Date: Wed 6 Feb 2008
Source: Public Health Agency of
Canada, Travel Health Advisory [edited]
<
www.phac-aspc.gc.ca/..._dr080206-eng.php>
;
Malaria in the
Dominican Republic --
The Public Health Agency of
Canada (PHAC) reminds travellers that
anti-malarial medication and the use of personal protective measures
against mosquito bites are recommended (see below) to prevent getting
malaria while visiting certain areas in the
Dominican Republic
There is a risk of getting malaria in the resort areas within the
province of La Altagracia, as well as all rural areas of the
Dominican Republic especially in areas bordering
Haiti. The tourist
resort destinations of
Punta Cana and
Bavaro are located within the
province La Altagracia.
Malaria is caused by a parasite (_Plasmodium_). There are 4 species
of the parasite: _Plasmodium falciparum_, _Plasmodium vivax_,
_Plasmodium ovale_, and _Plasmodium malariae_. Infection with _P.
falciparum_ can be fatal. Symptoms of malaria include fever,
headache, nausea, vomiting, muscle pain, and malaise. Rigors (severe
shakes or muscle spasms) and chills often occur.
Malaria is most commonly transmitted to humans through mosquito
bites. The mosquito that transmits malaria is typically active during
the evening, night, and early morning.
Malaria is endemic (that is, constantly present) in most of
sub-Saharan Africa; in large areas of the Middle East, South Asia,
South East Asia, Oceania,
Haiti,
Dominican Republic, Central and
South America; and in parts of
Mexico and North Africa.
The Public Health Agency of
Canada recommends that travellers use
personal protective measures against mosquito bites and use
appropriate anti-malarial medication when travelling to destinations
where malaria occurs.
Chloroquine is the anti-malarial drug of choice for travel to areas
at risk of malaria transmission in the
Dominican Republic.
Alternative effective medications are atovaquone/progranil --
Malarone (R) --, doxycycline, and mefloquine.
Personal protective measures --
Two important measures can help you prevent malaria infection: avoid
mosquito bites and use effective anti-malarial medications.
1. Prevent mosquito bites
Take the following personal protective measures to reduce the risk of
exposure to mosquitoes that bite from dusk to dawn (evening, night,
and early morning time). - Apply insect repellent to exposed skin. Use DEET-based products
only on exposed areas of skin. Remove the repellent with soap and
water when it is no longer required. - Cover up! The less exposed skin you have, the less likely you are
to be bitten. Wear light-coloured, long-sleeved shirts and long pants. - Sleep under a mosquito net. Mosquito nets protect you when you're
sleeping. Permethrin-treated nets are much more effective than
untreated nets and are safe for children and pregnant women. - Consider your accommodations. When possible, remain in
well-screened or completely enclosed, air-conditioned areas.
More detailed information on preventing mosquito bites can be found
in the Statement on Personal Protective Measures to Prevent Arthropod
Bites
Canada Communicable Disease Report Volume 31 ACS-4, 15 May
2005, available at
<
www.phac-aspc.gc.ca/...-dcc-4/index.html>;
2. Take antimalarial medication (prophylaxis)
Antimalarial medications decrease the risk of developing symptomatic
malaria. Your individual need for antimalarial medications should be
discussed with your physician or travel medicine professional at
least 6 weeks before travel.
If your physician or travel medicine clinic prescribes an
antimalarial medication, it is important that you take it as directed
in order to maximize the protective effect. Each drug has its own
dosing regime that should be strictly followed.
A traveller must seek medical attention as soon as possible for
unexplained fever that arises during or after travel to an area where
malaria occurs.
If identified early and treated appropriately, almost all malaria can
be completely cured. However, even short delays in the diagnosis of
malaria can make treatment more difficult and less successful.
For more detailed information, visit the Public Health Agency of
Canada's Disease Information Backgrounder on malaria at
<
www.phac-aspc.gc.ca/...fo/pal_mal_e.html>;.
Monitor your health --
If you have been taking medication to prevent malaria while
travelling, you must continue to take it for the full course
prescribed, even if that means after your return to
Canada. If you
have been to an area where malaria occurs and you develop fever
within a year of returning home (especially in the 1st 3 months),
inform your doctor immediately. Anti-malarial medication doesn't
guarantee absolute protection against malaria. If you become ill on
your return and malaria is suspected, a blood test is recommended.
PHAC strongly recommends that Canadian travellers consult their
personal physician or a travel clinic at least 6 weeks prior to
international travel regardless of destination, for an individual
risk assessment to determine their individual health risks and their
need for vaccination, preventative medication, and personal
protective measures.
PHAC recommends, as well, that travellers who become sick or feel
unwell on their return to
Canada should seek a medical assessment
with their personal physician. Travellers should inform their
physician, without being asked, that they have been travelling or
living outside of
Canada, and where they have been.
