Malaria in the Amazon: Prevention and Treatment
When travelling to the Amazon it is important to be fully aware of the malaria situation in the region. Of all of the frightening and impressive creatures you will see on your Amazon River cruise, from the black caiman to the giant anaconda, there is no creature more dangerous than the tiny mosquito. It's not that the mosquito will cause you immediate pain when it bites, apart from some itching and irritation, but the mosquito is the most dangerous creature in the Amazon because of the disease it carries, malaria. Malaria is one of the world's most dangerous diseases, if not treated or prevented properly, it can be deadly. Malaria is indeed treatable and preventable; by talking to your local Travel Doctor, taking Malaria medication and protecting yourself from potential mosquito bites, will significantly reduce your risk of contracting Malaria in the Amazon.
What is Malaria?
Malaria is a potentially life-threatening blood disease that is caused by parasites. It can transmitted to humans by the Anopheles mosquito, after it has bitten you. The parasites multiply inside your liver, before infecting and destroying vital red blood cells.
Malaria is one of the biggest killers on earth, and currently affects 97 countries and territories around the world. There are a number of strains of malaria that are usually found in tropical regions around the world, including Africa, Southeast Asia and South America. The strain in South America is known as P. vivax, and is also found in Africa and Asia.
How do I know if I have Malaria?
First of all, malaria can be put into two categories of symptoms: uncomplicated and severe. Individuals suffering with uncomplicated malaria may have symptoms such as fever, chills, headache, muscle ache, tiredness, nausea, vomiting and diarrhoea, but won't have clinical or laboratory signs that they have vital organ dysfunction. However, it is important to seek treatment for this type of malaria immediately as it can lead to severe malaria if left untreated.
Severe malaria symptoms include: fever and chills, impaired consciousness, prostration, multiple convulsions, deep-breathing and respiratory distress, abnormal bleeding and clinical jaundice or evidence of vital organ dysfunction. Even in mild cases malaria can be life-threatening if left alone, particularly for pregnant women or young children.
Can Malaria be Treated?
Malaria is both preventable and treatable. There has been a lot of effort into treating malaria. In fact, in the past 12 years funding has increased nearly 10-fold and the number of new cases has declined by 25% globally, while the number of deaths have decreased by 42%. It's important to note the history. Malaria did in fact exist in non-tropical regions of the West, and was eliminated from most of the Western world by the 1930s and from the USA by the 1950s. This proves that it is possible to eliminate the disease completely.
The Bill & Melinda Gates foundation is supporting a multi-year malaria strategy to combat and eliminate malaria. One of the measures they have taken is to create a vaccine, with the help of GlaxoSmithKline, that can be administered for free or very cheaply to those most at risk in Africa. This vaccine is the first of its kind, and the only vaccine ever to prevent a parasitic infection. The vaccine is designed for the Falciparum specific variety, the strain that is the most fatal.
The vaccine is a great start and the Foundation continue their work, and have invested almost $2 billion to combat malaria since 2013. The Foundation also recognizes that work to eradicate malaria needs to take place locally in every region, as the biological and ecological differences of a place contribute to the effectiveness of treatment.
If you do contract the disease and have access to treatment, it is usually very straightforward and most malaria can be cured within around two weeks. However, if left untreated malaria can return even if symptoms appear to have gone away. People with severe malaria may need to be monitored in an intensive care unit for some of their treatment, this is to prevent the disease causing breathing failure, a coma, and kidney failure. Without treatment malaria is fatal – with 10-40% of people with severe malaria losing their life as a result, even with advanced medical treatment.
How to Protect Yourself from Malaria
Mosquitoes can also carry the deadly Yellow Fever disease. For Yellow Fever you can pay for a vaccination before you leave your country to ensure you are protected from the disease. For malaria, however, there are a number of things you can do yourself to prevent being bitten and contracting the disease.
1. Talk to your local Travel Doctor: The best advice is to schedule an appointment with your local travel Doctor. Your Doctor will know the current conditions of Malaria outbreaks in your travel destination. Prescribed Anti-Malarial drugs are often recommended by health care professionals.
2. Take anti-malarial drugs: Prescribed anti-malarial drugs such as Atovaquone-proguanil, Doxycycline, and Mefloquine are often recommended by your travel physician for your trip to the Amazon. You are usually expected to begin taking the drugs between 4-6 weeks before your trip and continue them for some weeks after your vacation.
3. Use an insect repellent: An insect repellent with a high percentage of DEET used and reapplied regularly should help to keep the mosquitoes at bay during your trip. It's important to spray the DEET on your skin and clothing.
4. Use a mosquito net: You are highly exposed to mosquitoes at night in the Amazon, so try to sleep with a mosquito net over your bed for protection.
5. Cover up your skin: By wearing loose-fitting strong clothing you can stop mosquitoes from biting you, cotton is a particularly good material. Do not wear black clothing, the color black attracts mosquitos.
For more information, view our Packing for an Amazon Tour article.
The Increase of Malaria in the Amazon
Throughout the nineties malaria started to reappear in the Amazon region. This increase was largely to do with the migration of non-immune people into malaria-endemic regions, the establishment of highly competent malaria-transmitting mosquitoes, the climatic fluctuations in the region, the minimal funding for malaria control programs, as well as the presence of resistant strains.
A recent study into the region has also shown that deforestation in the Amazon causes a greater number of mosquitoes and a higher risk of malaria. The University of Winsconsin-Madison and the Johns Hopkins University found that malaria-inducing mosquitoes are likely to bite humans more than 200 times more often in cleared areas of forest versus forested ones. By dramatically changing the landscape in the Amazon we are potentially increasing the risk of malaria transmission.
Focusing on the Peruvian Amazon, after cases increases dramatically throughout the nineties from just a few hundred cases to 120,000 cases, the study found that forestation made all the difference. This means conservation policies in the Amazon are also vital in the prevention and eradication of the disease in this region.
After this rapid increase, which peaked at 635,000 cases in 1999, the Amazon Malaria Initiative was set up in 2001, with a goal of preventing and controlling malaria in the Amazon basin region. The program has been largely effective and in the Brazilian Amazon, for example, the number of cases have dramatically decreased to 300,000 in 2008 and 2009.
Please note, it's not advisable just to take one of these precautions. It's best to take as many precautions as possible to reduce your risk of contracting the disease during your stay in the Amazon. If you have any further questions or concerns about malaria then please contact your local Travel Doctor or contact us. For more information about Bugs, view our How Bad are Bugs in the Amazon article.