While the emergence of colourful butterflies is a welcome sign of summer, the constant buzzing of mosquitoes is an annoying part of the season.
Mosquitoes are more than just pests. They are the world’s most dangerous animal. Their presence signals the start of the malaria season in southern Africa.
It is for this reason that the Southern African Development Community recognises the first week of November as SADC Malaria Week, with 6 November as SADC Malaria Day.
During this week the dangers of malaria are highlighted. As South Africa edges closer towards malaria elimination, this has become more important as many South Africans are unaware of the malaria risk within the country’s borders.
Read more: The seven steps South Africa is taking to get it closer to eliminating malaria
Know your enemy
Malaria is usually spread through a bite of an infected female Anopheles mosquito. In rare cases, malaria can spread through blood transfusions, organ transplants or sharing contaminated needles.
There is also the possibility that mothers can pass on the disease to their babies while pregnant or during delivery.
Mosquitoes that spread malaria are usually only active between dusk and dawn. Some mosquitoes, particularly the large black and white Aedes mosquitoes, are active during the day. These mosquitoes spread diseases like yellow fever and Zika.
Although malaria-spreading mosquitoes are active at night, they are not the mosquitoes that make the annoying buzzing sound that prevents you from getting a peaceful night’s sleep.
Instead, malaria mosquitoes are near-silent, often referred to as silent killers. Frequently, you only realise you have been bitten when it is too late.
Most malaria vectors tend to bite and rest outdoors. This means that you have to take extra care when outdoors.
Know your enemy’s whereabouts
Malaria mosquitoes require specific environmental conditions to breed and survive.
They are found in low-lying tropical areas in most southern African countries, with the exception of Lesotho and the Seychelles. Angola, the Democratic Republic of Congo, Malawi, Mozambique, Tanzania, Zambia and Zimbabwe have regions of high malaria risk.
In South Africa, malaria is restricted to the low-lying border regions of northern KwaZulu-Natal, Mpumalanga and Limpopo provinces.
Before visiting any of these areas, familiarise yourself with the malaria risk map for South Africa and take the appropriate precautions.
In the southern hemisphere, the malaria risk is particularly high over the December holidays. This is due to the warm, wet weather conditions that favour mosquito growth.
Over the past few years, the non-endemic South African province of Gauteng has reported a high number of cases. This can happen in any province: there have been incidents in the Eastern Cape and Western Cape, as well as the North-West.
Most of these cases are imported from high-risk regions within and outside South Africa.
A few rare cases are the result of odyssean malaria (also known as taxi or airport malaria).
This happens throughout Africa. It is largely associated with migration. This happens when one or more malaria-carrying mosquitoes are accidentally transported from their natural home. They can then randomly infect people outside the malaria-risk area.
When you have an unexplained fever in summer, think malaria. This is true even if you have not travelled to a malaria-risk area.
It is especially important if you stayed near a major transport route or transport hub. These include places such as taxi ranks or bus depots.
Know your enemy’s gameplan
Malaria is preventable and treatable. The odds of a complete recovery are very high if a malaria infection is detected early. This is aided by prompt treatment with effective antimalarial medication.
Symptoms of the milder version of malaria (uncomplicated malaria) are non-specific. This can include fever, headaches, sluggishness, nausea, and muscular/joint pains.
Loss of consciousness, convulsions, jaundice and kidney failure are associated with the more severe, life threatening form of malaria.
Read more: We're a step closer to figuring out why mosquitoes bite some people and not others
Keep yourself safe from the enemy
The easiest way to prevent yourself from getting malaria is to avoid being bitten by an infected mosquito.
If outdoors during the evening, wear long-sleeved shirts, trousers and socks, and use repellents that contain at least 30% of the insect repellent DEET.
Doors and windows should be screened. Where possible, sleep under a bednet or in an air-conditioned room.
In addition to these non-pharmaceutical measures, you can protect yourself by taking anti-malarial medications which you can get from a pharmacy or primary healthcare clinic.
Discuss your anti-malarial options with a healthcare professional.
Medication that prevents malaria does not mask the symptoms of the disease.
The recommended treatment in South Africa, artemether-lumefantrine (Coartem), is highly effective. This is the most widely used malaria treatment across Africa.
Know the myths about the enemy
You cannot get malaria from drinking contaminated water or eating rotten fruit.
There is limited evidence that vitamin-enriched products or home remedies containing natural products like citronella offer any protection against malaria.
In addition, tonic water contains a very low concentration of antimalarial ingredients. It is therefore not possible for one person to drink sufficient quantities to protect against malaria.
Crucially, one malaria infection will not keep you safe from future infections. You can get malaria more than once.
Finally, always be aware – although the malaria risk is higher in summer, you can also get the disease in the dry season. You could also potentially be infected in any province due to an infected travelling mosquito.
So if you have an unexplained fever, think malaria!