The TRAVELER'S JOURNAL: August sixteenth, avoiding the world's most prevalent parasitic disease.

Last time, we looked at preventative vaccinations travelers might need, depending on where they're headed. But there's still no shot against malaria. With 400 million annual cases and some three million deaths worldwide, malaria is a problem. Most victims are indigenous population in rural areas of Asia, Africa, South and Central America. But malaria also strikes 10,000 travelers a year, a number that's rising with the popularity of adventure travel. And it's getting worse.

The mosquitoes that spread the disease are increasingly resistant to eradication efforts. Same for the various viruses that cause it. Chloroquinine tablets, the most common malaria prescription, are ineffective on cases in India and South Pacific islands. Larium, a widely prescribed alternative, has been linked to nasty psychological reactions, from depression to hallucinations. Doxycycline, another drug used to treat malaria, can also have unfortunate side effects. A fourth drug, proguanil, boosts chloroquinine, but isn't approved in the U.S., even though sold over the counter in Canada and Europe. There's talk of a possible vaccine, but it's still years away.

Until then, the best prevention is take the medicine appropriate to your destination and health and to not get bitten. That means avoiding being out at night when mosquitoes feed and, when you have to, covering all bare skin. You can make yourself less appealing to mosquitos by taking vitamin B6 or coating yourself with various bug sprays. But never take malaria for granted. Although it can usually be cured, its symptoms are distinctly unpleasant, and occasionally fatal. 

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