Malaria: mosquito protection, prophylaxis and fever after travel

When travelling, you protect yourself from malaria above all with consistent mosquito protection from dusk and through the night. In high-risk areas the DTG (German Society for Tropical Medicine, Travel Medicine and Global Health) also recommends preventive medication, and in very remote regions an emergency standby treatment can make sense. A travel health consultation works out the right combination for you. Most importantly: any fever during or after a trip to a malaria area must be checked by a doctor straight away.

What makes malaria dangerous

Malaria is caused by single-celled parasites called plasmodia and spread by Anopheles mosquitoes. According to the German Federal Foreign Office, these bite mainly between dusk and dawn and are almost silent. Malaria does not pass directly from person to person.

The WHO estimates around 282 million malaria cases and 610,000 deaths worldwide in 2024, most of them in sub-Saharan Africa. In Germany, 890 imported cases were reported in 2025 according to the DTG, more than 80 per cent of them after stays in Africa. The most dangerous form, falciparum malaria, can be fatal within a few days without proper treatment, the DTG warns.

Where the risk is

Malaria occurs in tropical and subtropical parts of Africa, Asia and South and Central America, but the risk varies greatly, often within a single country. Every year the DTG publishes maps and a country table that group its advice by region:

DTG map category	What the DTG usually recommends
High risk, all year	mosquito protection plus year-round preventive medication
High risk, seasonal	mosquito protection, prophylaxis during the malaria season, usually the rainy season and shortly after
Moderate risk	mosquito protection, usually no preventive medication (exception: pregnant women), standby treatment only in very remote areas
Low risk	mosquito protection
Malaria-free	no malaria measures needed, though protection from other mosquito-borne diseases may still matter

Our country pages show how your destination is classified, for example Kenya, Tanzania or India. The DTG points out that the situation can change quickly because of rainy seasons, flooding or political crises, so what counts is the position at the time of your consultation.

Pillar 1: avoid mosquito bites

According to the DTG, mosquito protection remains essential even if you take preventive medication. Because some Anopheles species bite during the day and malaria areas usually also have dengue, chikungunya or Zika, the DTG recommends protection by day and by night.

• Repellent on the skin: products containing DEET or icaridin are the best tested. Apply to all exposed skin, including ankles, neck and face, and reapply as directed on the pack, more often if you sweat. Put sunscreen on first and repellent afterwards. For children, check the age guidance on the product.
• Clothing: long, loose and preferably light-coloured, ideally treated with insecticide.
• Mosquito net: sleep under a treated net, even in rooms with window screens, and check nets provided by your accommodation for holes.
• Rooms: air conditioning and screens on windows and doors reduce bites.

The DTG and the Federal Foreign Office list repellent wristbands, ultrasonic devices, garlic and vitamin supplements among the measures that do not work. As repellents in tropical countries are not always available at an effective strength, take enough from home. More in our guide to mosquito protection.

Pillar 2: preventive medication

For trips to areas with a high transmission risk, the DTG recommends chemoprophylaxis, which can substantially reduce the risk of falling ill. Which medicine is suitable depends, according to the DTG, on the exact destination, season, length of stay and travel style, as well as your age, health and other medicines. There is therefore no one-size-fits-all advice, and this guide deliberately names no products.

What matters for you as a traveller:

• Depending on the medicine, prophylaxis starts before you arrive in the malaria area and must be continued for a while after you leave. Your doctor will explain exactly how.
• Not every bit of discomfort on a trip comes from the medication. Do not stop taking it on your own; ask a doctor.
• Do not buy malaria medicines in the tropics. According to the DTG, a high share of products there are counterfeit or substandard.
• No prophylaxis gives complete protection. Malaria can still occur even if you take it correctly.

Pillar 3: emergency standby treatment

For travellers staying in remote areas with a moderate malaria risk who are more than 48 hours from the nearest facility able to diagnose malaria, the DTG may recommend carrying an emergency standby treatment. In today’s well-connected world this is rarely needed, the DTG says, and a medical check-up is still urgently required afterwards. The DTG does not generally recommend malaria self-tests, as they are hard to use and a negative result does not reliably rule out malaria.

Travellers with special needs

Malaria can be more severe in pregnancy and poses a high risk to mother and child. The DTG therefore generally advises pregnant women against travel to malaria areas, and against stays in high-risk areas for children under 5. Long-term travellers and people visiting family and friends in their country of origin also face a higher risk, according to the DTG. If you belong to one of these groups or have existing conditions, book your travel health consultation particularly early.

Fever during or after your trip

Malaria symptoms are non-specific: usually high fever, chills, feeling very unwell, headache and aching limbs, sometimes diarrhoea. That is why it is easily mistaken for flu or a stomach bug.

What to do:

1. Take a thermometer. The DTG recommends this for everyone travelling to malaria areas, and it belongs in your travel health kit.
2. Act quickly on fever. If a fever of 38 degrees or more lasts longer than 24 hours or comes back, seek medical help without delay, the DTG advises.
3. Mention your trip. Any unexplained fever from the seventh day after first entering a malaria area until several months after returning is suspicious for malaria. Tell your doctor actively, even if you took prophylaxis.

Malaria can only be confirmed or ruled out by a blood test. For advice before your next trip, our directory of travel clinics lists practices and tropical medicine institutes near you.