[From malaria chemoprophylaxis to malaria self-treatment (1975-1989)]

Swissair's 3000-odd cockpit and cabin personnel spend an aggregate total of one year in the tropics for every ten years of flight service with the airline. Since 1975, company policy has been to issue all crews with a 'treatment dose' of anti-malaria medication to be taken if malaria contraction is suspected. Up until 1985, this treatment dose medication was recommended to crews for cases in which malaria was suspected even though chemoprophylactic medication had been taken. Since 1985, crews have been advised to rely solely on the treatment dose (i.e. not take any chemoprophylactic medication) if they are exposed to only low or moderate malaria risk. Experience so far has been encouraging: There has been no increase in incidences of malaria; the approach has been widely accepted among crews; the treatment dose (1%) has been judiciously used; the amount of chemoprophylactic tablets issued has declined; the number of repellents issued has increased; and the fear of side-effects from anti-malaria medication has decreased. The risk of contracting malaria-about one case per 200 to 300 years of service-is accepted. The question of whether and to what extent these experiences, which have been recorded among a small and selected group of the population, can be applied to other frequent flyers merits further investigation.