Malaria: One Thing You Must Be Aware Of On Your African Safari

Although we have written an article in the past on Malaria, Steve and I concurred that what happened to us on our recent trip to the Dark Continent would be interesting for this installment.

A typical Tonga fishing village and also breeding ground for the Anopheline mosquito, the carrier of the dreaded disease Malaria.

Having been on many safaris in the past to South Africa, Botswana and Zimbabwe, we have only taken malaria prophylaxis (prevention medication) one time and that was our first trip to Africa. The CDC recommends malaria prophylaxis for all trips to Africa, but it doesn't take into account exactly where or what time of the year you will be visiting the locality. We imagine that you're thinking that The Hunt Doctors don't follow the recommendations of the CDC but in all reality we do.

The difference is that we've always hunted in the middle of the African winter, or "dry season" as it's called and the areas we frequent are devoid of mosquitoes that time of the year. We've never even seen a mosquito on our trips and some parts of South African are known as malaria free zones to boot.

So on this particular trip, nothing was out of the ordinary as far as traveling nor the areas we would be hunting. We flew into Bulawayo, Zimbabwe and drove northwest towards Hwange National park for the first part of our hunt where we hunted buffalo and plains game. As expected, the area was bone dry and not a bug to be found. After successfully taking our intended game, we moved up north to hunt hippo in the Lake Kariba area.

Through discussions with local villagers, we quickly learned that large male hippos were plentiful around all the villages, but unfortunately they only came out of the water at night and kept a wary eye out when surfacing for air during the day. We found that odd as the hippos faced very little hunting pressure and the local villagers steered clear of these dangerous beasts.

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The process of finding a big bull involved climbing a surrounding hill and glassing a pod of hippos resting in the still, weed-choked water of a back bay off the lake, studying them as they surfaced for a shooter before they submerged again. It was extremely difficult keeping straight which animal was surfacing where.

After finding a large pod located in an area that was amenable to being stalked, Steve and I sat under the shade of large bush high up on the steep bank to avoid being seen by sharp-eyed hippos. While we were sitting, we started being bitten by what we perceived to be a less potent variety of our South Carolina fire ants. The bites burned some, but the pain was tolerable and diminished quickly.

We searched in vain for our tormentors, looking all around us on the ground and vegetation but to no avail. After putting up with this for close to an hour while glassing the hippo pod, we noticed that none of our fellow companions were having a similar problem sitting in the sun just back from us, so we moved.

After inquiring what was biting us in the shade, we were nonchalantly told that it was the Anopheline mosquito that carries the dreaded malaria.

We told them it couldn't be since we never heard them buzzing around or saw them flying...also the bites didn't itch or whelp up like a normal mosquito bite.

"Exactly" was the response by one of the PHs.

"That is the tell tale sign of the female Anopheline mosquito," he went on to say, "and according to the last survey, 20 percent of the mosquitoes in this area carry malaria due to the proximity to all these villages"

A fine representation of a Zimbabwean hippo

Well that was just great information since none of us were taking malaria prophylaxis and had at least 100 bites between us. On top of that, Steve's fully stocked medical kit never arrived in Africa. We ended up taking a full treatment course of antibiotics when we got home.

The hippo hunting was vastly successful with two huge bulls being taken and we were able to witness the absolute chaos that ensued over the meat by the villagers. It was amazing seeing 150 villagers swinging axes and knives into the carcass with total disregard for themselves and those around them just to obtain any part of the hippo. In a scant 20 minutes, all that remained was a blood spot.

Malaria is still frightfully common. There are 200-300 million cases per year of which two to three million are fatal. We realize that these numbers sound abstract and may be difficult to relate to, but they are certainly real. Every PH will tell you they have had malaria many times.

The dreaded disease is transmitted by the Anopheline mosquito. When this critter draws its blood meal from you, it leaves behind a parasite called Plasmodium. There are four varieties of this parasite: Falciparum, Vivax, Ovale and Malariae. While all are nasty, some are clearly nastier than others.

After the photos were taken, chaos ensued with the local villagers as they "butchered" the kill for table meat.

The parasite has a remarkably complex life cycle. Basically the Plasmodium parasite enters your red blood cells after the mosquito infects you. It then greatly multiplies in your red blood cells until these cells literally break open and release numerous new parasites that repeat this cycle. Other organs can be infected and there can be dormancy.

The first symptoms resembling a virus illness appear after 5 to 15 days depending on which type of malaria you have contracted. These symptoms consist of headache, fatigue, muscle aches and mild abdominal discomfort. Classic malarial symptoms of pain, high fever and chills begin to occur every 48 to 72 hours depending on which type of malaria you have. These rigors and paroxysms are the result of the parasite exploding your red blood cells and surging into your blood stream until they settle in uninfected red blood cells and repeat the cycle. Without treatment, severe complications can occur because of small blood vessel damage

that results in destruction of lung, brain and kidney tissue. Ultimately this can lead to death especially with the Plasmodium falciparum.

Plasmodium falciparum is the most virulent of this parasite family with highest complications because of its high rate of reproduction. Plasmodium vivax and ovale are less dangerous with malariae bringing up the rear simply because its rate of reproduction is the slowest of the four types. With these bad boys, less dangerous is still quite dangerous. The ovale and vivax varieties can leave dormant parasites in your liver which can take up to 6 to 12 months for them to reactivate and cause relapsing malaria. That means you can get the symptoms of malaria up to one year after your trip when you thought all was safe. Isn't prevention sounding better all the time?

Dr. Paul Plante and PH Johan Van Der Merwe stand next to an African Thorn Acacia or Fever Tree Acacia, which grows near marshy areas and riverbanks and at one time was believed to be the cause of malaria. In reality, the tree doesn't cause diseases, but actually carries multiple legitimate medicinal properties.

The diagnosis is easy if malaria is suspected because a simple stain of your blood smear will confirm the diagnosis to your doctor. It's also possible to have two types of malaria at the same time (occurs 5 percent of the time). As with most parasitic infections, you will build little immunity regardless of how many times you get exposed. And there are no vaccines.

Preventing malaria can be broken into three distinct approaches. Mosquito control via the judicious use of insecticides and drainage of breeding sites works but are not adequately employed in most countries that we hunt in. Simply using an insect repellent containing DEET can be a lifesaver. You shouldn't worry about the smell spooking game; you already play the wind when you hunt. The third option is to take prophylactic medications. You'll note that we do not suggest quinine. Yes the native "fever tree" (pictured with Paul and PH Johan Van Der Merwe) has retained some usefulness still, but it is inadequate these days.

Chloroquine is also less useful then it once was because of the emergence of resistant strains of the parasite(s). The dose is 500mg one time per week starting one week prior to travel and continuing for four weeks after your return. It's pregnancy safe and the side effects are minimal. They include headache, dysphoria and itching in folks with darker skin.

Larium (mefloquine) is used in areas that have chloroquine resistant malaria which includes most of Africa, South America and Southeast Asia. The preventative dose is 250mg one time per week starting one week prior to travel and continuing for four weeks after your return. It's also pregnancy safe but does carry the side effects of nausea, dizziness, psychiatric symptoms and disturbed sleep.

Doxycycline at 100mg per day is an alternative to Larium but isn't pregnancy safe, shouldn't be used in children and causes skin sensitivity to the sun.

Malarial resistance and endemic geographic patterns are constantly in flux. Instead of providing you with data that is likely to be less than accurate down the road, we urge you to look at the CDC website (www.cdc.gov/travel) or make a phone call to their travel hotline; FYI TRIP at 1 877-394-8747 prior to your hunt.

In conclusion, planning and prevention are the order of the day. It's not the other guy who always gets sick. It can be you too. Malaria is the real deal and must be treated that way. Copy this article and file it away for future reference. BE SAFE and ENJOY THE OUTDOORS.