The Buzz: Malaria & Mosquitos in South and Southeast Asia

What is malaria, anyways?

One of the most frequent and most important questions we get is about malaria. Malaria is a mosquito-borne infectious disease of humans and other animals caused by parasitic protozoans.  The disease is most often transmitted by a bite from an infected female mosquito, which introduces the organisms from its saliva into a person’s circulatory system.  In the blood, the parasites travel to the liver to mature and reproduce.  In short: malaria is a parasite transmitted through the bites of female mosquitos. 

Malaria causes symptoms that typically include fever and headache, which in severe cases can progress to coma or death.  Malaria is common in tropical and subtropical regions because rainfall, warm temperatures, and stagnant waters provide an environment ideal for mosquito larvae.  Disease transmission can be reduced by preventing mosquito bites by using mosquito nets and insect repellents, or with mosquito-control measures such as spraying insecticides and draining standing water. Despite a need, no effective vaccine exists, although efforts to develop one are ongoing. (The Bill & Melinda Gates Foundations has spent upwards of $2 Billion to eradicate malaria). Several medications are available to prevent malaria in travelers to malaria-endemic countries.  A number medications are available for those who have the disease.  

So, what do I do while traveling?

Malaria is a serious illness and nothing to be taken lightly, and we take it very seriously in our life abroad. We often choose to forego the malaria prophylaxis (pills you take to reduce the risk of getting malaria) due to the resistance against those drugs and their potential side-effects which BJ has experienced first hand. Instead, we choose to focus on preventing bites in the first place.

This website is a comprehensive article on how to prevent getting mosquito bites. In short, wear a mosquito repellent and cover up (long sleeves and pants), especially during dawn and dusk. Also, use mosquito nets when provided.

There are many options for mosquito repellent; here’s a list of some of the most highly rated ones by Consumer Reports.  We’ve used Natrapel before (the active ingredient is picaridin instead of DEET) with good results.  Since we don’t encounter many ‘skeeters, Lauren will often use a natural, essential-oil based product like this one by Badger.  If you do use a chemical-based one, just make sure to wash it off before you go to bed (given there are no mosquitos in your sleeping quarters!)

In reality, we very rarely get bitten by mosquitos.  I could tell you it’s because of the precautions we take, but in actuality, it’s because there are very rarely mosquitos in the locations we visit when we visit.  We almost never see mosquitos. I don’t mean we see few mosquitos—we see almost none.  In a typical 12-month period we probably see no more than 20 mosquitos (no exaggeration).

There are a number of reasons we don’t see many mosquitos, from it being too cold in Ladakh and parts of Nepal to active mosquito elimination programs in many regions in SE Asia. Whatever the reasons, we can anecdotally attest that we encounter few to no mosquitos in the specific areas we visit at the times of year we bring our tour groups.

What about dengue fever?

More importantly, malaria is not the only mosquito-borne illness that exists in regions you may visit.  Dengue (pronounced DEN-gee or DEN-gay) fever is a serious (though generally not life-threatening) illness that is transferred to humans by mosquitos. These particular mosquitos generally bite during the daytime hours (unlike the species that may carry malaria which generally bite at dusk and dawn). There is currently no vaccine or prophylaxis for dengue fever and the only prevention is to keep mosquitos from biting you.

IMPORTANT DISCLAIMER:  Our personal experiences are just that and we are not doctors.  We have found that physicians generally seem to advise people to take malaria medications even when maps and research show it may not be necessary.  We advise you to research the topic of mosquito-borne illnesses and prevention and make the decision yourself with the consultation of your physician and make a decision you fee comfortable with. Never disregard professional medical advice or delay in seeking it because of something you have read online.

So where is malaria still a problem?

We encourage you to visit the most up-to-date malaria maps at Scotland’s comprehensive Fit For travel website, part of the NHS.  This article is from CIWEC, the foremost travel medicine hospital in Nepal, and is probably the best information available on the subject of malaria in Nepal.