Risk Assessment

Preventing malaria – Employees increasingly travel beyond our borders, either to conduct business or to attend conferences or lecturers. For that reason, companies also have to assess risks attached to diseases that are unheard off or less common in South Africa. Malaria is one of those diseases. Except for the Kruger National Park and a small piece of land along the Zimbabwe and Botswana borders, the malaria mosquito is no longer a common occurrence in our country. But when South Africans travel beyond their borders, the malaria bug won't feel restricted from infecting South Africans too.

Prevention malaria infection starts and ends with the employee himself. But companies are encouraged to always assess such a risk and inform employees about what to do. The internet has various comprehensive websites where one can see which countries or areas are malaria-prone. The National Institute for Communicable Diseases runs a website (www.nicd.ac.za) that is updated regularly. Another useful sources is the website of the Travel Clinic (www.travelclinic.co.za). But I have no doubt you will find many other useful source on the web.

Personal protection measures against mosquito bites include; use of an appropriate insect repellent containing di-ethyl toluamide (also known as deet); wearing clothing that covers as much of the body as practical, sleeping under a mosquito net; and spraying sleeping quarters at night with a suitable pyrethroid containing insecticide; or burning an insecticide laden coil. Avoiding being outdoors at night is also a simple way reducing the risk of getting infected as mosquitoes are more likely to bite at night. Convincing a South African travelling outside our borders to respect these guidelines might, however, be a bit of a challenge.

But there is no guarantee that mosquitoes will not bite.

Part of the risk assessment should be to advise people to always take anti-malaria medicine when visiting a high-risk area. Effective prophylaxis are only available with doctor's prescription but which medication works best is often a matter of personal preferences, body-type and work the employee is expected to do in the particular area. Some medication can cause side-effects that might influence judgement and ability to perform certain tasks. So always consult a doctor to determine which medication the employee should take and always make sure the employee carries the medication in its original box, preferably with a copy of the doctors prescription, in order to avoid any confusion when customs officers need to identify the medication. Also make sure that employees carry their medication with them in their hand luggage and not in the luggage that goes in the haul. Baggage pilferage and luggage going missing, are still rampant in many countries, regardless of the reputation of the airline.

Companies with office in malaria-infested areas should continuously do a risk assessment regarding malaria. These companies can also be proactive in the prevention of malaria. Much can be achieved by simply informing and educating staff and their families. And, apart from providing protective clothing, (treated) bednets or diagnostic services, employers are also encouraged to do fogging and screening, as well as to spray effective repellents all over their site. Some companies seem to achieve some good results by using organophosphate insecticides.

By implementing proper environmental management of standing water and controlling of mosquito breeding sites companies can also play a role in preventing the disease occuring in the first place. The installation of special screens and doors will allow employees to leave doors and windows open to allow fresh air in, without having to fear an unwelcome visit from the malaria mosquito.

Lastly; malaria is not transmitted directly between humans. But a malaria infected employee can be a source from which a mosquito can extract the disease and infect another employee when the latter is bitten. It is my advice that employers always screen their staff upon return from a trip and, if necessary, take active measures to avoid things going from bad to worse.