Malaria

[hocuspocus]

I have family from the UK visiting us in Chiang Mai for two weeks at the beginning of September and they have asked me if they need to take anti-malaria tablets during their visit. Mainly we will be in the Chiang Mai area but we will be travelling to the Golden triangle and as far South as Tak and maybe to the Myanmar border near Tak. Can some please advise me if they need to take tablets, personally as with most expats I do not take any anti-malaria tablets but I do get bitten a lot. Thanks in advance.

[Aachen]

My Doctor says: NO.

[Sheryl]

Unless they will literally spend nights in the deep jungle (highly unlikely -- even on overnight treks will generally sleep over in a village) - NO.

[masuk]

Get a decent mosquito repellant.   I haven't heard of anyone locally getting malaria, but dengue YES!    

[bazza40]

Better to be safe than sorry - a daily dose of 100 mg of doxycycline will not hurt,and may well help ward off other opportunistic infections.

[RedQualia]

My wife contracted malaria many years ago when she was living and working in Mae Sot, on the Myanmar border west of Tak. She was lucky that the doctors there were familiar with the symptoms and so could treat her quickly. I hear the doctors in Chiang Mai don't know malaria and have sometimes been unable to diagnose it for those who have traveled to areas where malaria is more common. Which is to say, malaria is exceedingly rare in the Chiang Mai area, but doctors in Mae Sot/Tak know it well enough. My understanding is that there are no malaria problems in the golden triangle area.

 

While I used to bring malaria tablets on visits to SE Asia, I never used them. This is because I'm a scuba diver and diving doesn't mix with the drug I was given. All in all, lots of nasty side effects: "Unfortunately mefloquine frequently produces annoying adverse neurological effects such as insomnia, vivid dreams, dizziness, mental clouding, anxiety and coordination problems. These are sufficient to interfere with daily activities in up to 10% of users and are probably aggravated by use of alcohol and cannabis. ... Consequently any person requiring a clear mind and good co-ordination should not use mefloquine. This may involve travellers to high altitude and definitely those contemplating aqualung (scuba) diving. Other contra indications include persons with a history of seizures, neuro-psychiatric disorder, the first 3 months of pregnancy and those with cardiac conduction problems. Women are advised to use contraceptives during and for 3 months after administration of mefloquine." -- http://www.nevdgp.org.au/info/travel/bots/antimalarial_se.htm

 

But they may not be prescribing that drug for Myanmar visits anymore. There are 3-4 different drugs they use in different areas of SE Asia, depending on what the malaria in one or another area is judged to be resistant to at different times.

 

Sometimes, yes... The "cure" sounds worse than the disease. I have lived in Thailand for many years now. Though I've traveled all along the northern borders of Myanmar and Laos, and all over Laos and Cambodia, the thought of taking malaria meds just never occurs to me. Nor do I generally carry insect repellent (though will take repellent and a mosquito net when I know I will be staying in a small village in the middle of nowhere for a while). I try not to be, but have surely been bitten by gobs of SE Asian mosquitoes by now. Have never had malaria, nor dengue (knock on wood). Both of my daughters have had dengue, contracted at schools in Chiang Mai City. No cure for dengue. Sometimes really nasty.

[masuk]

I use roll-on mosquito repellant when I venture out across the street to the open door cafe in the evening, although dengue mozzies are about in the day too.     There is dengue in Chiang Mai I've read, and it's hard to treat.  Malaria is not a problem.  I'd rather be sure than sorry, as I've had malaria once (from Papua New Guinea) and I'm told dengue is much more persistent.

[connda]

Unequivocally, no.  However, don't forget your mosquito repellent just yet.  Dengue fever can be just about as nasty, and that they do have here in spades. 

[mankondang]

As stated by others NO. There is little chance of catching it in Chiang Mai or Mae Sot, where i visit regularly. A good mosquito repelent is advisable, if only to stop the normal irritations some people suffer.The side effects of the anti-malaria medication are not good news either, and could make for an unpleasant holiday.

[ClutchClark]

2 hours ago, bazza40 said:

Better to be safe than sorry - a daily dose of 100 mg of doxycycline will not hurt,and may well help ward off other opportunistic infections.

 

What?

 

Jesus.

 

i hope the OP does not follow these instructions for his child.

[oldlakey]

1 hour ago, RedQualia said:

My wife contracted malaria many years ago when she was living and working in Mae Sot, on the Myanmar border west of Tak. She was lucky that the doctors there were familiar with the symptoms and so could treat her quickly. I hear the doctors in Chiang Mai don't know malaria and have sometimes been unable to diagnose it for those who have traveled to areas where malaria is more common. Which is to say, malaria is exceedingly rare in the Chiang Mai area, but doctors in Mae Sot/Tak know it well enough. My understanding is that there are no malaria problems in the golden triangle area.

 

While I used to bring malaria tablets on visits to SE Asia, I never used them. This is because I'm a scuba diver and diving doesn't mix with the drug I was given. All in all, lots of nasty side effects: "Unfortunately mefloquine frequently produces annoying adverse neurological effects such as insomnia, vivid dreams, dizziness, mental clouding, anxiety and coordination problems. These are sufficient to interfere with daily activities in up to 10% of users and are probably aggravated by use of alcohol and cannabis. ... Consequently any person requiring a clear mind and good co-ordination should not use mefloquine. This may involve travellers to high altitude and definitely those contemplating aqualung (scuba) diving. Other contra indications include persons with a history of seizures, neuro-psychiatric disorder, the first 3 months of pregnancy and those with cardiac conduction problems. Women are advised to use contraceptives during and for 3 months after administration of mefloquine." -- http://www.nevdgp.org.au/info/travel/bots/antimalarial_se.htm

 

But they may not be prescribing that drug for Myanmar visits anymore. There are 3-4 different drugs they use in different areas of SE Asia, depending on what the malaria in one or another area is judged to be resistant to at different times.

 

Sometimes, yes... The "cure" sounds worse than the disease. I have lived in Thailand for many years now. Though I've traveled all along the northern borders of Myanmar and Laos, and all over Laos and Cambodia, the thought of taking malaria meds just never occurs to me. Nor do I generally carry insect repellent (though will take repellent and a mosquito net when I know I will be staying in a small village in the middle of nowhere for a while). I try not to be, but have surely been bitten by gobs of SE Asian mosquitoes by now. Have never had malaria, nor dengue (knock on wood). Both of my daughters have had dengue, contracted at schools in Chiang Mai City. No cure for dengue. Sometimes really nasty.

sometimes really fatal and thats about as nasty as it gets

[Carib]

3 hours ago, bazza40 said:

Better to be safe than sorry - a daily dose of 100 mg of doxycycline will not hurt,and may well help ward off other opportunistic infections.

Very, very bad advice. Never ever take an antibiotic when not needed.

[oldlakey]

23 minutes ago, ClutchClark said:

 

What?

 

Jesus.

 

i hope the OP does not follow these instructions for his child.

Why not after all Thai visa is world renown for solid medical advice

 

[Carib]

2 minutes ago, oldlakey said:

Why not after all Thai visa is world renown for solid medical advice

 

 

For advice coming from Sheryl, yes TV has a good reputation, not to say a very good reputation, all other advice is to be scrutinized.

[oldlakey]

This is to the original poster and it will end my participation in this medically centered thread on a lighter note.

I have no medical expertise which should be obvious to all and sundry by now so I will withdraw

 

 But not before I offer the OP this proven piece of advice

The only sure cure I know to stop getting bitten is to give the missus written instructions to stop doing it  

[tifino]

sensible not to take MalariaMeds when not necessary, quite good sense that...

 

i followed the idea only take the malaria precaution if quite sure I will be venturing out to the wilder parts. 

My Dr warned, and missus backed this up that once a particular malaria med(whether a pill, or otherwise) can only be used the one time, and useless if the same is repeated. (I'd luv to have that confirmed for real, or nay)

I've been through a few different ones, so will soon need to wonder what happens when all options run out?

 

Missus had malaria, caught from the canals near Amphawa, so her concerns are even deeper. It scares her to return now, more than me

 

At least I am allowed to eat grapefruits and drink Tonic water, unlike her

 

 

[212Roger]

6 hours ago, masuk said:

Get a decent mosquito repellant.   I haven't heard of anyone locally getting malaria, but dengue YES!    

I caught Dengue in August of 2012.  NOT fun.  That's the only thing to worry about.  Cover up, use repellant, and cross your fingers.

[Sheryl]

1 hour ago, Carib said:

Very, very bad advice. Never ever take an antibiotic when not needed.

+1

[Johpa]

Use mosquito repellents and coils.  But unless you are  volunteering in the refugee camps along the Thai-Burmese border, and clearly that is not the case, there is no need to take prophylactic medicines for malaria. And visiting the bustling border town of Mae Sot is not the same as being in the refugee camps which are located quite a distance from Mae Sot itself.

[oldlakey]

3 hours ago, Carib said:

 

For advice coming from Sheryl, yes TV has a good reputation, not to say a very good reputation, all other advice is to be scrutinized.

For medical advice or treatment I consult a suitably qualified Doctor you sir can do as you please

[Carib]

21 minutes ago, oldlakey said:

For medical advice or treatment I consult a suitably qualified Doctor you sir can do as you please

 

Sure, and if you want to know who is a qualified doctor in Thailand and where to find them...ask Sheryl. 

[oldlakey]

You assume far too much SIR,

I live in a country that has a border with Thailand

I live in a country where I can legally own LAND

I live in a country where I spend no more than one hour in the local immigration office at a cost of 93 RM

each year

For six months of the year I know where to go for medical help

I normally visit Thailand between 10 / 12 times a year depending on funds

I am sure Sheryl would not hesitate to advise me at these times if I was to ask for her help

In reality Sir, I am hoping that when my time comes I am dead before I hit the ground and well beyond any wasted efforts of revival

If I was resident in the UK I would have passed the running stage, passed the walking stage I would now be at the stopping for a cup of tea stage

 

Have a nice day old cock