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Articles » Preventing Malaria in the Pregnant Woman: DPD
 

Preventing Malaria in the Pregnant Woman: DPD

Article title: Preventing Malaria in the Pregnant Woman: DPD

Conditions: Malaria

Source: DPD


 


Information for the Public:

Preventing Malaria in the Pregnant Woman

 

See Your Health Care Provider

  • 4–6 weeks before travel if your trip is outside the United States or Canada.
  • Find out what shots and prescriptions you need.

Know Your Risk

  • Malaria is a serious but preventable disease spread by the bite of an infected mosquito.
  • Anyone, any age, can contract malaria.

CDC has three sources of information about malaria risk and prevention:

  • Toll-free Voice Information Service. Call 1-877-FYI-TRIP.
  • Toll-free Fax Information Service. Call 1-888-232-3299 and listen to the instructions. Request document number 000005 for a directory of all available travel faxes.
  • The CDC Travelers' Health website.

    Identical malaria prevention information is provided at the CDC website and through CDC's toll-free Fax Information Service.

Caution: Travel During Pregnancy Is NOT Recommended

It is best if you can postpone travel to a malaria-risk area during your pregnancy. If you must travel, take an antimalarial (a drug to prevent malaria) and prevent mosquito bites to reduce, but not eliminate, the risk of developing malaria. Experience with the antimalarial chloroquine and limited experience with the antimalarial mefloquine indicate that they are safe to take during pregnancy, including the first trimester. Pregnant women should NOT take Malarone™ or doxycycline to prevent malaria.

Find Out Which Antimalarial Is Recommended for You

  • Antimalarials are available only by prescription through a health care provider.
  • The kind of antimalarial you are prescribed will be based on the area of the world in which you are traveling and any other medical conditions you may have.
  • Your health care provider will prescribe one of the following antimalarials. Find the drug below; read the directions for use and side effects. If you have any questions about the drug recommended, call your health care provider or pharmacist.

Antimalarial Warnings and Instructions

  • Overdosage of antimalarials can be fatal. Keep drugs in childproof containers out of the reach of children.
  • Take antimalarials exactly on schedule without missing doses.
  • Buy antimalarials in the United States before travel overseas. The quality of antimalarials sold outside of the United States may not be reliable.
  • Pregnant women traveling to malaria-risk areas in South America, Africa, the Indian subcontinent, Asia, and the South Pacific should take mefloquine as their antimalarial drug.

Mefloquine/ brand name Lariam®*

Directions for use

  • The adult dosage is 250 mg (one tablet) once a week.
  • Take the first dose of mefloquine 1 week before arrival in the malaria-risk area.
  • Take mefloquine once a week, on the same day each week, while in the malaria-risk area.
  • Take mefloquine once a week for 4 weeks after leaving the malaria-risk area.
  • Mefloquine should be taken on a full stomach, for example, after dinner.

Mefloquine side effects
Most travelers who take mefloquine have few, if any, side effects. The most commonly reported minor side effects include nausea, dizziness, difficulty sleeping, and vivid dreams. Mefloquine has very rarely been reported to cause serious side effects, such as seizures, hallucinations, and severe anxiety. Minor side effects usually do not require stopping the drug. Travelers who have serious side effects should see a health care provider.

Do NOT take mefloquine if you have

  • Ever had an allergic reaction to mefloquine;
  • Epilepsy or other seizure disorders;
  • A history of severe mental illness or other psychiatric disorders;
  • Been diagnosed or treated for an irregular heartbeat.
  • Pregnant women traveling to malaria-risk areas in Mexico, Haiti, the Dominican Republic, and certain countries in Central America, the Middle East, and Eastern Europe should take either chloroquine or hydroxychloroquine sulfate as their antimalarial drug.

Chloroquine/ brand name Aralen®*

Directions for use

  • The adult dosage is 500 mg chloroquine phosphate once a week.
  • Take the first dose of chloroquine 1 week before arrival in the malaria-risk area.
  • Take chloroquine once a week, on the same day each week, while in the malaria-risk area.
  • Take chloroquine once a week for 4 weeks after leaving the malaria-risk area.
  • Chloroquine should be taken on a full stomach to lessen nausea.

Chloroquine side effects
Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching can occur. Chloroquine may worsen the symptoms of psoriasis.

Hydroxychloroquine sulfate/ brand name Plaquenil®*

Directions for use

  • The adult dosage is 400 mg hydroxychloroquine sulfate once a week.
  • Take the first dose of hydroxychloroquine sulfate 1 week before arrival in the malaria-risk area.
  • Take hydroxychloroquine sulfate once a week, on the same day of the week, while in the malaria-risk area.
  • Take hydroxychloroquine sulfate once a week for 4 weeks after leaving the malaria-risk area.
  • Take hydroxychloroquine sulfate on a full stomach, for example, after dinner, to minimize nausea.
  • Hydroxychloroquine sulfate may be better tolerated than chloroquine.

Hydroxychloroquine sulfate side effects
Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching have been reported. Hydroxychloroquine sulfate may worsen the symptoms of psoriasis.

  • Pregnant women should NOT take either doxycycline or Malarone™ to prevent malaria.
  • Pregnant women who cannot take the recommended antimalarial drug for their malaria-risk area should contact the CDC Malaria Hotline at 770-488-7788 for advice on alternative antimalarial drugs.

Take Your Antimalarial While Breast-Feeding

If you are breast-feeding, a very small amount of antimalarial will be passed into your breast milk. This small amount of drug will neither harm your infant nor be enough to protect him or her against malaria. Infants need to be given their own antimalarial. For more information, see Preventing Malaria in Infants and Children (Information for the Public) .

Prevent Insect Bites

Protect yourself from mosquito bites. Prevent mosquito bites by wearing long-sleeved shirts and long pants; apply insect repellent to exposed skin. Mosquitoes that transmit malaria bite between dusk and dawn. Use insect repellents that contain DEET.

When using repellent with DEET, follow these precautions

  • Always use according to label directions.
  • Use only when outdoors and wash skin after coming indoors.
  • Do not breathe in, swallow, or get into the eyes.
  • Do not put on wounds or broken skin.
  • Use a concentration of 30% to 35%.

Travelers who will not be staying in well-screened or air-conditioned rooms should use a pyrethroid-containing flying-insect spray in living and sleeping areas during evening and nighttime hours. In addition, travelers should take additional precautions, including sleeping under mosquito netting (bed nets). Bed nets sprayed with the insecticide permethrin are more effective. In the United States, permethrin is available as a spray or liquid to treat clothes and bed nets. Bed nets may be purchased that have already been treated with permethrin. Permethrin or another insecticide, deltamethrin, may be purchased overseas to treat nets and clothes.

Know the Signs and Symptoms of Malaria

Malaria can occur despite taking antimalarials. Malaria causes a flu-like illness; symptoms include fever, shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria symptoms will occur at least seven to nine days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, ill travelers should still seek immediate medical care. Although malaria is unlikely to be the cause, any fever should be promptly evaluated. If you or your child becomes ill with a fever or flu-like illness while traveling in a malaria-risk area and up to 1 year after returning home, seek immediate medical care. Tell your health care provider where you have been traveling.

For more information on malaria risk and prevention, please see the following:

  • Malaria: General Information
  • Prescription Drugs for Preventing Malaria (Information for the Public)
  • Preventing Malaria in Infants and Children (Information for the Public)

 

*Use of trade names is for identification purposes only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health and Human Services.

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care provider.

 

 

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