The SA National Institute for Communicable Diseases (NICD) released an advisory on increased malaria risk in three provinces earlier December, with travellers advised to take precautionary measures if travelling to affected regions. Traveller24 reports that South Africa has seen an alarming rise in malaria cases over the last few months. This spike has been attributed primarily to unseasonably high rainfall and levels of humidity.
The report says many South Africans regard malaria as a problem outside of South Africa’s boarders, however, now malaria cases have become more prevalent in SA, making it increasingly important to increase awareness and educate ourselves about the disease.
The NCID announced that there’s an extended seasonal risk of malaria, with an increase in number of cases of severe malaria, specifically in Limpopo, Mpumalanga and northern KwaZulu-Natal, including the Kruger National Park. Travellers are also advised to look out for symptoms as early diagnosis can prevent death from the deadly disease.
The organisation especially advises safari tour operators taking clients on long safaris to have the necessary medication on hand for when they are far out of reach of medical care. This includes taking preventative malaria medication before the trip, and advising their clients to do the same. You can also spray or soak clothes in permethrin, wear long sleeves and pants and carry mosquito nets and repellants.
Operators should also make sure to have malaria rapid diagnostic tests on them and know how to use them properly, as well as carry emergency anti-malarial therapy, namely Co-artem.
The report ays if it is determined someone has malaria or shows sypmtoms, it’s crucial to take Co-artem immediately as the first 48 hours is crucial in minimising the severity of the disease.
The NICD said in warning December: “In keeping with the general increase in malaria incidence in South Africa in 2017 as previously described in the Communique, numbers of malaria cases and deaths (1 414 and 10, respectively) reported in November showed a substantial increase compared with the same period in 2016 (294 cases and two deaths). However, incidence has reduced from the October 2017 period, when 3 488 cases were documented (Figure 3).
“In November, 90% of the malaria cases were in Limpopo and Mpumalanga provinces, which remain the dominant sources of cases. Vhembe and Mopani districts provided the majority (90%) of Limpopo Province’s cases, while in Mpumalanga Province, Bushbuckridge, Nkomazi and Mbombela districts provided 94% of the provincial total. In Mpumalanga Province, 62% of cases were classified as locally transmitted, and 38% as imported, mostly from Mozambique. Malaria case numbers in the third endemic province, KwaZulu-Natal, were low (34, compared with 189 in October, and 30 in November 2016).
“Provincial malaria control programmes are currently busy with annual indoor residual spraying and other malaria control and surveillance activities. An above normal to high risk of outbreaks across the malaria transmission areas of the southern African region is forecast, based on local and regional trends and temperature and rainfall patterns.
“Travellers to malaria risk areas during the holiday season are advised to take necessary precautions against malaria (avoidance of mosquito bites, use of repellents and appropriate antimalarial drug prophylaxis).
“Healthcare professionals in both transmission and non-transmission areas should consider the possibility of malaria in any patient with unexplained fever, particularly if there is history of travel, but also remember that infected mosquitoes may travel and transmit malaria in nonendemic places (odyssean malaria; see NICD Communique Vol 16(10), October 2017). Updated guidelines for the prevention and treatment of malaria are available at www.nicd.ac.za.
There has been a spike in the number of malaria cases in Limpopo, with farmers reporting many cases of workers being affected. Farmers Weekly quotes Agri Limpopo CEO Willem van Jaarsveld as saying that some members of his organisation had been supplying malaria test kits and medication to other farmers in need of them.
Professor Lucille Blumberg, an infectious diseases specialist at the NICD, said that that although this was currently ‘high season’ for malaria, the number of cases had been almost three times above the average. The drought of recent year had reduced the number of outbreaks as mosquitoes. By contrast, the recent high rainfall, humidity and heat had created the optimal environment for parasite development, she said.
According to Blumberg, government had cut back on anti-malaria spraying programmes as there had been fewer cases of the disease during the years of drought. Spraying had nonetheless been ongoing.
Malaria presented particular difficulties for farmworkers as they were far from health facilities, and mobile clinics seldom visited rural areas, she said. Affordable methods of preventing malaria included applying mosquito-repellent products such as Tabard, and covering up exposed skin by wearing long trousers and long-sleeved shirts, especially if outside at dusk or dawn.
“People have to be aware that there are more cases than usual and any flu-like symptoms such as tiredness, fever or headache should be seen as a possible case. Testing for malaria should be conducted as soon as possible. If done timeously, malaria is amenable to treatment, but waiting could lead to complications such as kidney damage or cerebral malaria (which was fatal),” Blumberg said.
She added that farmers should cooperate with government teams spraying pesticide against malarial mosquitoes and allow them to do their work.