Patient information · Travel health
Travel health and malaria
plan six weeks ahead, and know the fever rule
Most travel illness is preventable. The two things that matter most are starting early enough for vaccinations to work, and taking malaria seriously — including on the return, because a fever after travel is an emergency until proven otherwise.
Seek medical help the same day if, during or after travel, you have
- a fever within a year of visiting a malaria area — and urgently within three months
- fever with confusion, drowsiness or a seizure
- bloody diarrhoea, or diarrhoea with a high fever
- jaundice, dark urine, or severe abdominal pain
- a rash that does not fade under a glass, or a stiff neck
- an animal bite, scratch or lick on broken skin abroad — rabies treatment is time-critical
Falciparum malaria can kill within 24 hours of the first symptoms and typically presents as flu without any distinctive feature. Always tell the clinician where you have travelled, even months later. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Timing
What you need depends on destination, season, rural or urban travel, accommodation, planned activities, length of stay, your age, pregnancy and medical history. A trekking trip and a beach resort in the same country carry different risk.
Vaccinations to consider
- Routine cover first — tetanus, diphtheria, polio, MMR and COVID. A great many travellers are overdue on these, and measles is circulating widely.
- Hepatitis A and typhoid for much of Asia, Africa and Latin America.
- Hepatitis B for longer stays, healthcare work, or where medical treatment might be needed.
- Yellow fever — required for entry to some countries and only available at registered centres.
- Rabies for remote travel, long stays, cycling and working with animals.
- Meningitis ACWY — mandatory for Hajj and Umrah, and advised for parts of Africa.
- Japanese encephalitis, tick-borne encephalitis and cholera for specific itineraries.
Visiting friends and relatives carries the highest risk
Travellers returning to a country of family origin account for a large share of imported malaria and typhoid in the UK. The reasons are consistent: longer stays, rural areas, staying in family homes rather than hotels, eating locally, less use of nets and repellent, and an assumption that childhood exposure confers lasting immunity. It does not. Any protective immunity fades within a year or two of leaving. If you grew up somewhere malarial and are going back, you need the same precautions as anyone else — and children born here have none at all.
Malaria prevention — the ABCD
- A — Awareness of the risk at your specific destination and season.
- B — Bite avoidance. The mosquitoes that carry malaria bite between dusk and dawn. Use DEET repellent, cover arms and legs after dark, sleep under an insecticide-treated net, and use air conditioning where possible. Bite avoidance also protects against dengue, Zika and chikungunya, for which there are no tablets.
- C — Chemoprophylaxis. Antimalarial tablets, chosen for your destination and health. Start before you go, take them throughout, and complete the course after you return — this is the step most often abandoned, and it is when infection declares itself.
- D — Diagnosis. Any fever during or after travel needs testing for malaria the same day.
Food, water and travellers' diarrhoea
- Boiled, bottled or properly treated water; avoid ice and unpasteurised dairy.
- Food that is thoroughly cooked and served hot; fruit you peel yourself.
- Treat diarrhoea with oral rehydration salts. Loperamide is reasonable for adults without fever or blood in the stool.
- Seek help for bloody diarrhoea, high fever, or symptoms lasting more than a few days.
- Standby antibiotics may be appropriate for remote travel — discuss it before you go.
Why come to us. We provide a full travel health consultation with a risk assessment for your specific itinerary, not a generic list — and administer the vaccinations here the same day where possible. We can also bring your routine vaccinations up to date, provide antimalarials and travel medication letters, and issue fitness-to-fly documentation. We are open seven days a week, 9am–7pm, which suits last-minute travel, and many of our clinicians speak the languages of the communities we serve.
Travel consultation and vaccines the same day
Seven days a week, 9am–7pm. Book six weeks ahead where you can.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.