Malaria Risk In Belize: What You Need To Know

Belize is a tropical nation in Central America, bursting with culture and fun for all types of travellers. However, it is important to be aware of the health risks associated with the country before planning a trip. While Belize was certified as a malaria-free country by the World Health Organization in 2023, antimalarials may be recommended based on your itinerary. This article will explore the risks of malaria in Belize and provide information on how to protect yourself during your travels.

Malaria prevention measures

Belize is a risk region for malaria, so it is important to take preventative measures to avoid mosquito bites and, if necessary, take antimalarial medication. Here are some key malaria prevention measures to consider when travelling to Belize:

Prevent Mosquito Bites

• Use mosquito repellent – Opt for repellents containing DEET, picaridin, or oil of lemon eucalyptus (OLE). Follow the instructions on the product label and reapply as directed.
• Cover exposed skin – Wear long-sleeved shirts, long pants, and hats to reduce the amount of skin accessible to mosquitoes.
• Use permethrin-treated clothing and gear – Treat clothing and gear, such as boots, pants, socks, and tents, with permethrin. Do not apply permethrin directly to the skin.
• Sleep in a protected area – Stay and sleep in air-conditioned or screened rooms to reduce the risk of mosquito bites while resting.
• Use a bed net – If sleeping in an area exposed to the outdoors, use a bed net to create a physical barrier against mosquitoes.

Take Antimalarial Medication

• Consult a doctor – Before your trip, visit your doctor or a travel clinic 4 to 6 weeks in advance. They can advise you on the most suitable antimalarial medication for your specific needs.
• Start medication before your trip – Some antimalarial medications need to be started 1 to 3 weeks before departure and continued during and after your trip. Follow your doctor's instructions.
• Be aware of side effects – Different medications have varying side effects and contraindications. For example, atovaquone-proguanil is more expensive but has fewer side effects, while doxycycline is more affordable but can cause stomach upset and bad reactions to sunlight.
• Continue medication after your trip – Even after returning home, continue taking the prescribed medication as instructed by your doctor. Stopping too soon could still leave you vulnerable to malaria.

Insect repellent

• Apply repellent after sunscreen, as the repellent may reduce the protection of your sunscreen.
• Avoid breathing in the repellent—if using a spray, spray it onto your hands and then rub it onto your face, avoiding the eyes.
• Keep repellent away from synthetic clothes or plastics, as it may damage them.
• Wash your hands after applying repellent.
• Do not apply repellent to the hands of young children, as they may rub their eyes.

In addition to insect repellent, there are other ways to prevent mosquito bites:

• Wear long-sleeved shirts, long pants, and hats to cover exposed skin.
• Stay in air-conditioned or screened rooms.
• Use permethrin-treated clothing and gear, such as boots, pants, socks, and tents. Do not use permethrin directly on the skin.
• Choose accommodations with air conditioning or screens on windows and doors to keep mosquitoes out.

Vaccinations

• Typhoid
• Hepatitis A
• Polio
• Yellow Fever
• Chikungunya
• Rabies
• Hepatitis B
• Influenza
• COVID-19
• Pneumonia
• Meningitis
• Chickenpox
• Shingles
• Tdap (tetanus, diphtheria and pertussis)
• Measles, mumps and rubella (MMR)

Some of these vaccinations are routine and recommended for all travellers, while others are selectively advised for those at highest risk. For example, the Typhoid vaccine is recommended for all travellers, while the Yellow Fever vaccine is only required if travelling from a country with a risk of yellow fever transmission. It is important to consult with a healthcare professional to determine which vaccinations are necessary for your specific travel plans.

In addition to the vaccines listed above, it is also important to be up-to-date on all routine vaccines, such as measles, mumps, rubella, chickenpox, and diphtheria-tetanus-pertussis. Travellers should also be aware of the risk of mosquito-borne illnesses such as Zika, dengue, and malaria in Belize and take appropriate precautions, such as using insect repellent and wearing protective clothing.

Food and water safety

• Tap water in Belize is generally considered safe to drink. However, some sources suggest sticking to bottled water to avoid getting sick, especially if you are only visiting for a short time.
• If you do choose to drink tap water, it is recommended to boil it first. Most lodgings will provide purified drinking water in big jugs.
• It is also considered safe to use tap water for brushing your teeth, cooking, and rinsing food.
• Outside of towns and cities, always check with your accommodation about the water source, as it may be from wells or rainwater tanks, which could be contaminated.
• It is generally considered safe to eat fruit and vegetables washed in tap water, but some travellers recommend soaking produce in microdyne before consumption.
• It is recommended to avoid salads and street food, but high-end lodgings and restaurants that cater to tourists are likely to be careful about the food they serve.
• To be extra cautious, you can follow the advice of the CDC for the country you are visiting.
• It is also recommended to wash your hands frequently and carry hand sanitiser.

History of malaria in Belize

Belize was certified as a malaria-free country by the World Health Organization (WHO) in 2023. The country had zero indigenous malaria cases since December 2018 and has been investing in the prevention of the re-establishment of malaria transmission.

Belize's history with malaria dates back to the 1950s when the country launched a targeted programme aimed at eliminating malaria nationwide. In 1957, a National Malaria Eradication Service (NMES) was established within Belize’s Ministry of Health. In 1959, the country began systematically collecting malaria case data to monitor programme performance. These actions yielded results: between 1957 and 1963, annual malaria cases fell from over 1000 to just 17. However, by 1965, the number of cases had increased twelve-fold, and there were significant fluctuations in cases.

In the 1980s, over half of all localities in Belize’s six districts reported malaria transmission. Cases continued to rise in the 1980s – a trend attributed to a shrinking malaria control budget and an influx of refugees from neighbouring malaria-endemic countries during a period of political upheaval. The last death due to malaria was reported in 2006, and the last indigenous malaria case was reported in December 2018.

Frequently asked questions