Malaria: still a threat to travellers.

Each year, some 25-30 million international travellers from non-tropical regions visit malaria endemic countries. Up to 10,000 cases of malaria are imported into industrialised countries with an average case fatality rate of around 1%. Malaria still poses a real threat to travellers, particularly in areas with high transmission such as sub-Saharan Africa, Papua New Guinea and the South Pacific islands. The spread of malaria resistant to an increasing number of drugs forces us to adjust chemoprophylaxis regimens. Although new drugs are available and can protect travellers effectively, the number of imported cases to Europe and North America remains substantial. An increasing proportion of imported cases is seen in migrants and foreign-born residents visiting friends and relatives (VFR) in endemic countries. New easy-to-use drugs, better understanding of risk perception of travellers, finding new and innovative ways to reach at risk travellers such as VFRs are among the new challenges to improve malaria prevention for international travellers.