Malaria cases in South Africa are increasing as expected during the summer months. As at the end of October 2018, more than 16,000 cases with 110 deaths have been reported.

Image/Robert Herriman
Image/Robert Herriman

This is fewer than during the large upsurge in malaria seen in the 2017- 2018 season, but still more than the average over the 10-year period 2007-2016, which was around 7,600 cases per year.

During the holiday season, many people will be exposed because of their travel to higher transmission areas, both internally and outside the country borders, particularly in Mozambique.

There has been some recent expansion of low or very low malaria transmission to some districts previously regarded as non-malaria areas in South Africa, such as parts of the Waterberg District. People who are planning to travel are urged to take adequate measures to protect themselves from malaria. All people in malaria risk areas should reduce contact with mosquitoes by limiting outdoor activity after dark, covering up bare skin (not forgetting feet and ankles), using mosquito repellents, ensuring mosquito screens on windows are closed, and using bednets, fans or air-conditioning, if available.

Consider antimalarial prophylaxis in higher risk areas – doxycycline and atovaquone-proguanil are available without prescription from pharmacies. Public sector travel clinics will also supply prophylaxis to travellers. It is important to understand that while these precautions will substantially reduce the chance of acquiring malaria, the risk is never completely abolished.

All travellers returning from malaria transmission areas, including very low risk ones, should get medical advice about ’flu-like’ illness (headache, fever, chills, muscle and joint pain) that occurs up to four to six weeks after first possible exposure, in case it is malaria.