Malaria In Thailand

[BoonToong]

I have been doing some trawling on the internet to try and establish whether Malaria cases appear in Thailand. A lot of websites advise about malaria risk but they often have a sub-agenda of making a commission on selling antimalarial drugs and insect repellents. One site (CDC, the Center for Disease Control and Prevention) reports cases have been found in rural, forested areas that border Cambodia, Laos, and Burma (Myanmar). Rare local cases in Phang Nga and Phuket. None in cities and in major tourist resorts. None in cities of Bangkok, Chiang Mai, Chiang Rai, Pattaya, Koh Samui, and Koh Phangan

The reason that I ask is because a Thai friend of mine went for a trip to the North of Thailand a few weeks ago and is now sick. Because I lived in West Africa for a few years, I am familiar with the symptoms of malaria and the symptoms she describes would have me off to get the test done if I was showing those symptoms.

So I just want to find out if anyone knows of any CONFIRMED (i.e., parasite discovered in the body) cases of malaria any where in Thailand?

For information, she has a severe headache and aching body.

Thank you in advance for any information.

[Mario2008]

Thailand is not free of malaria, it is better to say that malaria in Thailand is under control.

Having lived near the Thai border with Burma I have seen many cases of malaria, including deaths. Especially remote areas are risky, and the border areas.

All over Thailand you can have a simple malaria test.

[FBN]

This seems to be just about the most informative site and this article seems fairly comprehensive. The RBM (Roll Back malaria) organisation was formed by Unicef World Bank and other international organisations so info should be fairly accurate:

http://www.rollbackmalaria.org/wmr2005/profiles/thailand.pdf

It must also be taken into account that probably most of the malaria cases occurring along the north western part on the Burmese border are not formally tested as over the counter treatment and self diagnosis and are then not recorded and/or reported. This report only takes into account laboratory confirmed cases.

Most hospital labs at the larger hospitals should be able to do a blood smear or other test for malaria. Accuracy of diagnosis on malaria smears is directly related to the experience of the technician so having a smear done in one of the hospitals in the most affected areas probably more reliable than BKK, but rapid blood tests are available.

[surangw]

whatever you do, stay away from mefloquine

caused me and some friends some serious problems

[BoonToong]

Thank you both for your help.

Yes, my experience is also that the success of detection is down to the experience of the person looking at the samples.

Her symptoms have developed further such that she now has a sore throat and has lost her voice. she has also been to the doctor.

Better safe than sorry though, especially with malaria.

Thank you again

[BoonToong]

whatever you do, stay away from mefloquine

caused me and some friends some serious problems

I agree most strongly. In the UK this is sold as 'Larium' and several people I know who have taken this have had awful psychological side-effects.

I took one tablet years ago and stopped immediately; I felt very strange!!

[hansell]

Hi BoonToong,

I asked a friend who's been in Thailand for 10 years now. She's stayed in different parts of the country and according to her, she's never known anyone who suffered from malaria. Although admittedly, she heard some cases on the bordering areas.

To anyone who plans to travel/ tour the remote & border areas of Thailand, please take vaccine shots. Remember, prevention is always better than cure!

[Forethat]

Unfortunately, Malaria is more common in Thailand than one would think. Sadly enough, despite huge government efforts to control the epidemic, the number of reported cases is still well over 25.000/year. Malaria mortality rates are unpredictable and difficult to estimate since there are a large number of unreported cases, but the current number in Thailand sits at about 0.004%, or 025/1000 (with 25000 cases, 100 deaths are expected)

Malaria in Thailand is very real.

[BoonToong]

Hi BoonToong,

I asked a friend who's been in Thailand for 10 years now. She's stayed in different parts of the country and according to her, she's never known anyone who suffered from malaria. Although admittedly, she heard some cases on the bordering areas.

To anyone who plans to travel/ tour the remote & border areas of Thailand, please take vaccine shots. Remember, prevention is always better than cure!

Thanks Hansell. Just to be clear though, for anyone reading this thread, to the best of my knowledge there is no vaccination for malaria or am I behind the times?

[BoonToong]

Unfortunately, Malaria is more common in Thailand than one would think. Sadly enough, despite huge government efforts to control the epidemic, the number of reported cases is still well over 25.000/year. Malaria mortality rates are unpredictable and difficult to estimate since there are a large number of unreported cases, but the current number in Thailand sits at about 0.004%, or 025/1000 (with 25000 cases, 100 deaths are expected) Malaria in Thailand is very real.

Thanks Forethat (NOW I get it!!! LOL).

I tried to research this on the internet but I obviously was not as successful as you. Where did you get this useful data from please?

[Mario2008]

There is no vaccine against malaria.

My understanding is that you can get malaria tablets to prevent malaria, but that is done if you go for a limited time to an area where there is malaria. It doesn't prevent malaria, it reduces the chance you get malaria. Some mosquitoes will be resistant to the medication. So the longer you stay in an area, the higher the chance you will get it and the medication will than suppress the symptoms of malaria. So you might get it without realizing it.

That is why I was advised not to use it, because I stayed long time in an area with malaria. But tourist who travel for a few weeks in malaria effected areas are often advised to use malaria tablets.

[FBN]

There is no vaccine for malaria and the chemical prophylaxis is also complex and changes from region to region as well as from time to time as drug resistant malaria strains appear.

At the moment it is Doxicycline for Thailand's border areas for short time visitors to those areas; chemical prohylaxis always has to be combined with precautions to prevent mosquito contact.

Most of these drugs have a significant side effect prophile and is also complicated by the fact that they have to be taken for a few weeks after returning from an endemic area. This is where a number of people default and end up with malaria which may be extremely difficult to confirm with blood smears. Usually these travelers are then back in home countries where malaria is unknown and physicians not aware enough so many of these cases end up as fatalities.

The approach of "there is no flu when returning from a malaria endemic area; it is malaria until proven otherwise" is the safest.

[Forethat]

Unfortunately, Malaria is more common in Thailand than one would think. Sadly enough, despite huge government efforts to control the epidemic, the number of reported cases is still well over 25.000/year. Malaria mortality rates are unpredictable and difficult to estimate since there are a large number of unreported cases, but the current number in Thailand sits at about 0.004%, or 025/1000 (with 25000 cases, 100 deaths are expected) Malaria in Thailand is very real.

Thanks Forethat (NOW I get it!!! LOL).

I tried to research this on the internet but I obviously was not as successful as you. Where did you get this useful data from please?

Plenty of statistics available for me. For the private consumer of health related reports for South East Asia (statistics and raw data is usually not available outside publications that comes at a cost for a majority of customers) i suggest you pay a visit to http://www.searo.who.int/

And, you're doing the right thing not ignoring Malaria - even though it'd be nothing but a suspicion. Get it checked.

[Forethat]

Although generally assumed that Malaria is most commen in the south , I haven't been able to find any stats on the geographical distribution of the cases reported in Thailand. So if I say that a majority of the cases are from the very south of Thailand you can consider that as an estimate purely based on speculation. I'd be intersting to find some stats on this, though.

Here's a related report from Ubon, not in the South at all...

http://www.en.mahidol.ac.th/journal/20092/5jaruwan.pdf

[BoonToong]

My understanding is that you can get malaria tablets to prevent malaria

For 3 years I lived in The Gambia, a hotbed for malaria and the home of the UK's Malaria Research programme (which has been running for about 20 years). That doesn't qualify what I am about to say; I just want to put some weight on the information that I am passing on.

My understanding is that if you are bitten by a mosquito carrying the malaria parasite, then that parasite may enter your bloodstream and begin to multiply. If you have been taking anti-malarials, then those drugs simply slow down the rate of multiplication of the parasite, NOT PREVENT IT, and full-blown malaria will eventually develop if not treated. The same anti-malarial pre-treatments can be used to kill off the parasite but not if you were taking it previously. Some people would argue, therefore, that it it better not to take anti-malarials, leaving a much wider spectrum of drugs available to fight the parasite.

My advice, similar to that already stated, is quite simple: If, after travelling to a known malaria zone, you develop flu-like symptoms between 10 -60 days afterwards, then go to seek medical assistance and mention your possible exposure to malaria. Many of my UK-based airline pilot friends when feeling ill will visit a tropical disease specialist in London, just to be sure that they are seen by someone who knows exactly what to look for.

When a blood test is done, it relies on someone inspecting the sample under a microscope and looking for the actual parasite. I remember a lab technician showing me a positive sample under the microscope and I still could not discern what it was that he had detected. As a result, diagnosing malaria is often symptom-based just to play safe.

Take care folks, it's a jungle out there

My friend is now feeling a bit better and we are now pretty sure that it is not/was not malaria.

[SantiSuk]

Advice of UK practitioners is that Malarone is currently the effective anti-malarial drug. The little buggers have developed resistance to the older forms. Tourists to the Cambodia and Burmese jungle border areas are advised to take precautions. Malarone is prohibitively expensive for more than tourist use, so us residents should continue to be vigilant and get blood tests for any signs of fever.

I live 50 k from the jungle border of Cambodia. The jungle is only a thin strip close to the border in the mountains and a local doctor told me he has seen no malaria in local residents (I get bitten only 2 or 3 times a month at our place), except for those who have traveled, in over ten years. He has seen a few dengue cases though.

[bina]

here's a link about malaria and israel... israel used to be a main 'hotbed' of malaria until the 'swamps were dried out' (now the swamps have been re created for ecological reasons but mosquito control is very strict)....however, the main source of malaria reports here seems to be from travellors abroad in africa who come back and then develop the symptoms.

http://www.haaretz.com/print-edition/news/nahariya-nurse-29-dies-of-malaria-after-returning-from-two-years-in-equitorial-guinea-1.323480

surprisingly enough, since we are a small country but have a huge amount of travellors to exotic desticnations, and almost all travellors that become ill after returning home are told to go to 'tropical disease' clinic, the statistics should be reliable (they are reportable diseases).

bina

israel

we should probably add bilharzia to the thailand bug list (always wondering if my daughter and i should be checked since we swam in some river in korat and there is bilharzia and some of the rivers)... but then again, we have jiardia and salomenellas galore here at home...

[geriatrickid]

Yes, there is malaria in Thailand. However, the incidence of malaria has fallen from 0.86 (2003) to 0.55:1,000 population in 2008. That means 55 cases per 100,000. Still a significant number. Around 26,000 laboratory-confirmed cases are reported per annum of which 47% are Plasmodium falciparum. Eleven (Tak, Yala, Mae Hong son, Narathiwat, Songkla, Ranong, Chanthaburi, Chumporn, Kanchanabur, Petchaburi, Prachua Khiri Khan) of the 24 provinces of have an incidence greater than 100 per 100,000. These provinces' incidence inflates the national number. The Thai-Cambodia and Thai-Myanmar borders have multi drug resistant P. falciparum malaria. There are no recent numbers because it takes about 2 years to compile and vet the data. The reason that Chiang Mai is a center of malaria research is because malaria still presents a serious problem to Thailand.

Source: Oct. 4, 2010 Malaria Journal 2010, 9:266

[ignoramus]

FWIW -- heard this chap on the radio tonight who said vitamin B1 protects him from mozzies [in the state of New South Wales]. Exotic mozzies not discussed. As I said, FWIW.

[sezze]

Malaria is present and so is dengue . Government is trying to get rid of mosquitos in infected areas once a while by spraying but that only helps a small bit . The areas in the north and northeast of Thailand do have a lot of mosquite problems ( more mozzie is more potential diseases ) . I always sleep under a net but i still get more then 5 or 10 bites a day ( Isaan ) , never had a problem down south .