Do any local Thais or expats ever take anti-malarials?

[chubby]

Do any local Thais or expats ever take anti-malarials? Perhaps, if one planned on being by the border for 2 weeks, say in Kanchanaburi/Sanghla, outdoors in evening, etc?

Just curious if there are any useful guidelines at all, for use or non-use in the Kingdom?

[Sheryl]

No-one takes it unless they have some very unusual habits. Transmission is limited to deep forest/jungle at night. Even on the border, the towns and villages are usually OK.

[meatboy]

I havnt taken any since the first time in Thailand [30yrs ago] as Sheryl says unless your going into jungle swamps or forests you don't need them.the ones I took I suffered side affects.

[AyG]

Even if there's no need to take anti-malarials you should still try to avoid being bitten. For dengue, which I suspect is becoming increasingly common here, has no preventative and no cure, and it's agonisingly painful. It's also not just restricted to less developed parts of the Kingdom.

[chubby]

well, there is some homestay type places up in sangkhlaburi, that look interesting and rough, in a way, so not sure what "deep jungle/forest" means exactly, I'm sure there must be some folks taking anti-malarials, albeit, possibly misinformed in Thailand....

what specifically do you find yourself doing to avoid 'getting bitten' , my maid , no matter how often I ask, just leaves the door wide open, while cleaning, and inevitably mozzies get in everyday ; it's so hot it seems difficult to keep "covered up" in long pants and socks , etc ; I wonder if there is any distribution of where people have gotten dengue in BKK, maybe in the poor, rural outskirts, at dusk and dawn ?

[AyG]

what specifically do you find yourself doing to avoid 'getting bitten'

- Have screens on all windows and doors.

- Liberal use of insecticide whenever you see a mosquito

- Cover all open water sources in the vicinity

- Mosquito net at night (preferably insecticide-treated)

- Mosquito coils when outside

- Wear light colours and cover the whole body

- Don't wear scent

I wonder if there is any distribution of where people have gotten dengue in BKK, maybe in the poor, rural outskirts, at dusk and dawn ?

Dengue isn't particularly associated with rural areas. In fact, Isaan has less than central Thailand. It's more correlated with how good the breeding conditions are for mosquitos, so Isaan is relatively dry and they don't particularly thrive there. Cases typically peak around May/June when it's rainy, but can occur at any time of year, anywhere.

[Daffy D]

Been here long time and stopped taking anti Malaria pills years ago, still get bites but no Malaria.

Try this for keeping mossies away.

[Sheryl]

well, there is some homestay type places up in sangkhlaburi, that look interesting and rough, in a way, so not sure what "deep jungle/forest" means exactly, I'm sure there must be some folks taking anti-malarials, albeit, possibly misinformed in Thailand....

what specifically do you find yourself doing to avoid 'getting bitten' , my maid , no matter how often I ask, just leaves the door wide open, while cleaning, and inevitably mozzies get in everyday ; it's so hot it seems difficult to keep "covered up" in long pants and socks , etc ; I wonder if there is any distribution of where people have gotten dengue in BKK, maybe in the poor, rural outskirts, at dusk and dawn ?

Deep jungle means deep jungle. Not where people live.

Dengue is transmitted by a daytime biting mosquito which breads in stagnant water (water jars or long-standing puddles etc). It occurs all over Thailand.

[partington]

well, there is some homestay type places up in sangkhlaburi, that look interesting and rough, in a way, so not sure what "deep jungle/forest" means exactly, I'm sure there must be some folks taking anti-malarials, albeit, possibly misinformed in Thailand....

what specifically do you find yourself doing to avoid 'getting bitten' , my maid , no matter how often I ask, just leaves the door wide open, while cleaning, and inevitably mozzies get in everyday ; it's so hot it seems difficult to keep "covered up" in long pants and socks , etc ; I wonder if there is any distribution of where people have gotten dengue in BKK, maybe in the poor, rural outskirts, at dusk and dawn ?

Deep jungle means deep jungle. Not where people live.

Dengue is transmitted by a daytime biting mosquito which breads in stagnant water (water jars or long-standing puddles etc). It occurs all over Thailand.

That's what I've heard too about malaria and deep jungle, but it's always puzzled me.

The endemic areas must contain enough people infected with malaria for the mosquitoes to acquire the parasite, because this is the only way they can transmit it. So there must be a reservoir of infected people that the mosquitoes can bite, and they must be able to reach them relatively easily during their life cycle of a month or so, so where are these people!

I've always wondered this....

Edit: Obviously you'd think biting other animals like primates might be the source, but the four most common strains of malaria (by far) are human host only....

Edited June 9, 2014 by partington

[AyG]

So there must be a reservoir of infected people that the mosquitoes can bite, and they must be able to reach them relatively easily during their life cycle of a month or so, so where are these people!

Human malaria infections can be asymptomatic, so there can be a reservoir of infected people who don't know they are so.

In the poorest parts of Thailand, treatment for people actually infected and showing symptoms is far from guaranteed. There are cases of people dying from malaria because they can't afford the cost of transport to the nearest hospital (which could be a long way away).

And finally, there are people living in Thailand (such as refugees and undocumented hill tribe people) who are not entitled to subsidised healthcare and so may not get treated.

[h90]

what specifically do you find yourself doing to avoid 'getting bitten'

- Have screens on all windows and doors.

- Liberal use of insecticide whenever you see a mosquito

- Cover all open water sources in the vicinity

- Mosquito net at night (preferably insecticide-treated)

- Mosquito coils when outside

- Wear light colours and cover the whole body

- Don't wear scent

I wonder if there is any distribution of where people have gotten dengue in BKK, maybe in the poor, rural outskirts, at dusk and dawn ?

Dengue isn't particularly associated with rural areas. In fact, Isaan has less than central Thailand. It's more correlated with how good the breeding conditions are for mosquitos, so Isaan is relatively dry and they don't particularly thrive there. Cases typically peak around May/June when it's rainy, but can occur at any time of year, anywhere.

To add: there are some electric mosquito insecticides....small bottle which is partially heated by the electric.....

And a spray for the skin, called "OFF". It really helps. Attention the mosquitos in Thailand are more related with German Stukas than with European mosquitos...These in Bangkok are very resistant to chemicals and these outside are so fast I can't catch them. Both can drill thru a jean to bite (rarely but it happened).

They aren't resistant to cool temperature....at 20 degree they can't fly anymore

Turn the aircon to 18 and you are safe.

[chubby]

It seems dusk/dawn is still wise everywhere, BKK included, too bad, as that is a nice time to be outside

• Although aedes aegypti mosquitoes most commonly bite at dusk and dawn, indoors, in shady areas, or when the weather is cloudy, "they can bite and spread infection all year long and at any time of day."^[6][7]

[HappyinNE]

I have been taken Doxycycline for when I taught School for 10 semisters (one/year) and still take it for the last four years I have been living in Nong Khai.

Recomended for border areas of Thailand.

[xamtac]

Gin and Tonic

[rethaier]

As I understand it the key medication for malaria protection is quinine but it is not cheap or easy to get. My doctor in Australia told me before I left that is I was concerned about malaria I should drink a glass of Schweppes Tonic Water every day as one of the ingredients, though in small amounts, is quinine.

[ALFREDO]

Until now, never took, live in TH, but do no jungle trekking!

[sandyf]

well, there is some homestay type places up in sangkhlaburi, that look interesting and rough, in a way, so not sure what "deep jungle/forest" means exactly, I'm sure there must be some folks taking anti-malarials, albeit, possibly misinformed in Thailand....

what specifically do you find yourself doing to avoid 'getting bitten' , my maid , no matter how often I ask, just leaves the door wide open, while cleaning, and inevitably mozzies get in everyday ; it's so hot it seems difficult to keep "covered up" in long pants and socks , etc ; I wonder if there is any distribution of where people have gotten dengue in BKK, maybe in the poor, rural outskirts, at dusk and dawn ?

Don't you believe it. I got dengue from a bite in a Pattaya hotel during the day.

Dengue is from a different variety of mosquito, bit smaller than normal. They are particularly attracted to humans and reported as the most intelligent of mosquitoes. They are fairly common in the Sattahip region and not adverse to catching the bus north.

[Maybole]

I worked in the Gulf for 20 years. The company doctor insisted we all took Paludrine every day and Melaprim? every week. When I moved to Malaysia, the local doctor(Chinese but a graduate of Glasgow Uni.)was horrified, insisting that all anti-malarial drugs were for short term use only and could cause kidney damage if used for a long time. He also said that these drugs were not 100% effective and could cause difficulties in treating a resistant strain by masking the symptoms.

I stopped taking them, and many years later, in spite of getting bitten often (I am a family joke over mosquito bites) I have yet to be infected.

[duanebigsby]

Just something to add to those saying not to have standing water around your house; if you like the big Chinese pots with papyrus or lotus in them, make sure you have little fishies to eat the mozzies. Also don't shoo out your geckos!

[saroq]

Been here long time and stopped taking anti Malaria pills years ago, still get bites but no Malaria.

Try this for keeping mossies away.

Off Insect Repellent.jpg

Or try this ...

[Gandtee]

Thirty years ago I was advised by a doctor to stop taking anti malaria tablets as the side effects could do more harm than good. I have never taken them since. The best way to avoid malaria is not to get bitten. Use 'Off' repellent sparingly, and wear long sleeves and trousers in the evenings when going out. Having said that my son and family came for a visit and he developed Bangkok Belly and I thought that I had given him medication for it but had given him a previous visitors anti malaria tablets. My daughter-in- law was most upset and accused me of trying to bump off her husband. My reply was 'Well. he didn't get malaria did he'!

[Gandtee]

As I understand it the key medication for malaria protection is quinine but it is not cheap or easy to get. My doctor in Australia told me before I left that is I was concerned about malaria I should drink a glass of Schweppes Tonic Water every day as one of the ingredients, though in small amounts, is quinine.

Yes! Tonic Water contains quinine which is I believe a cure for malaria. That is how I explain my drinking of large gin and tonics. Well, that's my excuse anyway.

[jobin]

U might look here for info:

http://www.cdc.gov/malaria/travelers/country_table/a.html

[bangkapi]

While working in Africa 2012-2014, there were 3 anti-malarial options, none of which were perfected.

All of them had negative side effects that, taken long term, could be worse than contracting malaria itself.

I chose to forgo the drugs after 3 months.. Three of my 19 coworkers got malaria over the 2 year period I worked there.

I was lucky.

[CharlesHH]

1. The one malaria med I took, Lariam, mefloquine hydrochloride, gave me significant hallucinations, first in dream and then after awaking. I also had rapid heartbeat for several hours and ended up in the hospital in, yes, KATHMANDU. No, that hospital does not use straw on the floor. It took three days to get it out of my system.

2. I had dengue fever and yes "break bone" feeling is correct.

I put DEET on my clothes if going into the back country where there is no spraying.

Someone, mooban or govt?, sprays the golf lagoons around my house. At home, no problems as family closes up doors and windows promptly at night even tho I have all screened windows.

Maybe there are better meds now days?

[Emster23]

I stopped taking long ago after reading pamphlet that came with drug saying it also cures malaria. " Dengue is from a different variety of mosquito, bit smaller than normal. They are particularly attracted to humans and reported as the most intelligent of mosquitoes." I have had dengue twice, and I live in Jomtien. To keep that intelligent mossie from biting me I either put Fox News on the tube or an unfinished sudoku puzzle on the table. Worked so far. Oh, also heard it is a daytime biter....

[Sheryl]

A post advocating dangerous quack treatment has been removed along with posts replying to same.

As stated previously, malaria transmission is limited to heavily forested areas around Thailand’s borders. Actual towns on the border, like Nong Khai, are free of transmission and there is no need to take malaria prophylaxis in them. Very, very few people would have any reason to need malaria prophylaxis here. Which is one reason why malarial medications (including those that might be used for prophylaxis) are controlled here and not available over the counter.

Those who do not want to take my word for this – or who think that their itinerary is such that it might place them in an endemic area at night -- suggest you go to the travel medicine clinic of the Mahidol Tropical Disease Hospital and discuss with tyhem there, they are thoroughly conversant with which parts of Thailand are endemic for malaria.

http://www.thaitravelclinic.com/

[ticher1941]

Back in 65 I took Paludrine daily for a year in Borneo, no malaria but i did get dengue fever.

[sandyf]

I stopped taking long ago after reading pamphlet that came with drug saying it also cures malaria. " Dengue is from a different variety of mosquito, bit smaller than normal. They are particularly attracted to humans and reported as the most intelligent of mosquitoes." I have had dengue twice, and I live in Jomtien. To keep that intelligent mossie from biting me I either put Fox News on the tube or an unfinished sudoku puzzle on the table. Worked so far. Oh, also heard it is a daytime biter....

Did you get the dengue in Jomtien or somewhere else. I live in Chonburi but got it in Pattaya, just went for the day.

I have not seen any figures for reported cases in Chonburi province.

[Sheryl]

Dengue is everywhere in Thailand. In a given year, there may be more cases in certain provinces, but not the same ones year after year. You can literally get it anywhere in the country and a very high percentage of long-term expat residents have had it at least once. (Do a search for "dengue" on this forum for various accounts).

It is highly unpleasant but there is a wide range in severity, some people have fairly mild cases, and only a small minority develop the complicated hemorrhagic form.