a tropical disease specialist if there is one nearby.
Travel with a backup course of treatment
We always travel with a back-up course of treatment that we can take as an emergency standby. This means that if we return home and start experiencing symptoms, we have a treatment option on hand that we can start taking immediately. In the case of West Africa, for example, coartem is recommended as an emergency treatment option. This can be purchased in pharmacies abroad with or without a prescription. There are different malaria treatment recommendations depending on where you have traveled. We discussed this here. The bottom line is that you should always have an emergency standy treatment on hand that you can take in the cases where you cannot get to a clinic in a reasonable window of time.
If you feel as if a doctor has misdiagnosed you or that they have prescribed a course of treatment that does not fall in line with what you were told at your travel health consultation before traveling, you should seek a second opinion and you shouldn’t hesitate to do so. While we are not in the business of second-guessing doctors, there are too many cases of misdiagnosed and mistreated malaria in travelers returning home for us not to address this.
Photo credit: flickr user Aesum