Travel news: Pill-free in India

Travel to the Indian subcontinent will become much easier if a recommendation from a network of infectious disease specialists is adopted. The group, called TropMedEurop, says holidaymakers should forget malaria tablets and concentrate on avoiding bites. A study concluded that the dangers from taking prophylactic drugs rated higher than the risk of disease.

"Some people, particularly families, believe that if there's a need to take pills, they won't touch a destination with a bargepole," says Pietro Addis, a specialist on India for Cazenove+Loyd. "Where most people generally travel, such as Rajasthan in dry season, you hardly ever see a mosquito."

"I've never heard of anybody who has caught malaria on the sub-continent," says Paul Goldstein, of the adventure travel agency Exodus. "Even though it exists there, I don't believe the risk is anything like as great as the pharmaceutical companies would like us to believe."

Despite the recommendation from TropMedEurop, many travel health experts in the UK still insist malaria tablets are necessary for visits to the Indian sub-continent. The travel medicine division at Health Protection Scotland maintains that "malaria precautions are essential in all areas [of India] below 2,000m, all year round".

Jason Gibbs, a pharmacist for the London-based adventure travel supplier Nomad, says: "There are areas of India where malaria prophylaxis is definitely still needed, including Assam." The current official advice is for chloroquine, together with proguanil (except in Assam where resistance is more widespread) and mefloquine, doxycycline or Malarone are recommended.

Health professionals agree that contracting malaria is a possibility whatever precautions are taken and that any fever should be promptly investigated. Nitin Kapoor, a 27-year-old IT specialist from Reading, contracted malaria after a visit to family in India. "About eight months after my trip I got a fever. I was in a very bad way. I didn't imagine it would have anything to do with my trip since it was so long ago. But apparently malaria stays dormant in the liver." Around 300,000 UK residents of Indian descent travel to India each year; they are considered to be at higher risk than travellers who stay on the tourist trail.

TropMedEurop's advice testifies to the success of campaigns in the sub-continent aimed at eliminating mosquitoes. The World Health Organisation estimates that, at the time of independence, there were 75 million cases of malaria a year, and 800,000 deaths. In the 60 years since, India's eradication programme has reduced the number of cases to two million annually, only 1,000 of which prove fatal. Health officials use techniques such as eliminating standing water and introducing fish that devour mosquito larvae.