Malaria is endemic in more than 105 countries. With travel predicted to grow to nearly 1.6 billion international arrivals by 2020, travellers will be at increased risk of exposure.1 2 The linked observational study by Smith and colleagues substantiates the public health concerns regarding the prevention of malaria in migrant families in the United Kingdom.3 4 The authors report that cases of imported malaria significantly increased between 1987 and 2006, with an increasing proportion attributable to Plasmodium falciparum rather than Plasmodium vivax.

The increase in cases of imported malaria is not unexpected. It reflects the increase in the number of visits abroad by UK residents—70.5 million in 2007—together with a 150% increase in UK residents travelling to malaria endemic areas during the past decade.5 One notable change is that with improved vector control in Asia, most cases are …