Standby Emergency Treatment for Malaria

The disease

Malaria is a disease which can be fatal within a few days. Since it is spread by infected mosquito bites you should cover your skin up with suitable clothing, use effective insect repellents and a mosquito net when necessary.
Preventive antimalarial tablets are important when you are at high risk but they are never 100% effective so always seek prompt medical attention if you get a fever. Malaria almost always starts with fever.
The illness usually begins with serious shivering, fever and sweating. Muscle pains, headache and vomiting are common. A few days later, jaundice (a yellow colour first seen in the white of your eyes), dark urine, diarrhoea and confusion can develop. The most serious form of malaria can cause illness from around 8 days after being bitten by an infected mosquito.
The illness can start while you are taking preventive tablets if they are not fully effective, and can also come on after you have finished taking your tablets.

You may be advised to carry with you a course of standby emergency treatment for malaria if travelling to areas remote from medical attention or in areas where medical facilities are poor.
If so, your doctor will explain what is the most suitable standby emergency treatment for you.
Make certain that you fully understand the correct dosages, how to recognise possible side effects and what to do about them, safe storage of tablets, and when you should use it.
There are various possible standby emergency treatments including atovaquone/proguanil (Malarone®) or Co-artemether-lumefantrine (Riamet®) on their own OR quinine taken together with doxycycline

Atovaquone/proguanil can cause nausea and diarrhoea.
Co-artemether-lumefantrine can cause dizziness and fatigue.
Quinine can cause nausea and sickness and also tinnitus (a buzzing in the ears).
Doxycycline can cause rashes.
Always discuss these, and other potential side effects, and what to do if they happen with your prescriber before you leave.

Always make sure you are clear about how to use your standby emergency treatment before you leave and check any instructions given on the bottle or packet.
- You should be provided with a Standby Emergency Treatment Traveller Information Leaflet.
It is usually safer to take standby emergency treatment that is not needed rather than to risk becoming seriously ill when no medical facilities are available.
If you have taken standby emergency treatment you must still seek medical advice as soon as possible. This is to ensure your treatment has been adequate and that no other illness is involved.
The doctor will also check that no complications have occurred, and you may need to discuss whether to change or start taking preventive antimalarial tablets.