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‘Super Malaria’: What You Should Know

Recent news reports about ‘super malaria’ are on the minds of many travelers. What exactly is ‘super malaria’ and to what extent should travelers be concerned about it?

Q: What is ‘super malaria’?

A: Super malaria’ is a term coined by the media that refers to resistance strains of malaria which have emerged in the Greater Mekong Sub-region (GMS): Laos, Myanmar, Cambodia, Thailand and Southern Vietnam.  There is no medical or scientific term called ‘super malaria.’

Q: Is ‘super malaria’ new?

A: No, it is not new. The public health and scientific communities have known about it since 2008.  However, based on recently published reports from the region, it is gaining a much larger footprint in Southeast Asia, which has everyone alarmed.

Q: What is malaria resistance?

A: Malaria resistance refers to strains of the parasite which seem resistant to the most commonly and effectively used treatments for malaria.  For many years, the World Health Organization (WHO) has recommended a two-drug therapy for simple infections caused by malaria -- medications commonly referred to Artemisinin Combination Therapy (ACT).  ‘Super malaria’ thus refers to cases in the GMS which are showing resistance to ACTs, something that seems to be more common and growing at an alarming rate.

Q: Is malaria resistance new?

A: No, malaria resistance is not new.  In fact, malaria resistance has been around ever since we’ve figured out how to treat malaria, but we have always been able to develop newer medications or combinations of medicines to combat the resistant infections.

Q: Can ‘super malaria’ be treated?

A: Yes, ‘super malaria’ can be treated.  Health facilities in the region have already begun using a different combination of ACTs, ones that include mefloquine.  Mefloquine is a commonly prescribed malaria prophylactic for people traveling into malaria regions, particularly by US travelers prescribed by US physicians.

Q: What should I do if I plan on traveling to this region?

A: The simple answer is to continue to do all the things travelers should do when traveling into areas where there’s malaria:

  • Use strong insect repellants
  • Be sure to cover your arms and legs to prevent mosquito bites (particularly at sunrise and sunset)
  • Sleep under mosquito nets when they’re available or bring them with you
  • Try to keep windows and doors closed at night when sleeping to prevent mosquitoes from entering your room
  • Check with your doctor to see if you should be taking preventive medications prior to traveling. They’re readily available.

Q: Is there anything else I should do?

A: Yes, you need to be aware of ‘super malaria’ if you’re traveling into a region where it’s known to occur: Laos, Cambodia, Thailand, Myanmar and Vietnam.  For the best updated information, visit the Centers for Disease Control and Prevention (CDC) or WHO websites for country-specific information on places you plan to travel.

Also, travelers going to malaria regions should consider picking up Rapid Diagnostic Tests (RDTs) and treatment medications from the local pharmacies when you arrive in country.  RDTs can be used by you to test yourself or a travel companion with a simple pin prick if you’re worried about malaria. They can also be used when returning home if you develop any symptoms for malaria: fever, headache, body aches, flu-like symptoms, nausea and vomiting.  Remember, it usually takes some time between being bitten by a mosquito carrying malaria until you develop signs and symptoms of the infection.  Picking up medications can also be helpful, as often times these treatment medications are not readily available in the United States.

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