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Malaria 101: What Travelers Should Know About the World's Biggest Killer

Essential information about this deadly and widespread disease


Every year, malaria kills approximately 660,000 people around the globe, according to the World Health Organization. Affecting almost half the world’s population, this disease is often a daily concern for those living in 100 countries worldwide. Here in the United States, however, we are safe out of its reach.

But all of this changes when you decide to take that bucket list vacation to Brazil or Kenya. Suddenly, you are just as likely to contract malaria as anyone else living in affected regions. To help keep you safe, we compiled the need-to-know information about the disease and spoke to Dr. David Shlim who has served as medical director at the Jackson Hole Travel and Tropical Medicine Clinic since 1998 for his take on this disease and how to prevent it.

What is Malaria?
Malaria is a disease that comes from parasites that spread through the bites of infected female Anopheles mosquitoes. Two related parasite species–Plasmodium falciparum and Plasmodium vivax–are the cause of most illness and death from malaria. 

The disease occurs in two stages, according to Shlim. In the first stage, the parasite stays in the liver. In the second stage, it moves out into the blood and causes symptoms. 

What are the symptoms and when do they occur?
Syptoms typically begin within a few weeks of infection, however some parasites can stay dormant in your body for months. Watch for recurring attacks of moderate to severe shaking chills, high fever, headache, vomiting, diarrhea and profuse sweating with a drop in body temperature. If you're living, traveling or have recently visited a high-risk region and spike a fever, visit your doctor immediately. 

Where am I at risk?
Although you most often hear about malaria in Subsaharan Africa, this disease is actually found across the world in countries as varied as Yemen, Vietnam, the Solomon Islands, Colombia and China. Click here to see a list of countries where Malaria is found.

How can I prevent malaria?
Because there’s no vaccine for malaria, malaria pills are the best way to keep yourself safe. Just be warned: the antibiotics are very expensive.

The best medication we have right now, Malarone, varies between six and nine dollars a pill,” Shlim said. Depending on how long your trip is, that can be a serious shock to your wallet. To make financial matters worse, manufacturing problems made the price of doxycycline—the drug known as a low-cost alternative—skyrocket from 20 cents to five dollars per pill.

Because of the high prices, some travelers opt to buy the drugs overseas, however this has become increasingly dangerous in recent years, Shlim said.

“Studies now show that 30-40 percent of drugs on shelves in developing countries are counterfeit,” he explained. These include fake, top-end malaria drugs that are made to look exactly like the real thing. Because of the potentially deadly consequences of these fake pills, malaria expert  Nicholas White at Mahidol University in Bangkok, Thailand, called this counterfitting “premeditated, coldblooded murder,” in an interview with Smithsonian Magazine.

For this reason, it’s much safer to cough up the money while in the United States.

It’s also imperative to follow the directions on malaria drugs for continuing doses after your trip, Shlim said. By continuing to take the drugs, you make sure that you won’t get sick with parasites you caught at the end of your stay abroad.

Additional Resources:
The malaria atlas project
The Mayo Clinic
World Health Organization

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About the expert: Dr. David Shlim has served as the medical director at the Jackson Hole Travel and Tropical Medicine Clinic since 1998 and is the president of the International Society of Travel Medicine. He was also the Medical Director of the CIWEC Clinic Travel Medicine Centre in Kathmandu, Nepal from 1983 to 1998. He is also the author of Medicine & Compassion. To learn more about Shlim, visit his website.

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