Malaria deaths in visitors to Canada and in Canadian travellers: a case series

Over the last decade there has been a marked increase in cases of drug-resi stant and severe malaria in Canadian travellers. We report 7 deaths due to falciparum malaria that occurred in Canada or in Canadian travellers. Risks for malaria infection include inappropriate recommendations for malaria pr evention by health care providers and lack of knowledge about or adherence to appropriate recommendations by the travelling public. Risks for death in clude delays in seeking medical attention, delays in diagnosis and inadequa te care by Canadian physicians and hospitals, and lack of access to parente ral therapy for severe malaria. Malaria infections and deaths are preventab le. Better education of health care providers and travellers about the risk s of malaria and appropriate prevention and treatment measures may decrease this unnecessary burden on the Canadian health care system.