A small campfire flickers in the distance and silhouettes of dark figures move between huts and bush. There is no hesitation as she makes her way slowly and silently towards the unsuspecting intruders.

She is deadly and she wants blood.

Amidst the hunters she carefully picks her target and moves in.

For one of them, death beginning is very near.

There are very few killers in the African bush more deadly than the female Anopheles mosquito carrying the deadly disease called Malaria.

Do not underestimate this disease. It is said that malaria is responsible for the death of a child somewhere in the world every 30 seconds. It infects 350-500 million people each year, killing 1 million, mostly children in Africa.

Ninety per cent of malaria deaths occur in Africa.

Not knowing the risks and not taking preventative measures could be fatal. The hunter becomes the hunted.

Malaria-carrying Anopheles species mosquitoes tend to be more active between dusk and dawn. Often biting between 5 p.m. and 22:00 p.m. and again in the early hours of morning. Usually the mosquito’s are breeding in collections of water within 2 kilometres of the place where you live or camp.

Malaria mosquito’s have white and black spots on their wings and they sit and feed at a 45 degree angle. These characteristics make them easily identifiable to the trained eye.

The Anopheles species mosquito injects malaria parasites which is contained in its saliva into its host while obtaining a blood meal. These parasites enter liver cells and after that the red blood cells where it replicates, causing the cells to break.

By-products are released into the bloodstream which cause chills, muscle aches, headaches and other flu-like symptoms. These symptoms usually start after an incubation period (time since parasite injection until the start of symptoms) of 10 to 14 days.

Some preventative malaria medications may prolong the incubation period.

Four species of parasites infecting man are of interest. P falciparum is the most deadly and may cause coma, kidney failure and death within a few days after initial infection. P vivax and P ovale, also known as chronic malaria, can live in the cells of the liver for many years causing relapses of the disease even after standard malaria treatment.

To kill these parasites in the liver, one would need a special type of treatment. Plasmodium malariae is another form of malaria and rarely causes death.

One fact has remained true throughout the years: prevention is better than cure.

Ways to prevent malaria infection when hunting in Africa

When sitting outside in the evening:

• Wear long sleeved tops and long pants. Malaria mosquito’s find it difficult to penetrate clothing.

• Make use of mosquito repellents and burn mosquito coils. Repellents are very useful early in the evening. They are usually active for 5-8 hours, then they have to be re-applied.

When sleeping:

• Sleep under mosquito nets. Some nets are treated with insecticides. Remember to tuck netting in under the mattress or mat. Make sure there are no holes in the net and kill mosquitoes found inside the net.

• Keep all windows and doors in the house closed.

• Rooms may also be sprayed with insecticides.

Repellents

DEET (N,N-diethyl-m-toluamide) is an effective insect repellent. It is available in many formulations, including lotions, creams, gels, aerosol and pump sprays.

Mosquitoes are attracted to hosts by carbon dioxide from their breath and skin odours. DEET products confuse the mosquito and make it very hard for the Mosquito to land on its host. These repellents are only effective over a short distance from the application or treated area and it is therefore not necessary to apply more repellent if mosquitoes are still flying nearby.

Insect repellent containing DEET or permethrin can also be applied to clothing, rather than directly to the skin. You may wish to use products not containing DEET which might give limited protection. Remember, Permethrin is a pesticide and exposure should be minimized. Do not apply permethrin to skin.

When planning a safari or hunting trip to the African bush, make sure to visit your doctor for a prescription for malaria chemoprophylaxis well in advance of travelling.

Your doctor will advise you on the best preventative medication which suites you best. Malaria prophylactic medication is individualised.

These medications are life saving and can prevent the malaria parasite from entering blood cells and thus prevent infection and serious complications including death.

Although anti-malaria preventative medication is not 100% effective it is still imperative not to leave without it. Do not take a chance. Many people have died because they did not see it necessary to take this treatment. Don’t be ignorant. It is not worth it.

Also, do not believe the urban legend that it is better not to take prophylaxis because "it confuses the doctor when he wants to diagnose you".

Many who believed that are now dead.

Be very wary of flu-like symptoms a few days to weeks after returning from a malaria area. Even if you were taking anti-malaria medications. Any flu-like symptoms should be followed up by a health care professional and malaria should be ruled out as a cause.

The symptoms of malaria vary from very mild to very severe. The most important feature of malaria is fever. Shivering and profuse sweating with headache are common symptoms.

Joint pains, muscle aches, diarrhoea and vomiting may also occur. The infected person may feel better the next day, but might have another attack the day after.

Do not wait for symptoms to subside before seeing your doctor for appropriate malaria testing. It is characteristic of malaria symptoms to subside for a few hours to a day.

Malaria from P falciparum kills quickly, but is curable if diagnosed early, so do not postpone.

Things to include when planning a hunting trip

Prevention is the key.

Dr. Swart has been involved in Communicable disease control since 2004 and is an authority on Malaria, tropical and infectious diseases in Africa.

To make your hunting trip memorable, remember to prevent mosquito bites which prevent infection.

Should you become ill during your trip or after, early diagnosis and treatment will save your life.