Malaria SBET and other travel kit meds available in Thailand

[wn78]

I was browsing the excellent blog from the Thai Travel Clinic, and saw articles on malaria standby emergency treatment (SBET)

https://www.thaitravelclinic.com/Knowledge/standby-emergency-treatment-of-malaria.html

https://www.thaitravelclinic.com/blog/all-about-malaria/sbet-regimen-in-thailand-and-southeast-asia.html

Seems like a useful item to have in your bag if you like traveling to remote islands (in Thailand, Philippines, Caribbean).  In the US doctors would not allow you to get “future need” drugs like that so I’m thinking of stocking up next time I’m in BKK.

 

What other “emergency medical kit” medications you would advise to get in Thailand which are not available in your home country at your request? 

 

[internationalism]

from the same blog you linked:

"Please be informed that Antimalarial medication in Thailand are special reserved medications. Our Ministry of Public Health has strict rule and regulation to control the use of antimalarial medication in our country. So they will be available in some public/university hospitals only. Antimalarial medication is not available over the counter and must be prescribed from a qualified medical doctor only."

 

it's not malaria you should be aware of (around 1-2 cases of infection to tourists per year) , but dengue fever (that might be in hundreds/thousands per year - total for thailand is 60k). 

For dengue there are 2 vaccines, also available in the USA (dengvaxia).

 

malaria is in sub-saharan Africa.

 

for prophylaxis of malaria is an antibiotic doxycycline - to be taken a week before entering endemic area and for 30 days after leaving it. That one is available in every pharmacy. 

 

for treatment of malaria only quinine and chloroquine are available at some large pharmacies. They are older generation drugs and cheap. 

In the USA you can ask for a prescription of malarone, might be expensive. Probably thai travel clinics would also give you prescription and point you which hospital to buy. Probably you would have to tell them, that you are going to africa, cambodia, laos or birma

 

[wn78]

2 hours ago, internationalism said:

it's not malaria you should be aware of (around 1-2 cases of infection to tourists per year) , but dengue fever (that might be in hundreds/thousands per year - total for thailand is 60k). 

For dengue there are 2 vaccines, also available in the USA (dengvaxia).

Thanks for your reply.  Dengue fever  vaccine was just covered in my other post a few days ago, so no need to repeat that discussion here

 

2 hours ago, internationalism said:

malaria is in sub-saharan Africa.

I don't have the distribution and maps in front of me, but I'm pretty sure it hasn't been the case for a long time now.  It's been spreading to many other areas.  I read a few travelers' post over the years reporting cases in the Caribbean and other areas.  While the risk is still very very low, it's  fatal disease and having an emergency med in your kit is a good idea if you travel to remote places

 

2 hours ago, internationalism said:

for prophylaxis of malaria is an antibiotic doxycycline - to be taken a week before

Yes fully aware of that, and don't want prophylaxis for the precise reason of the risk of infection being so small.

 

2 hours ago, internationalism said:

for treatment of malaria only quinine and chloroquine are available at some large pharmacies. They are older generation drugs and cheap. 

That's good info, I will check it out.  I would of course prefer more modern treatments, more effective I assume

 

2 hours ago, internationalism said:

In the USA you can ask for a prescription of malarone, might be expensive. Probably thai travel clinics would also give you prescription and point you which hospital to buy.

You can ask, but in 99% case you will not get it.  Very few clinics are willing to go that route.

 

2 hours ago, internationalism said:

"Please be informed that Antimalarial medication in Thailand are special reserved medications. Our Ministry of Public Health has strict rule and regulation to control the use of antimalarial medication in our country. So they will be available in some public/university hospitals only. Antimalarial medication is not available over the counter and must be prescribed from a qualified medical doctor only."

Yes I saw that, but I assumed since they recommend SBET in their blog, they could prescribe it for a remote traveler who wants it

Edited December 19, 2022 by wn78

[Sheryl]

2 hours ago, wn78 said:

 I assumed since they recommend SBET in their blog, they could prescribe it for a remote traveler who wants it

Doubtful unless you will be traveling in near future to a malarious area.

 

Which on SE Asia means overnighting in dense jungle.

 

 

[wn78]

16 hours ago, Sheryl said:

Doubtful unless you will be traveling in near future to a malarious area.

 

Which on SE Asia means overnighting in dense jungle.

 

 

Ok then, maybe I was misjudging the situation.  I presumed Thailand doctors would be more flexible then in the West on this issue.  In the US doctors would rather have a patient take the risk and go somewhere without a supply of emergency medicines, than take the risk of having some patients misuse the prescribed meds and then come back and sue the doctor.

[Sheryl]

10 hours ago, wn78 said:

Ok then, maybe I was misjudging the situation.  I presumed Thailand doctors would be more flexible then in the West on this issue.  In the US doctors would rather have a patient take the risk and go somewhere without a supply of emergency medicines, than take the risk of having some patients misuse the prescribed meds and then come back and sue the doctor.

Actually the risk everyone is concerned about has to do with the emergence of multi drug resistant strains of malaria.

 

Which are especially  prevalent on SE Asia and malaria drugs are tightly controlled for this reason.

[simon43]

On 12/19/2022 at 11:26 AM, wn78 said:

...

While the risk is still very very low, it's  fatal disease and having an emergency med in your kit is a good idea if you travel to remote places

...

Well, it can be a fatal disease, but not the norm.  My father contracted malaria at a young age after growing up in Egypt.  He had occasional malaria fevers throughout his life and died of other causes at 89 years old. You would have to be very unlucky to contract malaria in Thailand.  I travelled and worked in remote areas of Laos and Burma, but malaria vaccine/medication was not part of my first aid kit - I was more likely to get bitten by a rabid dog!

[BritManToo]

1 hour ago, simon43 said:

Well, it can be a fatal disease, but not the norm.  My father contracted malaria at a young age after growing up in Egypt.  He had occasional malaria fevers throughout his life and died of other causes at 89 years old. You would have to be very unlucky to contract malaria in Thailand.  I travelled and worked in remote areas of Laos and Burma, but malaria vaccine/medication was not part of my first aid kit - I was more likely to get bitten by a rabid dog!

If I may add,

Side effects for anti-Malaria tablets can result in serious mental problems.

One of my work pals went completely bonkers from anti-malarial tablets, had to be locked up for a couple of weeks, while locked up stopped taking the meds, then caught malaria while in the mental institution.

 

You also need to start taking the meds 2 weeks before travelling, so absolutely no use as a backup to keep in your bag.

Edited December 21, 2022 by BritManToo

[wn78]

10 hours ago, BritManToo said:

One of my work pals went completely bonkers from anti-malarial tablets, had to be locked up for a couple of weeks, while locked up stopped taking the meds, then caught malaria while in the mental institution.

That is most bizarre turn of events!

 

10 hours ago, BritManToo said:

You also need to start taking the meds 2 weeks before travelling, so absolutely no use as a backup to keep in your bag.

Are you talking about prophylaxis here? I  am not talking about the preventive meds, I am talking about the emergency treatment regimen

[bendejo]

There is a tropical disease research lab that is part of Mahidol Univ, near Victory Monument.  Once when preparing to travel to a remote part of Indonesia I went there for malaria pills.  Apparently they don't get many farang, and the only person they could dig up to speak English with me was a young research doctor, the receptionist was embarrassed to summon him.  He was reluctant at first, but then gave me them.  I asked about mosquito repellents and he laughed, said nothing else works the way DEET does.

This was nearly 20 years ago, so things may have changed.  On google maps there is a "Thai Travel Clinic," it's all between the monument and the elevated expressway.

 

 

[wn78]

4 minutes ago, bendejo said:

There is a tropical disease research lab that is part of Mahidol Univ, near Victory Monument.  Once when preparing to travel to a remote part of Indonesia I went there for malaria pills.  Apparently they don't get many farang, and the only person they could dig up to speak English with me was a young research doctor, the receptionist was embarrassed to summon him.  He was reluctant at first, but then gave me them.  I asked about mosquito repellents and he laughed, said nothing else works the way DEET does.

This was nearly 20 years ago, so things may have changed.  On google maps there is a "Thai Travel Clinic," it's all between the monument and the elevated expressway.

 

 

Yep, that's the same clinic that does the blog I referenced on my OP.

 

I hope the receptionist learned to speak better English in the 20 years she's been there...  I will report back on that. ????

[internationalism]

at that clinic they have a lot of foreigners, mostly for vaccination. Everybody speaks good english.

They also have european doctors, I came across french speaking one. I think she was senior one, probably a teacher. She was invited to a consultation room when a junior doctor couldn't answer to my questions.

 

as I believe those 2 medicines mentioned by me earlier (quinine, chloroquine) don't have side effects, just important not to overdose (low tolerance to them).

[Lorry]

In the blog quoted by OP, they recommend  SBET if you cannot have your blood checked within 12-24  hours.  There is no place like this in Thailand. Maybe some extremely remote Islands in Indonesia or the Philippines, maybe somewhere in Myanmar. Even in Laos its hard to think of a place like this. 

 

Having said that, SBET is easily available in Europe. Many European tourists here carry a pack of Malarone (for a beach holiday in Phuket!), completely unnecessary and potentially dangerous.