Airlines should be legally required to warn travellers about malariaBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e463 (Published 17 January 2012) Cite this as: BMJ 2012;344:e463
All travel agents and airlines should be legally required to warn travellers about malaria if they sell flights or holidays to high risk regions, a specialist has said.
David Lalloo, a professor at the Liverpool School of Tropical Medicines, said that between 1400 and 2000 new cases of malaria and between five and 16 deaths are now reported in the United Kingdom every year. Of these cases 60% occur in UK citizens who travel to visit family and friends in countries where malaria is endemic and 63% are in patients (infected with Plasmodium falciparum) who had not taken antimalaria prophylaxis. Professor Lalloo was speaking on the issue of malaria in the UK at an all party parliamentary group on malaria and neglected tropical diseases on 11 January.
“The Gambia is a favourite winter sun destination for UK travellers,” said Professor Lalloo. “Since 2000, more deaths from malaria in the UK have been associated with the Gambia than with any other country, although no deaths were reported in 2010 or so far in 2011.”
Sarah Kline, executive director of the charity Malaria No More UK, said that raising awareness and educating the public about the risk of malaria and the importance of taking antimalarials is essential.
But Professor Lalloo said that raising awareness about malaria in the UK presented several challenges. Firstly, many communities consider the risk of malaria to be a minor issue, particularly if they were born in a malaria endemic country, and people often mistakenly believe that they have natural immunity.
He pointed to the increasing trend of booking travel at the last minute, leaving less time for people to consider vaccinations and appropriate prophylaxis.
“People will pay for flights but won’t pay for vaccinations,” said Professor Lalloo. “I would personally favour legislation that obliged travel agents and airlines to highlight the risk of malaria if they sell flights or holidays to high risk regions. Responsible travel companies already do this, but all should.”
He also cited the problem of people taking homoeopathic remedies as prophylaxis for malaria. Several websites advocate it as a form of prevention, he said. One case of a UK patient dying from malaria after taking a homoeopathic remedy had recently been reported, he added.
Improvements could also be made in the clinical setting, particularly in areas of the UK where malaria would not typically be at the forefront of healthcare workers’ minds.
“The main issues is that there is failure at several levels,” said Professor Lalloo. “People do not get pre-travel advice, take no or inadequate precautions, delay seeking help on return, and do not mention foreign travel. The medical profession does not ask frequently enough about travel history and does not always think of malaria or respond rapidly enough.”
Cite this as: BMJ 2012;344:e463
bmj.com News: Regulator drops cases against pharmacies offering homoeopathic malaria prophylaxis (BMJ 2011;342:d338, doi:10.1136/bmj.d338)