Malaria infection control

Overview of Malaria

It is an acute febrile illness transmitted by mosquitoes infected with the malaria parasite. In Korea, malaria occurs frequently from May to October in areas near the Demilitarized Zone (DMZ), so residents and travelers to these regions should take precautions.
There are five protozoan species capable of infecting humans (Plasmodium vivax, Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi). However, in Korea, only infections caused by Plasmodium vivax occur.
Malaria is not transmitted through airborne infection or routine contact with patients.

(Domestic) The main malaria occurrence areas are Seoul, Incheon, Gyeonggi, and Gangwon, with around 700 cases reported annually on a consistent basis.
(Overseas) Cases of infection continue to occur from visits to Africa and Southeast Asia.

The main symptoms of malaria include fever, chills, sweating, headache, muscle pain, nausea, vomiting, and diarrhea. The incubation period varies, so symptoms may appear immediately or the disease may manifest the following year.
In Korea, the most common type, Plasmodium vivax malaria, often shows a pattern where fever occurs one day, is absent the next day, and then returns the following day.
Recurring symptoms at 48-hour intervals
- cold stage
  
  Severe chills may occur, making it difficult to write or causing teeth to chatter to the point of impaired speech, lasting about 30 minutes to 2 hours.
- fever stage
  
  A high fever above 39℃ occurs, accompanied by severe headache, vomiting, and thirst, lasting for several hours.
- sweating stage
  
  Body temperature rapidly returns to normal with sweating, followed by fatigue and drowsiness.
  *As the fever subsides, profuse sweating soaks blankets or clothes, accompanied by generalized weakness.
Malaria occurring abroad can progress to severe disease and cause death within 24 hours if left untreated, so treatment must begin immediately upon diagnosis.

If suspected symptoms appear after visiting a malaria-endemic area, you should immediately visit a medical institution for diagnosis and treatment.
Malaria can be diagnosed within 15–30 minutes using a Rapid Diagnostic Test (RDT), and with prompt treatment, it is fully curable.

CategoryCategory, Testing Criteria, Testing Methods, Detailed Testing Methods Table
Category	Testing Criteria	Testing Methods	Detailed Testing Methods
Confirmatory diagnosis	Confirmation of malaria parasites (trophozoites) in the specimen (blood) through smear examination	Microscopic examination	Smear and microscopic examination
Confirmatory diagnosis	Detection of specific genes from the specimen (blood)	Genetic Detection Test	PCR, LAMP, etc.
Presumptive diagnosis	Detection of specific antigens in the specimen (blood), including rapid diagnostic test kits	Antigen Detection Test	RDT, etc.

Malaria vector mosquitoes are most active between May and October, mainly from sunset to sunrise, so avoid going out at night.
When going out, prepare appropriate repellents (long clothing to minimize skin exposure, repellents, etc.) to reduce mosquito bites.
Mosquitoes are attracted to sweat, so always shower after outdoor activities.
When sleeping indoors, keep windows closed if possible and use mosquito nets properly installed before sleeping.
Malaria vector mosquitoes are attracted to dark colors, so wear light-colored long clothing.
Remove standing water from artificial containers and puddles, and install light traps around livestock facilities.

Malaria Preventive Measures

Country-specific information on infectious diseases can be found on the Korea Disease Control and Prevention Agency (KDCA) website(http://www.kdca.go.kr)
When traveling to malaria-endemic countries, those who stay for 6 months or longer in a year are restricted from donating whole blood and platelets for 3 years, while those who stay for less than 6 months in a year are restricted for 1 year. In both cases, only plasma donation is allowed.
Since the types of malaria and drug resistance vary by country, consult a doctor and take appropriate preventive medication depending on the destination country.
For malaria prophylaxis, depending on the type of medication, it must be continued for up to 4 weeks after leaving the risk area. Therefore, adhere to the prescribed duration and follow the correct dosage instructions.

Korea has been designated by the World Health Organization (WHO) as a priority country for malaria elimination* and must achieve zero domestic cases from 2028 in order to eliminate malaria by 2030.
** Need
* South Korea, North Korea, Mexico, Thailand, Saudi Arabia, Iran, Mexico and most other developing countries
** Elimination Certification Criteria: Achieving zero (0) indigenous malaria cases for three consecutive years
To this end, the 2nd National Strategic Plan for Malaria Re-Elimination (2024–2028) has been established, which includes four key strategies*, and is being implemented in cooperation with local governments and relevant ministries.
* Strengthening patient surveillance and risk management, enhancing vector mosquito monitoring and control, activating cooperation and communication systems, and establishing the foundation for malaria elimination

01Strengthening Patient Surveillance and Risk Management
1. Proactive patient surveillance
2. Strengthening patient management
3. Strengthening management of malaria risk areas
4. Strengthening malaria control in the military
02Enhancing Vector Mosquito Surveillance and Control
1. Strengthening investigations of vector mosquito density and parasite infection
2. Strengthening tailored control measures based on environmental conditions
03Activating Cooperation and Communication Systems
1. Strengthening domestic and international cooperation
2. Diversified prevention campaigns and enhanced expertise
04Establishing the foundation for malaria elimination
1. Establishing evidence for domestic malaria occurrence
2. Establishing a domestic malaria elimination certification system