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Prepare against mosquitoes to travel to an exotic country

Malaria, chikungunya, zika, dengue... In many regions of the world, mosquitoes are vectors of serious diseases, sometimes fatal. Before traveling to an exotic country, you must plan effective protection against mosquitoes and the pathogenic organisms they transmit. Our pharmacist answers questions from Lucie, a mother planning an exotic trip.

The risks associated with mosquitoes during an exotic trip

Lucie wants to travel to an exotic country with her husband and children in a few months. She has several destinations in mind (in Asia and South America) but is worried about the presence of mosquitoes in many geographical areas of the globe. Our pharmacist answers his questions.

Lucy :What is the risk of being bitten by mosquitoes during an exotic trip?

The pharmacist :Did you know that mosquitoes cause hundreds of thousands of deaths worldwide each year? For comparison, snakes kill about 100,000 people a year, and sharks only about ten. These insects are vectors for the transmission of infectious diseases that are sometimes serious or even fatal. We find in particular:

Mosquitoes of the genus Anopheles

They can transmit malaria (or malaria ). This disease is present in Africa, Southeast Asia, and South America. It is caused by a parasite called Plasmodium , including one of the most widespread, Plasmodium falciparum , is potentially fatal. It attacks liver cells and red blood cells, is responsible for anemia, headaches, vomiting, weakness and cycles of fevers (malaria attack), and can lead to other complications.

Mosquitoes of the genus Aedes (like the tiger mosquito )

They can transmit:

  • Chikungunya, due to a virus present in Africa and South Asia responsible for disabling joint damage, severe muscle pain and fever. It recently reached Europe and the South of France, and spread to the West Indies before reaching the American continent.
  • Zika fever, caused by a virus present in Asia, Africa, South and Central America. Fever, headache, joint and muscle pain are the main symptoms. The fetus of a pregnant woman infected with Zika could suffer from microcephaly, a malformation responsible for severe mental retardation.
  • Dengue fever, mainly present in tropical and subtropical regions of the world. In strong progression, it even touched Europe recently. The dengue virus is responsible for fever, joint and muscle pain, vomiting, headaches... In some people, the disease can be seriously complicated by dengue hemorrhagic fever . This form can be deadly.
  • Yellow fever, caused by the yellow fever virus also transmitted by other mosquitoes of the genus Haemagogus . It is present in Africa, South America and Central America, and a few cases have even been declared in China. Symptoms resemble those of the flu, but some forms may be complicated by hemorrhagic syndrome with vomiting blood, jaundice (jaundice) and kidney problems.

Culex mosquitoes

They can transmit West Nile fever due to West Nile virus , present in East Africa, around the Mediterranean, in Central Europe and in North America. Only 20% of infections are symptomatic, with sudden fever, joint and muscle pain, nausea and diarrhea, respiratory symptoms. neurological complications can be fatal in the most sensitive subjects.

For more information on these vector-borne diseases, you can consult the website of the Ministry of Health, or the website of the World Health Organization (WHO).

Vaccination and prophylactic treatments

Lucy :Are there means of prevention to protect oneself from these infections?

The pharmacist :There is indeed a vaccine and prophylactic treatments to protect you from some infections carried by mosquitoes. Consult a doctor well before departure to know the vaccinations recommended in the country of destination.

Vaccination

At the start of 2019, there is only one yellow fever vaccine . International regulations require it before any first trip to an endemic area. You will also be asked for the document proving the vaccination when entering endemic countries! A single injection is now enough:it offers lifelong protection.

Please note that your pharmacist will not be able to provide you with the yellow fever vaccine. Only vaccination centers have them:you will therefore have to prepare well before your departure!

It is not possible to get vaccinated against the other infections mentioned above.

Chemoprophylaxis

chemoprophylaxis anti-malarial is sometimes necessary to travel to countries at risk of malaria. This is an oral treatment to protect you from the parasite. Depending on the region of the globe, Plasmodium has become resistant to certain chemoprophylactic molecules. Your doctor will therefore prescribe the recommended molecule for your destination and your condition.

Take care to bring the necessary quantity to cover your stay. Attention, many treatments are to begin the day before departure and to continue up to 3 weeks after the return! The effectiveness of chemoprophylaxis depends on it.

Always keep your prescriptions on you during the trip. They could be required at airports and in the country of destination, and they could be useful in case of health concerns. See also the list of basic medicines to take on a trip.

Provide protection against mosquitoes

Mosquito release times

Lucy :It is said that mosquitoes bite at night. Can we do without protection during the day?

The pharmacist :Mosquitoes of the genera Anopheles (vectors of malaria) and Culex (vectors of West Nile fever) have a mainly nocturnal activity :they usually bite between sunset and sunrise. Be careful though:they can sometimes sting in broad daylight!

Mosquitoes of the genus Aedes (vectors of Zika fever, dengue and chikungunya), for their part, have a rather diurnal activity . Again, this behavior is not exclusive.

It is therefore necessary to protect yourself day and night against bites.

Mosquito repellents

Lucy :How can my husband, my children and I effectively protect our skin against mosquitoes in exotic countries?

The pharmacist :To guard against infections transmitted by mosquitoes, use the recommended synthetic mosquito repellents. They are applied to uncovered skin (face, neck, limbs, etc.). They are formulated from:

  • of DEET :this molecule has been the subject of a documented European evaluation;
  • of IR3535 :already authorized at European level;
  • of icaridin and PMDRBO (para-menthane-3,8-diol) :authorized and under reassessment.

Their effectiveness lasts from 4 to 8 hours. Bathing and sweating eliminate repellents:it is then necessary to apply new ones. Please note that not all of them are compatible with pregnancy. These molecules also work on ticks and other mites, flies and gnats. Ask your pharmacist for advice on choosing the products best suited to the age of your children. If you are breastfeeding, be careful not to apply it to your breasts.

Natural molecules, including essential oils, are not suitable for an exotic trip.

Lucy :The country of our vacation will be very sunny. How to apply mosquito repellent and sunscreen?

The Pharmacist :The synthetic mosquito repellent should be applied 20 minutes after applying sunscreen. To find out more, read the articles Sun protection, How to prepare your skin and repair the harmful effects of the sun.

Clothing and mosquito nets

Lucy :Thanks to synthetic repellents, is it possible to dress in short clothes?

The pharmacist :Synthetic repellents do not exempt you from wearing covering clothing which is an additional bulwark against mosquitoes. You can also impregnate the textile fibers with permethrin , a synthetic repellent that cannot be used on the skin.

Lucy :How to protect yourself from mosquitoes at night?

The pharmacist :The most effective protection during the night remains the mosquito net. The ideal is to opt for a mosquito net impregnated with permethrin. . The bed of adults, the cradle of children can thus be protected. During the day, the mosquito net can even be used to cover a stroller!

For more details on protection against insects, consult the Weekly Epidemiological Bulletin (BEH) of Public Health France.

In any case, in order not to put yourself in danger, never forget to find out about the living and security conditions of the country of destination. Consult the “Tips for travelers” and “Tips by country” pages of France diplomatie.