Mosquitoes, Malaria and Travel: What South Africans Need to Know
A mosquito bite is usually little more than an itchy irritation.
But in certain parts of South Africa and neighbouring countries, mosquitoes can transmit malaria — a potentially serious disease that requires prompt diagnosis and treatment.
As we mark World Mosquito Day on 20 August, it’s a useful reminder to understand where malaria occurs, how to reduce your risk and why feeling “a bit flu-ish” after travelling deserves more attention than you might think.
This is particularly important as we move closer to the warmer months and more South Africans begin planning trips to the bushveld, game reserves and neighbouring countries.
Is Malaria Still a Risk in South Africa?
Yes, although malaria transmission is limited mainly to certain parts of the country.
According to South Africa’s National Institute for Communicable Diseases (NICD), malaria-risk areas occur primarily in the north-eastern regions of Limpopo, Mpumalanga and northern KwaZulu-Natal.
Risk is not the same throughout these provinces, and it can change according to location, season, rainfall and environmental conditions.
South Africa’s higher malaria transmission season generally runs from around September to May, when warmer temperatures and increased rainfall create favourable conditions for malaria-carrying mosquitoes.
That means August is actually a good time to start thinking about prevention — particularly if you’re planning spring or summer travel.
What Exactly Is Malaria?
Malaria is caused by parasites that are transmitted to humans through the bite of an infected Anopheles mosquito.
Unlike many mosquitoes that seem determined to ruin an afternoon braai, malaria-carrying mosquitoes are mainly active between dusk and dawn.
Once infected, a person may initially experience fairly general symptoms that can easily be mistaken for flu or another infection.
This is one of the reasons awareness is so important.
Malaria is preventable, treatable and curable, but early diagnosis matters.
What Are the Symptoms of Malaria?
Early symptoms can include:
- Fever
- Chills or shivering
- Sweating
- Headache
- Muscle aches
- Fatigue
- Nausea or vomiting
- Abdominal discomfort
- Diarrhoea
- Loss of appetite
The problem is that none of these symptoms immediately screams “malaria”.
They could easily be mistaken for influenza, a stomach bug or another common infection.
This is why your recent travel history matters.
If you develop flu-like symptoms after visiting an area where malaria occurs, tell your healthcare professional where you have recently travelled.
Don’t assume it’s simply flu.
“But I Took Malaria Tablets”
Preventative medication can significantly reduce your risk of developing malaria, but no preventative method provides complete protection.
This means you still need to take mosquito-bite precautions — and you should still seek medical advice if you become ill after visiting a malaria-risk area.
The type of preventative medication recommended can depend on where you’re travelling, how long you’ll be there, your age, pregnancy status, medical conditions and other medication you may be taking.
For this reason, it’s a good idea to discuss malaria prevention with a doctor, pharmacist or travel healthcare professional before your trip.
How to Protect Yourself From Mosquito Bites
Medication is only one part of malaria prevention.
Reducing your exposure to mosquitoes is important whether or not you are taking preventative medication.
Use an Effective Mosquito Repellent
Apply mosquito repellent to exposed skin, particularly from late afternoon through the evening and at night.
The NICD recommends DEET-containing repellents as one of the preventative measures for people in malaria-risk areas.
Follow the instructions provided with the product, particularly when using repellents on children.
Cover Up in the Evening
When you’re outdoors after sunset, wear:
- Long trousers
- Long-sleeved shirts
- Closed shoes or socks where practical
Feet and ankles are easily forgotten but can be particularly exposed when you’re sitting outdoors.
Check Your Accommodation
If you’re staying in a malaria-risk area, make use of available protection such as:
- Mosquito screens on windows and doors
- Mosquito nets
- Air conditioning
- Fans
- Appropriate indoor mosquito-control products
Sleeping under a mosquito net can provide an additional physical barrier between you and mosquitoes.
Remove Standing Water Around Your Home
Mosquitoes breed in water.
Buckets, plant saucers, containers, blocked gutters and other objects that collect stagnant water can become breeding sites.
Regularly emptying or covering containers around your home can help reduce mosquito populations.
This is particularly useful as rainfall increases during the warmer months.
Who Needs to Be Especially Careful?
Anyone travelling to a malaria-risk area can contract malaria.
However, some people can be more vulnerable to serious illness, including:
- Young children
- Pregnant women
- Older adults
- People with compromised immune systems
- Travellers who normally live outside malaria-endemic regions
If you fall into a higher-risk category, discuss your travel plans with a healthcare professional beforehand.
Don’t Forget About Travel Outside South Africa
Malaria risk extends well beyond South Africa.
Many popular destinations across sub-Saharan Africa have areas where malaria transmission occurs.
If you’re planning an international trip, check the malaria risk for the specific region you’re visiting, rather than assuming the entire country is either safe or high risk.
Your risk may also differ depending on whether you’re staying in a city, coastal resort, rural community or wildlife area.
Your accommodation, length of stay and planned activities can all influence the precautions you may need.
Feeling Sick After a Holiday? Mention Where You’ve Been
This is one of the most important messages to remember.
If you develop a fever or flu-like illness after travelling to a malaria area, tell the healthcare professional about your travel history immediately.
It may completely change which conditions they consider.
The NICD advises that malaria should be considered in people who develop flu-like symptoms after potential exposure in malaria-transmission areas, and early testing and treatment are important because the disease can progress rapidly.
Do not wait several days to see whether the symptoms simply disappear if malaria is a possibility.
Can You Get Malaria Without Travelling?
It is uncommon, but it can happen.
South Africa occasionally records cases of what is known as odyssean malaria, where an infected mosquito is transported from a malaria area by vehicle, aircraft or other means and bites somebody elsewhere.
Cases have even occurred outside the country’s traditional malaria regions.
This remains unusual, but it illustrates why healthcare professionals may sometimes consider malaria in a very ill patient even without an obvious travel history.
For most people, however, recent travel to a malaria-endemic region remains an important clue.
Prevention Starts Before You Pack Your Bags
Malaria prevention shouldn’t begin when the first mosquito lands on your ankle.
Before travelling to a malaria-risk destination:
- Check whether malaria occurs in the area.
- Ask whether preventative medication is recommended.
- Pack an appropriate mosquito repellent.
- Choose clothing that provides coverage in the evenings.
- Find out whether your accommodation has mosquito nets or screens.
- Know which symptoms to watch for after your trip.
A little preparation can significantly reduce your risk.
Not Every Mosquito Bite Means Malaria
It is also important not to panic every time you’re bitten.
Most mosquito bites do not result in malaria.
The level of risk depends on where you are, whether malaria is being transmitted in that area and whether the mosquito itself is infected.
World Mosquito Day isn’t about making us afraid of mosquitoes.
It’s about understanding that mosquito-borne illnesses can be prevented more effectively when we know the risks and take sensible precautions.
Travelling Soon? Ask Before You Go
If you’re planning a holiday, business trip or visit to a malaria-risk area and you’re unsure whether you need preventative treatment, speak to a healthcare professional before travelling.
And if you return home and start experiencing fever, chills, headache or flu-like symptoms, don’t forget one crucial piece of information:
Tell your doctor where you’ve been.
Through TruMD, South Africans can access qualified healthcare professionals online for medical advice, assessment and guidance on whether further testing or an in-person consultation is required.
Travelling soon or feeling unwell after a trip? Talk to a doctor with TruMD.
