What Anti Malaria Medicine?

[wellred]

Which do you recommend? I know of 2 but both seem to give strange side effects. Doxycycline apparently makes you break out in blisters in the sun and Mefloquine can causes anybody suffering from irregular heartbeat seizures, epilepsy, anxiety attacks and anxiety related disorders, as well as people that have a medical condition or history of psychiatric problems as well as depression or any form of psychosis.

So any advice people? I'm not sure how high risk the areas I'm going to are but some advice on what you have taken in the past would be good. I'm going to Chang mai, chiang rai, Bangkok, krabi, koh phangan, pnomh penh and ubon.

[bkkjames]

Seriously, I would not take it for the places you plan to visit.

I would worry more about Dengue Fever than malaria in Thailand.

[wellred]

Ok thanks. I've since looked at the CDC and WHO sites and they both concur with the above. I'm going to be using some mosquito patches too, supposedly better than spray as they cover your whole body as oppose to only spryed areas but I'm not too keen on DEET.

[tutsiwarrior]

yeah...I'd say that if you're a healthy adult with a healthy immune system and staying in western style tourist accommodation then there ain't much to worry about with regard to malaria...dengue is much more insidious but if you take the usual precautions with chemical repellants when sitting outdoors in the evening you should be OK...

I remember mobilising for my first overseas assignment in Indonesia (Jakarta) in 1993 and the list of possible afflictions read like something with indigenous tribes in Papua New Guinea...the 'old hands' would just smirk at all the preventive medication and say: 'you like takin' that shit?...'

[Soutpeel]

yeah...I'd say that if you're a healthy adult with a healthy immune system and staying in western style tourist accommodation then there ain't much to worry about with regard to malaria...dengue is much more insidious but if you take the usual precautions with chemical repellants when sitting outdoors in the evening you should be OK...

Does gin & tonic count as a chemical reprellant for the mozzies...LOL

[bkkjames]

yeah...I'd say that if you're a healthy adult with a healthy immune system and staying in western style tourist accommodation then there ain't much to worry about with regard to malaria...dengue is much more insidious but if you take the usual precautions with chemical repellants when sitting outdoors in the evening you should be OK...

Does gin & tonic count as a chemical reprellant for the mozzies...LOL

Check out the ingredients of Tonic Water...

Tonic Water Components

In those old days, tonic water ingredients were water, soda, gin and quinine. These days, quinine is produced chemically and is used in much larger doses to treat malaria. It has been proved now, that quinine therapy does not exactly kill malaria; but it helps lower fever and malarial symptoms. Most of the times, a person has to take antibiotics to experience full recovery from malaria. Tonic water actually contains a very small amount of quinine, added just to enhance the flavor of the drink. If tonic water is considered as a cure for malaria, then the patient may have to drink at least 1.77 liters of tonic water a day or at least ten 'gin and tonics'! This would be quite expensive and it might give rise to other health complications!

Though it doesn't have enough quinine to reduce the symptoms of malaria, the drink is still known as "tonic water" meaning essentially healthful, perhaps because it contains quinine. Tonic water is sweetened and flavored with fruit extracts too. It does not contain caffeine. Following are the ingredients of tonic water.

• Spring water
• Natural quinine
• Sugar
• Citric acid
• Some 'botanical' flavors (presumably some of the usual bitter herbs)
• Carbonated water
• Sodium citrate
• Natural fruit flavors
• Sodium benzoate (preservative)
• Saccharin (5.1 mg per fluid ounce)

[bifftastic]

I didn't realise that there was a mosquito patch that covers your whole body! Can you get it off quickly if you need to go to the toilet?

Seriously though, the side effects of those anti-malarials sound almost as bad as malaria! Where you're going, you'll be fine.

If you're getting shots though, make sure you have a rabies one

[tutsiwarrior]

yeah...I'd say that if you're a healthy adult with a healthy immune system and staying in western style tourist accommodation then there ain't much to worry about with regard to malaria...dengue is much more insidious but if you take the usual precautions with chemical repellants when sitting outdoors in the evening you should be OK...

Does gin & tonic count as a chemical reprellant for the mozzies...LOL

dunno..I don't drink gin and sugar free tonic water is hard to come by in these 'savage' locations (I've got diabetes) but tonic is a tasty mixer for the voddy...

[Sheryl]

The places you are going are not a risk for malaria transmission...regardless of the state of your immune system.

Malaria transmission in Thailand and Cambodia is only in dense forested areas, not towns or villages, and you'd have to stay out at night in said jungles.

Dengue on the other hand is transmitted pretty much everywhere in these two countries. it's spread by a day-time biting mosquito. Best defense is just to do what you can to avoid/minimize mosquitoe bites.

[tutsiwarrior]

'Dengue on the other hand is transmitted pretty much everywhere in these two countries. it's spread by a day-time biting mosquito. Best defense is just to do what you can to avoid/minimize mosquitoe bites.'

What?...I thought that dengue mosquitoes slept during the day so as to preserve their efforts for infecting unsuspecting humans when they were having a drink with friends on the terrace in the evening and minding their own business...

[Digitalbanana]

The places you are going are not a risk for malaria transmission...regardless of the state of your immune system.

Malaria transmission in Thailand and Cambodia is only in dense forested areas, not towns or villages, and you'd have to stay out at night in said jungles.

Dengue on the other hand is transmitted pretty much everywhere in these two countries. it's spread by a day-time biting mosquito. Best defense is just to do what you can to avoid/minimize mosquitoe bites.

A colleague of mine is planning a month or two in some fairly rural parts of Cambodia, Prear Veah province. Any recommendations for that with regards prophylaxis?

[bkkjames]

The places you are going are not a risk for malaria transmission...regardless of the state of your immune system.

Malaria transmission in Thailand and Cambodia is only in dense forested areas, not towns or villages, and you'd have to stay out at night in said jungles.

Dengue on the other hand is transmitted pretty much everywhere in these two countries. it's spread by a day-time biting mosquito. Best defense is just to do what you can to avoid/minimize mosquitoe bites.

A colleague of mine is planning a month or two in some fairly rural parts of Cambodia, Prear Veah province. Any recommendations for that with regards prophylaxis?

Take Kevlar instead.

[Sheryl]

'Dengue on the other hand is transmitted pretty much everywhere in these two countries. it's spread by a day-time biting mosquito. Best defense is just to do what you can to avoid/minimize mosquitoe bites.'

What?...I thought that dengue mosquitoes slept during the day so as to preserve their efforts for infecting unsuspecting humans when they were having a drink with friends on the terrace in the evening and minding their own business...

Nope, they bite during the day.

people napping during the day being a favorite target....

[Sheryl]

A colleague of mine is planning a month or two in some fairly rural parts of Cambodia, Prear Veah province. Any recommendations for that with regards prophylaxis?

Unless he will for some reason be camping out at night deep in the jungle (in which case malaria is but one of many things to worry about), same advice -- none.

The malaria mosquito bites only at night, and in this part of the world lives only in deep forest. (Apparently not the case in Africa). As long as he's staying in towns at night, should be OK and as above, more at risk of dengue than malaria.

[Thanyaburi Mac]

Ok thanks. I've since looked at the CDC and WHO sites and they both concur with the above. I'm going to be using some mosquito patches too, supposedly better than spray as they cover your whole body as oppose to only spryed areas but I'm not too keen on DEET.

I use the DEET available here in the orange OFF! can. Not real sure how effective it is as it's just 15% whereas the www seems to recommend 25% on up to perhaps 50%, altho with cautions for the latter.

Mac

[endure]

yeah...I'd say that if you're a healthy adult with a healthy immune system and staying in western style tourist accommodation then there ain't much to worry about with regard to malaria...dengue is much more insidious but if you take the usual precautions with chemical repellants when sitting outdoors in the evening you should be OK...

Does gin & tonic count as a chemical reprellant for the mozzies...LOL

dunno..I don't drink gin and sugar free tonic water is hard to come by in these 'savage' locations (I've got diabetes) but tonic is a tasty mixer for the voddy...

Fraser & Neave Extra Dry tonic water from Singapore is the one to drink. It's like sucking lemons.

[tutsiwarrior]

yeah...I'd say that if you're a healthy adult with a healthy immune system and staying in western style tourist accommodation then there ain't much to worry about with regard to malaria...dengue is much more insidious but if you take the usual precautions with chemical repellants when sitting outdoors in the evening you should be OK...

Does gin & tonic count as a chemical reprellant for the mozzies...LOL

dunno..I don't drink gin and sugar free tonic water is hard to come by in these 'savage' locations (I've got diabetes) but tonic is a tasty mixer for the voddy...

Fraser & Neave Extra Dry tonic water from Singapore is the one to drink. It's like sucking lemons.

oh...fer fcuks sake, I'm just coming to terms with the generic brand tonic an' you got to go and complicate things...

'she watched as he mixed his drink after torrid sex using the generic brand of tonic and it was piquant to her that their desire had thus been cheapened...'

Edited November 11, 2011 by tutsiwarrior

[californiabeachboy]

A very timely thread for me, as I am sitting here in a mosquito-free environment getting ready for my trip over to Thailand, and just returned from the pharmacist to pick up my malaria pills (malarone).

My health care provider has a travel clinic, and as others have said here, they recommended malaria pills only if you are going into a rural area of Thailand. I got them because I might be going into some rural areas outside Chiang Mai (but the pills are not cheap by the way - 10 bucks a pill).

I just called the travel clinic again because I was wondering if the flooding in Bangkok and other areas has changed their recommendation with respect to malaria, and the travel nurse said no. The problem with the urban area flooding according to her is typhoid, not malaria.

And to answer the op's question about side effect, the pharmacist said soemtimes dizzyness, sometimes upset stomach so take them with food, and occasionally mouth sores. I jokingly asked her if I oould wait until I felt the little bugger bite me then down a few pills and she said it doesn't work that way, you need to start two days before you are in the infected area.

I am wondering if Pai and Mae Song Hon in Northern Thailand are considered rural areas? If not I will skip the malaria pills and go with the DEET and gin and tonics (not mixed together, althought now that I think about it that could be a million-dollar invention)

I am not a health care professional so just passing this on for what it is worth.

Edited November 11, 2011 by californiabeachboy

[Soutpeel]

I just called the travel clinic again because I was wondering if the flooding in Bangkok and other areas has changed their recommendation with respect to malaria, and the travel nurse said no. The problem with the urban area flooding according to her is typhoid, not malaria.

The problems in the flood area's will be Dengue, Cholera and possibly typhoid, (god forbid they do break out) Maleria will not even come into the equation.

Further with maleria medication (as was told many years ago while working in maleria area's in Africa) do not take the medication unless you really need it, as long term use can cause liver damage.

On the med's I was always told you needed to take them a week before you enter a maleria area, not 2 days, and you have to keep taking them once you leave for a period of 1 to 2 weeks, this may have only related to Larium, which is what we used to take

[Digitalbanana]

A colleague of mine is planning a month or two in some fairly rural parts of Cambodia, Prear Veah province. Any recommendations for that with regards prophylaxis?

Unless he will for some reason be camping out at night deep in the jungle (in which case malaria is but one of many things to worry about), same advice -- none.

The malaria mosquito bites only at night, and in this part of the world lives only in deep forest. (Apparently not the case in Africa). As long as he's staying in towns at night, should be OK and as above, more at risk of dengue than malaria.

Thanks Sheryl.

[Sheryl]

A very timely thread for me, as I am sitting here in a mosquito-free environment getting ready for my trip over to Thailand, and just returned from the pharmacist to pick up my malaria pills (malarone).

My health care provider has a travel clinic, and as others have said here, they recommended malaria pills only if you are going into a rural area of Thailand. I got them because I might be going into some rural areas outside Chiang Mai (but the pills are not cheap by the way - 10 bucks a pill).

I just called the travel clinic again because I was wondering if the flooding in Bangkok and other areas has changed their recommendation with respect to malaria, and the travel nurse said no. The problem with the urban area flooding according to her is typhoid, not malaria.

And to answer the op's question about side effect, the pharmacist said soemtimes dizzyness, sometimes upset stomach so take them with food, and occasionally mouth sores. I jokingly asked her if I oould wait until I felt the little bugger bite me then down a few pills and she said it doesn't work that way, you need to start two days before you are in the infected area.

I am wondering if Pai and Mae Song Hon in Northern Thailand are considered rural areas? If not I will skip the malaria pills and go with the DEET and gin and tonics (not mixed together, althought now that I think about it that could be a million-dollar invention)

I am not a health care professional so just passing this on for what it is worth.

As above -- unless you are going to be camping out at night in the jungle, you do not need malaria prophylaxis in Thailand, including rural Thailand. Certainly not in towns in rural provinces.

If you nonetheless insist in taking something, doxycycline would be a better choice than malarone.

[californiabeachboy]

Thanks for the above advice. I have no intention of camping out in the jungle, so I will probably just take a pass on the malaria medicine. Cheers.