Malaria in South Africa update February 2017
The number of malaria cases has increased over the past two months following on good rainfall in the malaria transmission areas as compared to the same period in 2016 during the drought. The number of cases of malaria are expected to increase in the following weeks. At this stage it is not possible to predict the effects on malaria transmission of cyclone Dineo which struck off Mozambique in mid February and the storms which followed in the Northern and eastern parts of South Africa.
Malaria is a parasitic disease transmitted by certain mosquitoes in the malaria risk areas in South Africa – the far north of KwaZulu-Natal Province bordering Mozambique, the lowveld areas of Mpumalanga Province including the Kruger National Park but excluding Nelspruit and White River, and the north-eastern parts of Limpopo Province (see map).
Typically, malaria infections increase in the South African summer months from September until the end of May.
Measures to avoid mosquito bites are the mainstay of malaria prevention and should be emphasised at all times. Malaria-transmitting mosquitoes feed at night; therefore people should ideally remain indoors from dusk until dawn, in rooms that have screens on the windows and doors. The use of DEET-containing insect repellants to exposed areas of the body from dusk to dawn is advised. The use of drugs to prevent malaria may be considered in addition to personal protection during the summer malaria season.
The risk of malaria in Mozambique, particularly in the northern areas, is higher than in South Africa. As well as mosquito prevention, drugs to prevent malaria are recommended.
Malaria typically presents with flu-like symptoms. Residents and visitors/tourists to malaria risk areas should seek medical assistance urgently should they develop fever, headache, cold shivers and hot sweats and muscle pains. These are typical symptoms of malaria but are also symptoms of influenza. Malaria is commonly misdiagnosed as " flu". Malaria must always be tested for in any traveller to a malaria risk area with flu-like symptoms irrespective of the time of the year, whether the area is low- or high–risk, and irrespective of whether drugs to prevent malaria have been taken. Malaria treatment is highly effective if administered early in the course of the illness. Complications of malaria can develop very quickly and severe malaria is much more difficult to treat.
The differential diagnosis of travellers presenting with fever after a visit to a malaria area is broad. Malaria is the most important infection to confirm or exclude and multiple blood tests should be performed urgently. Tick bite fever is common in South Africa during the summer months and is an important infection to consider. Fever, headache, the presence of a black "scab" and an enlarged lymph node with or without a spotty rash (typically on the palms and soles) are important findings. Blood tests to confirm tick bite fever may not always be positive during the acute stage of the illness and tick bite fever should be treated on the bases of the findings mentioned. Doxycycline is the most effective drug for treatment.
Source: National Institute for Communicable Diseases: Malaria Directorate and National Department of Health
Updated: February 2017