To get the scary bits out of the way, let's review the medical reality. You can be fine when you wake up in the morning but, by the time night comes around, you can be flat on your back, pouring sweat and in a delirious condition. Malaria kills more people around the world than every other disease. About 500 million catch it every year. Thanks to good treatment less than 1% die (that's about 3 million people) and, of those, one child dies every second in the worst affected parts of the world. When you add up the cost of treatment and the economic losses as infected people stop work, the disease is estimated to cost about $6 billion a year. This is a worldwide problem and, as global warming increases, the temperature in previously temperate parts of the world, now encourages the spread of mosquitos.

Over the last 20 years, the World Health Organization has been pushing the Roll Back Malaria Partnership, but this has produced few good results. The one high point has been the distribution of nets treated with insecticide. Hung over beds, these keep people safe while sleeping. Sadly, these are routinely taxed in African countries and are priced out of the reach of the poor who are most at risk. Most efforts to persuade countries to use the modern drugs have failed. Even though many strains of the disease are now resistant to the older drugs, local prejudices favor the continued use of the long-trusted medications. This is increasing the death rates.

So what is malaria? The name itself means "bad air". People associated the disease with the miasma, the bad-smelling mist that hangs over swamps and stagnant pools at night. It came as a surprise when doctors discovered the mosquito was responsible. The bite of a pregnant female between dusk and dawn is the means of transmission. With this news, there was a real effort to kill off the mosquito and human deaths were reduced by 90%. But, since the 1960s, the disease has been spreading. Today, 40% of the world's population is at risk. As a tourist, the odds now favor you traveling to an infected area.

One of the best preventative measures is to start taking Doxycycline before you travel. None of the repellents is 100% effective. You reduce the risk by wearing long-sleeved shirts and blouses, trousers, socks and shoes. It may be hot, but this is better than being bitten. Sleep under a net or with a fan to keep the air moving. There is, however, one problem with Doxycycline. It makes you more photosensitive. Make sure you stay covered up and wear a hat. Sunscreen will keep the sunburn to a minimum. If you feel ill, and develop a temperature and a headache, get emergency treatment. Doxycycline is good, but it's not 100% effective. The only sure way of avoiding malaria is to avoid being bitten. For some, the sensible decision may be to find a safer place for the holiday. If you have no choice because work or some other commitment takes you to an at-risk area, take drugs before, during and after your visit. The symptoms may not appear for weeks or months after your return. If you fall ill back home, always tell your local doctor if you have been to an infected area.