Selous, you do not need to have malaria for life. You can take a course of Primaquine, which will kill the parasite in its liver stage. Other anti-malarials do not clear the liver, hence the recurrent features of some varieties of the parasite.

There is a blood factor which needs to be tested for before you take Primaquine. Any doctor can take care of this part for you, but some don't know much and need to have their hands held.

Hope this is useful information. If not, please feel free to ignore.

Mark

Except for 3 years in Malaya/Borneo/PNG in my youth when I took whatever the Ministry of Defence gave me, I have used Larium and fortunately enjoyed the the dreams on pill night. Remember, different areas of the malarial world sometimes need different prophylactic pills. If Larium is suitable for the area that you are travelling to/through and you are worried about side effects, take one at home before you go, you never know, you might enjoy it. Joking aside, malaria/dengue fever is really nasty and the biggest weapon of mass destruction on the planet. Take the pills, take the precautions enjoy the trip. Ride safe.

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Mike

Hi,

I was very sensitive to Chloroquine (Resochin, Bern Laboratories) and my bladder almost burst in Bolivia 13 years ago (I was volunteering in Bolivia with a NGO). Stopped having the pills and everything went right again and did not have to be operated, as they suggested initially (nobody thought it could be the pills, except me!!!). But this is just the exception, look at the others.

I would never recommend not having the pills if you go to a risk area during the risky season. In any case, as others said, prevent mosquito bites and don't rely completely on the pills, they don't protect you 100%.

Concerning Central America, years ago I backpacked from Panama to Mexico during the summer rainy season (the worst time) with no worries. I remember the worst area was supposed to be the Caribbean coast of Nicaragua (Bluefields, but there are no roads, only rivers to get there, so shouldn't be a problem for you). I did not go since I was not having pills after the Bolivian experience and thought it just too stupid since I have a "very sweet blood"!

I currently carry Malarone just in case I would contract it (if prescribed by a doctor, of course!), since it has a great reputation of no side effects... it is covered by the Spanish Social system! (obviously, we have a deep economic crisis now). Lariem had a terrible one, but look here at guys with no side effects at all, so do not take them for granted. But always ask a doctor to know the right prophylaxis (different types of malaria in different areas, as pointed out).

Just a lesson from my case: if something goes really wrong, think immediately it may be because of the tablets.

Safe and happy travels,

Esteban

PS: Being Dutch, you may read German or French: this is a really good site by the Tropical Medicine departments of several Swiss hospitals: http://www.safetravel.ch Really updated, so check "destinations".

yesterday we took our first Lariam ;-)

Thanks for all the advices!

Glad you've got some pills - we met lots of people on our travels with some odd ideas on the subject - some even boasted about the amount of times they had been struck down with it We were even advised to try and get malaria so we could be given strong doses of anti malarials in hospital!

Number one rule is avoid getting bitten in the first place. Always sleep in a good net, use repellant and cover up at night. Be anal about closing up all the gaps in the net at night.

See how the Larium works for you, if you have problems (met a couple of people who struggled with it and got emotional problems) switch to doxys. I had long term probs with doxys over several months, nausea and sun sensitivity, gave it a break for a while in a low risk countries then went back on when mozzy risk went up. Overall it was fine though.

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www.afritracks.com

Thought that eightpot was still suffering the side effects of Lariam(aka erotic dreams and thoughts), and it seems that it is actually me the one sufferint them!

A combination of words that sounded way too bad for a non native speaker still suffering from Chloroquine... (please, don't want to sound rude)

I am taking lariam now for more than 5 month but stopped it last week ! Currently in benin and still going to spend more than 6 month in west and centralafrica ( high risk area ).

My sideeffects were often tiredness and "don´t wanna do nothing" attitude. Sexual fantasies during dreams sometimes, vivid dreams very often ! The main problem I have is that nearly ALL doctors down here tell me to stop it and I am talking of local and expat doctors ! ( for example doctor of french and german ambassy here in cotonou )

Longterm it can seriously damage the liver for a lifetime. Nobody of the expats here takes anything, even a medical scientist researching about malaria in westafrica here highly adviced me to stop lariam due to its longterm sideeffects ! I bought 3 packages of Riamet / Coartem ( same thing, same lab but 10 times more expensive in europe, called riamet there ) If you get malaria, you take it for 3 days and you´ll be fine, seems to be the most useful stuff one can get hold of.

If I get fever just take coartem, should do it I guess.

Anybody needs 4 unopened packages of lariam ??


greetings from cotonou,

Chris

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Hamburg - Kinshasa - Nairobi - Khartoum - Beirut - St. Petersburg - Hamburg ( powered by a 1975 vespa 125cc ) 2011/2012

I've never used anti-malarials in 25 years of travel and never caught malaria. Having said that I have had dengue twice, apparently the third time can kill you. It's all good.

Whereas I've generally used anti-malarials wherever I go and have had acute malaria twice....but never dengue. There's a takeaway lesson here, for anyone interested, sometimes put as follows: the plural of "anecdote" is not "data."

In other words, if you go on the internet for information and make life-altering decisions on the basis of someone saying "I've been doing it this way all my life and nothing bad has ever happened, so do it my way and you'll be fine," or "I've taken all possible precautions and none of them ever did me a bit of good," or even "Everything has always worked perfectly for me, so do exactly as I've done and you'll achieve overlander nirvanna," you stand a good chance of being deeply disappointed. Or sick, or dead, or whatever.

These choices are best based on statistics, not anecdotes. Ask yourself, what are the chances of getting ill, and what are the likely consequences if I do? And ask, what are my options and what positives and negatives attach to each? Then make the best decision you can.....but try to have a backup plan, since it's all about probability, not certainty.

Hope that's helpful.

Mark

Mirjam stopped with Lariam because she got some side effects, noise in her ear... pretty annoying.
To be honest, nobody living in these countries take any preventive drugs, so Mirjam will start with Doxy when we arrive in Colombia.
We have some Malarone with us, as emergency treatments... but that is way too expensive to take for a few months!
Managed to get Doxyciline for about 6US/month, although there were cheaper pharmacies in Nicaragua... about 4 USD/month.

Just MY OPINION below, I am not a doctor!

Honestly, I do think you can cut down on usage, as they prescribe preventive meds when there had not been Malaria for decades in an area. Seems an effective lobby...

Got some report from a medical institute in The Netherlands on people who didn't take any meds and go to the tropics.
According this research, for every 100.000 people WHO DON'T TAKE MEDICATION going to the tropics, 240 get Malaria and 48 die as a result of it.

Perhaps it is safer to get off your bike and not take medication, then the other way around! ;-)

But nevertheless, there are definately risky area's where you MUST take preventive medication.

This kind of statistic is so meaningless it's almost silly. "The tropics" covers a lot of ground--about 45 degrees of latitude circling the globe. It includes places where almost everyone who does not take anti-malarials gets sick to places which have not seen a native (i.e. local-origin) case in years. "People going to the tropics" includes people who spend years at a time unprotected as well as people who barely slow down while transiting malaria-free zones. Mortality varies greatly as well, depending on specific strains, which to some extent vary by location. Etc.

You can't reasonably make real-life decisions on the basis of this sort of "statistic." You need better statistics or other forms of information, tuned to where you are going, how you are traveling, and your tolerance for risk. You might also consider the effect on your long-planned trip should you get sick. It's not much fun, even if you take the cure immediately.

I just had a discussion with some West African friends: they agreed that getting acute malaria once a year was about the norm. These are people who carry varying degrees of both genetic and acquired immunity (unlike you or I), and they often carry lesser parasite loads without getting acutely ill for much of the rest of the year between getting seriously sick. That happens to match my own experience: I've gotten acute malaria twice in approximately two full years of living and traveling in malarial zones.

YMMV....as you know.

Mark

I can't comment on other drugs but I have some experience with Lariam. I took it for 3 months while traveling in West Africa. I had vivid dreams and dizzyness from day one, occasionally had panic attacks, I felt like I was going to die, my heart starting beating fast and I started to breath faster, my arms went numb, my legs didn't move or I fell because I couldn't feel my left leg in a sudden... for no reason at all. After 2 months I had episodes of malaria like attacks, I felt like I had fever, I was shivering and felt dizzy and tired for a few days. It went on like that for about two months after I stopped taking the drug, every 2-4 weeks I had an episode of illness. They did a full check on me in a hospital in Spain and they found nothing, they suspected that it was the side effects from taking Lariam.

Since then I got better but I would VERY strongly advise against taking Lariam.