Malaria and encephalitis in thailand

[rdcny]

Hello,

If I will be in the area of Chumphon in Thailand in Sept/Oct/Nov (it is the rainy season), what is the incidence of malaria and Japanese encephalitis at that time in Chumphon?

Is Larium the drug of choice for malaria in Thailand these days, or is doxycycline just as good?

Are these drugs available over the counter in Thailand (without a prescription)?

Thanks,

Robert DeCandido, NYC

[naja]

check out your CDC site[centre for disease control,atlanta].very good.

before i went to thailand in 2001,i was advised to be vaccinated against japanese encephalitis,rabies,and hepatitis b.

an australian doctor who had spent 1 year teaching medicine in southern thailand,advise me NOT to take anti-malarial tablets.now,for the life of me i've forgotten the reason why-incipient senility.something to do with the tablets 'masking'the malarial symptoms.

i was in northern thailand during the wet season -many mozzies,but no problems.i'm not very attractive to mosquitoes,or to women for that matter.maybe there is a correlation.

[lopburi3]

advise me NOT to take anti-malarial tablets.now,for the life of me i've forgotten the reason why-incipient senility.something to do with the tablets 'masking'the malarial symptoms.

This is, and has been the advise of most experts here for many years from my understanding (I have lived in this area since the days of using quinine pills).  The tablets do not provide a high degree of protection and can hide the symptoms delaying proper treatment, as well as promoting more drug resistant strains.  Also, the drugs sold here in Thailand are often not real if bought in the countryside from recent reporting.  Save the drugs for treatment in the unlikely event of getting malaria.

[Jade]

Larium is the most recommended by foreign doctors overseas, although it can upset some people's stomachs. Doxycycline is more gentle and is suitable for the broader spectrum. Both are very effective. I have always used Larium and have never had a problem.

Doxycycline can be purchased over the counter without prescription. Not sure about Larium though. Hope this helps.

[wolf5370]

I asked my Doctor about Rabies when I first took my kids out to LOS (didn't bother for myself). He said that for Thailand it is a waste of time. Apparantly all the vaccination does is extend the time you need to get to a hospital by 24 Hours. That is, if you are bitten you have 48 hours to get to a hospital instead of 24. As there are very few places in LOS that are more the 24 hours from a hospital, its no point.

He also said only have hep-B if you are going to be doing anything that wil put you directly at risk - i.e. spending time in a massage parlour etc. Blood in Thailand is checked and only clean blood is used.

[keestha]

Jade mentioned the anti malarial drug Lariam.....Dont underestimate the negative side effects this drug can produce. In at least one country (Denmark) prescribing it has already been prohibited. Lariam seems (sometimes) to have an effect on the mind that causes people for instance to have bizarre dreams, and reportedly it causes one in a thousand people who take it to become psychotic. It can very well be that the negative side effects only start kicking in after having taking the drug for an extended period like 5-6 weeks.

Generally speaking a tourist visiting Thailand should only take anti malarial drugs if he goes trekking in border areas in Northern Thailand, or if he intends to spend a lot of time in national parks or other remote areas.

As a disclaimer I should add there is still a theoretical chance that people following this advice would contract malaria anyway, after all one mosquito bite can be enough to contract the disease. In Europe there have been cases of people getting malaria after being bitten at an international airport in their own country, surprisingly enough the mosquitos transmitting malaria can survive a flight from Asia or Africa to Europe. This theoretical chance is so small though, that it doesnt outweigh the negative side effects all anti malarial drugs have. Tourists should  worry more about the chances of having a traffic accident in Thailand, the likelyhood of this occurring is hundreds of times higher.

Talking about negative side effects anti malarial drugs can have, I just cant refrain from telling this anecdote about what happened to me in Kalimantan (or Borneo, in Indonesia) where I was taking Nivaquine and Paludrine which where the preferred anti malarial drugs at the time. Every time I combed my hair I was sad to see I was losing lots of hair, but approaching 40 what else could I do than just resign to my fate, after all you cant remain a handsome man forever. Once back in Europe, having stopped to take the tablets after a few weeks, I was overjoyed to see that the loss of hair halted immediately.