Malaria is a common and potentially serious disease caused by the bite of a mosquito. Malaria symptoms can be mild, but if they are left to develop, the disease can lead to life-threatening complications.

Risk areas
Africa, Asia, Central and South America, Haiti and the Dominican Republic, parts of the Middle East and some Pacific Islands
Deaths in 2017
People at highest risk
Children under five years old, pregnant women, people with HIV/AIDS
Worldwide cases in 2017
219 million
Cases in UK travellers in 2017
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01. How is malaria spread?

Many people wonder whether malaria is caused by a virus or a bacteria. However, malaria is actually not caused by any of them. Instead, the cause of malaria is an organism, known as a parasite.

Malaria is mainly spread through the bite of an infected mosquito. When the mosquito bites you, it can spread the malaria parasite into your blood, causing the disease.

You cannot become infected after contact with someone who has the disease, as malaria is not contagious. However, malaria can be spread through blood transfusions and sharing needles when injecting non-prescription drugs, but this is very rare.

Malaria transmission occurs all year-round. However, the risk is higher during,  just after the rainy season, as there are more active mosquitoes during this time.

This is because malaria is commonly spread near water, where mosquitoes prefer to lay their eggs. Mosquitoes can hatch in even very shallow water, such as puddles.

Therefore you should always ensure that any water that has collected nearby, for example in sinks or buckets, is drained thoroughly when you are travelling in countries that have a malaria risk.

Malaria transmission is higher from dusk until dawn, so it is important to be more vigilant at night and remember to check your skin regularly for mosquito bites.

02. Malaria risk countries

Malaria is found in more than 100 countries, mainly in tropical regions of the world where mosquitoes are common.

In 2017, 92% of malaria cases and 93% of malaria deaths occurred in Africa. Moreover, travellers are also at high risk of malaria in large areas of Asia, Central and South America, Haiti and the Dominican Republic, parts of the Middle East and some Pacific Islands.

Malaria is not found in the UK currently, but it may be diagnosed in travellers who return to the UK from risk areas.

However, outbreaks can occur anywhere in the world. This means that the malaria risk changes. Check if the country you are travelling to has a risk of malaria through the search bar below.

03. Symptoms of malaria

Malaria symptoms usually develop seven to 18 days after you become infected. This is known as the malaria incubation period.

In some cases, signs of malaria can take up to a year to occur.

Early malaria symptoms are often mild and flu-like. They can include:

  • fever

  • headaches

  • vomiting

  • muscle pains

  • diarrhoea

  • generally feeling unwell

With some types of malaria, symptoms can occur in 48-hour cycles, known as malaria fever.

During these cycles, you feel cold at first with shivering. You then develop a high temperature, accompanied by severe sweating and fatigue.

Without prompt treatment, the most serious type of malaria can quickly lead to severe and life-threatening complications. So you should seek medical help as soon as you suspect you have been infected with malaria or if you begin to experience malaria symptoms.

04. Diagnosis of malaria

Prompt malaria diagnosis will improve your chances of making a full recovery from the disease.

Even if it has been several weeks, months or a year after you have returned from travelling, it is really important to tell your doctor if you suspect you have malaria.

If you have been bitten by a mosquito or travelling in an area where there is a risk of the disease in the last year, telling your doctor this information will help them to make a malaria diagnosis.

Malaria diagnosis can be difficult even when symptoms do occur, because initial symptoms can be mild and easily mistaken for flu.

If there is a possibility you have malaria, a blood test can be carried out to confirm if you have been infected.

You should receive the results of your blood test on the same day. If you have malaria, treatment should begin straight away.

05. Treatment of malaria

The right malaria treatment can cure the disease if given promptly.

Specific medicines for treating malaria, known as antimalarials, are very effective when given promptly, allowing the majority of people to make a full recovery.

It is really important that you make a note of any malaria prevention tablets you take prior to travel.

This is because many of the same antimalarial medicines used to prevent malaria can also be used to treat the disease. However, you should not take the same one to prevent and treat the disease.

Telling your doctor the name of the malaria prevention tablets you have taken, will help them to provide you with the right malaria treatment.

The type of antimalarial medicine and how long you need to take it, will depend on other factors such as the type of malaria you have, where you caught malaria and the severity of your symptoms.

Antimalarial medication is usually given as tablets or capsules. If you are very ill, it will be given through a drip into a vein in the arm in hospital.

Malaria treatment can leave you feeling very tired and weak, but this usually improves after several weeks, when you will begin to feel well again.

06. Complications of malaria

Serious complications of malaria can develop within hours or days after malaria symptoms first occur, so it is vital you receive prompt malaria treatment.

If malaria is left untreated it can begin to affect the brain, causing a condition known as cerebral malaria. This can lead to seizures and permanent brain damage.

In some cases, cerebral malaria can cause you to become unconscious for days, weeks or longer. This is known as a coma.

Other complications of malaria can include:

  • dehydration

  • liver and kidney failure

  • yellowing of the skin, known as jaundice

  • shock 

  • a build-up of fluid in the lungs and difficulty breathing

  • blood disorders, such as anemia

  • swelling and serious damage of the spleen

If you suspect that you may be experiencing malaria symptoms, you should see a doctor urgently.

07. Malaria in pregnancy

If you are pregnant, malaria prevention is vital. You should avoid travelling to areas where there is a risk of malaria. This is because pregnant women have an increased risk of the disease.

Becoming infected with malaria in pregnancy can cause serious complications for you and your baby. This can include premature birth before 37 weeks of pregnancy, low birth weight, miscarriage and stillbirth.

If you are pregnant and unable to postpone or cancel your trip, it is very important to check if you need malaria prevention tablets.

Some of the antimalarials used to prevent and treat malaria are harmful for pregnant women because they can cause side effects for both mother and baby.

However, other antimalarials may be suitable, so seek medical advice from one of our prescribing nurses who can recommend the best malaria prevention for you.

You should also seek advice if you are breastfeeding, as the ingredients of some antimalarials may pass into your breast milk and harm your child.

08. Malaria in children

Children, particularly those under five years old, have a higher risk of severe and life-threatening malaria infections.

Malaria in children is more common because their immune system has not yet fully developed.

Parents are advised to avoid travelling to malaria risk countries with babies and children. If you must travel, it is vital that children are protected against mosquito bites.

Malaria prevention tablets suitable for children are available, but you should get advice on the most suitable treatment for your family and whether you need it.

If your child is infected with the disease, they will usually experience similar malaria symptoms to adults. They will also be diagnosed and treated in the same way.

09. Prevention of malaria

There are many things you can do to decrease your risk of becoming infected with malaria.

Avoiding mosquito bites is very important for the prevention of malaria, as being bitten by an infected mosquito is the main way you can become infected with the disease.

There are things you can do to limit your chances of being bitten by mosquitoes, but that is impossible to guarantee if you are travelling in a risk area. This is why it is important to check if you need malaria prevention tablets.

If you need malaria prevention tablets for your travels, you can book an appointment online for a prescription.

If you are unsure if malaria prevention tablets are right for you, you can book a free telephone consultation to speak to one of our prescribing nurses. They can give you a personal recommendation based on your health and travel plans.

For effective prevention of malaria while travelling in risk areas, it is recommended that you:

  • check if you need malaria prevention tablets for your trip

  • learn about malaria so you can spot signs

  • wear clothing that covers your arms and legs

  • tuck your trousers into your socks while outside

  • avoid being outside between dusk and dawn

  • use insect repellent containing DEET

  • dispose of any standing water, for example in sinks or buckets

  • use mosquito nets or screens while sleeping

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Content reviewed by

Anne Marie Major, Independent Nurse Prescriber
24 June 2019