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Malaria is an infection of the liver and red blood cells caused by microscopic parasites. There are five types of parasites that cause malaria: Plasmodium ovale, P. malariae, P. knowlesi, P. vivax and P. falciparum. Malaria parasites are spread through the bite of certain mosquitoes. Mainland Australia is free of malaria, but malaria is occasionally present in the Torres Strait Islands. Australians can contract malaria while travelling in tropical and subtropical areas of Asia, Africa, Central and South America, the Pacific Islands and parts of the Middle East. Currently, approximately 500 cases of malaria are diagnosed in Australia each year - almost all are in people who have travelled to malaria-affected countries and didn't take anti-malarial medications.

Symptoms of malaria include sudden fever, chills, headache, sweating, nausea, vomiting and pain in joints and muscles. In severe cases symptoms can include seizures, confusion, kidney failure, breathing difficulty and coma. The infection is sometimes fatal. Malaria caused by the Plasmodium falciparum parasite can be especially dangerous. Malaria symptoms usually develop 9-14 days after being bitten by an infected mosquito. Occasionally symptoms develop weeks or months later. Some types of malaria can re-occur months or years after exposure.

Malaria is spread through the bite of the female Anopheles mosquito. The malaria parasites live inside the gut and salivary glands of an infected mosquito. When a person is bitten by an infected mosquito, the parasites are injected into the person's blood. The parasites then infect the liver and blood cells. When a mosquito bites a person with malaria, the mosquito may become infected and can then spread the disease.

In rare cases, malaria can also be spread from person to person through blood transfusion, sharing injecting equipment, and from mother to foetus.

Any person who lives in or travels to a country where malaria is present is at risk of contracting the disease. The risk is usually higher in rural areas than in cities. Those at increased risk include:
  • Pregnant women: Malaria can be more severe in pregnant women. Malaria can also increase the risk of miscarriage, premature labour and stillbirth.
  • Young children: Children of any age can get malaria. When children get malaria, the disease can progress very rapidly. Malaria can be more severe in children, especially those aged under 5. Pregnant women and young children are sometimes advised not to travel to malaria-affected areas if the risk is especially high.
  • People visiting friends and relatives overseas: People returning to malaria-affected areas to visit friends and relatives are often at high risk of getting malaria. This is because immunity against the malaria parasite wanes quickly, and people visiting friends and relatives in malaria-affected areas may not be aware that they need to avoid mosquitoes.M

Overseas travellers can prevent malaria by avoiding mosquito bites and taking preventive antimalarial drugs that kill the parasite.

Four to six weeks before travelling overseas, visit a GP or a travel health clinic for specific advice about avoiding malaria based on your itinerary and medical history.

Depending on the risk of malaria in the areas you are visiting, you may be advised to take drugs to prevent malaria. The choice of antimalarial depends on a range of factors including the drug resistance patterns of malaria in the areas you will visit.

It is important to take antimalarials exactly as advised by your doctor. All antimalarials need to be taken before, during and after you travel. Some need to be started several weeks before you travel. It is also very important to continue taking antimalarials as directed after you leave the affected area. Sometimes this means taking antimalarials for up to 4 weeks after you leave.

No antimalarial drug is 100% effective. Travellers taking antimalarial drugs still need to protect themselves from mosquito bites. Mosquitoes can carry other diseases too - another reason to avoid being bitten.

To protect against mosquitoes and reduce the risk of diseases they transmit:
  • Cover-up with a loose-fitting long sleeved shirts and long pants when outside
  • Apply mosquito repellent to exposed skin
  • Take special care during peak mosquito biting hours. The mosquitoes that transmit malaria are most a twilight hours (dawn and dusk) and into the evening.
  • Stay and sleep in screened or air-conditioned rooms
  • Use a bed net if the area where you are sleeping is exposed to the outdoors. Nets are most effective when they are treated with a pyrethroid insecticide, such as permethrin. Pre-treated bed nets can be purchased before travelling, or nets can be treated after purchase.
  • Avoid known areas of high mosquito-borne disease transmission or outbreaks.

For more detailed information on reducing the risk of mosquito bites at home and while travelling see the Mosquitoes are a Health Hazard information. This also includes more information on mosquito repellents.

Malaria is diagnosed by special blood tests that detect malaria parasites. It is important that your doctor knows about your travel history and symptoms so the right blood test can be ordered.

If you become ill with symptoms of malaria while overseas or after travelling, visit a GP or hospital emergency department as soon as possible. Tell the doctor where you have travelled, as this will help to make the right diagnosis. If you are travelling to a remote area where you know it will be difficult to access medical care, you may need to be prepared to treat yourself for malaria if you get symptoms (as well as taking drugs to prevent malaria). Speak to your doctor about this before you travel.

Laboratories are required to notify cases of malaria on diagnosis to the local public health unit.

Further Information
For further information on safe travel see Staying healthy when travelling overseas. The Smartraveller website also has health advice for specific destinations.
For more information about malaria and other travel health topics, refer to the US Centers for Disease Control and Prevention Travelers' Health site.
For further information please call your local Public Health Unit on 1300 066 055

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Autism & Immunisation

Immunisation DO NOT cause autism

How do we know?
A number of high quality studies have compared the health of large numbers of vaccinated and unvaccinated children over many years. The largest study included 537,303 children born in Denmark and found that unvaccinated children were just as likely to develop autism as vaccinated children. When the results of this study were combined with the results of nine other studies to include medical information from nearly 1.5 million children living all around the world, researchers were able to confirm that vaccination could not be causing autism.

Then, what causes autism?
It is not known exactly why some children develop autism. The idea that vaccination caused autism was attractive to some people who wanted to find a clear cause. However, this idea arose from a few studies that were badly conducted and have since been proven wrong. Current research suggests that autism cannot be explained by a single cause, but is probably due to a combination of developmental, genetic and environmental factors.

What about autism?
Many large studies have found vaccines do not cause autism. If you would like more information, you can call the Immunise Australia Information Line on 1800 671 811.

So, where did the misunderstanding come from?
In 1998, a research group in the UK, led by Andrew Wakefield, suggested that some children who had received measles-mumps- -rubella (MMR) vaccine went on to develop bowel disease and developmental disorders such as autism. The results of the research, which had included only twelve children, were published in a respected medical journal. However, the authors retracted their claim that there was any association between vaccination and autism in 2004.

The paper was withdrawn from the journal in 2010 after the General Medical Council found that results reported in the paper had "proven to be false". An apology was printed in the journal. After it became clear that MMR vaccine was not the problem, some people suggested a preservative sometimes used in vaccines that are packaged in multi-dose containers might be linked to autism. The preservative, called thiomersal, is a salt that contains a tiny amount of mercury. The mercury salt in thiomersal is not the kind of mercury compound that accumulates in the human body. None of the vaccines normally given to children in Australia are packaged in multi-dose containers so none of them contain thiomersal or any other form of mercury.

Separate vaccines for measles and mumps are not available in Australia. The idea of using separate measles, mumps and rubella vaccines was first suggested by Wakefield. A study of all of the children born in Yokohama, Japan, found that children who received separate vaccines are no less likely to develop autism than those who receive the combined MMR vaccine.

This fast fact sheet has been developed to help doctors and nurses to answer parents' questions about vaccinations by a group of researchers called the SARAH Collaboration. It was written by Nina Berry PhD and Julie Leask PhD from the University of Sydney, Margie Danchin PhD from the University of Melbourne, Tom Snelling PhD from the Telethon Kids Institute, and Kristine Macartney MD and Melina Georgousakis PhD from NCIRS. SARAH is funded by the Australian Government Department of Health.

Source: www.immunise.health.gov.au

The information in the above were collected from the internet,
either from government websites or from reasonably reliable health information sources.
They are for general information only and should not replace the need of seeking medical care during illnesses.

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