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Staying Healthy on the Road Medical info, e.g. malaria, vaccinations, travel medical tips, medical insurance, where to find a doctor.
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  #1  
Old 12 Jul 2009
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Natrapel and Malarone - Anti mozzie & Malaria

Hi all,
We're taking off soon for central and south america.
Not being fans of DEET, has anyone used the above Natrapel 8 hour non deet mosquito repellant - any good?

Also Malarone anti malarial tablets. Has anyone used as a treatment dose?

Cheers
Julie
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  #2  
Old 12 Jul 2009
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I have not used Natrapel myself, but I have tried plenty of other DEET free products. Whilst these are fine in Europe (where being bitten only an inconvenience anyways and not a risk), I seriously would not recommend them in the tropics. Most simply do not work at all. DEET is not nice, but so far it has always worked 100%. So unless you find plenty of reports of Natrapel working well in that area, I would take DEET at least as a backup. And considering weight ... take DEET only, because you know it works.

What does surprise me though is why you need an 8h+ protection? Presumably you spend the night under a mozzie net and a large part of most days in riding gear + riding. In both scenarios you won't be bitten. Depending on the type of mosquito you may only need protection at dusk/dawn as is the case for the anopheles fly (malaria). It is usually not active during the day (though other mosquitoes are). During the night you are protected by the net, so you only have two short time windows to worry about. Wear suitable clothing if you are at risk, then skin exposure is a minimum and DEET usage shouldnt be a problem. In addition in comes in handy when spraying door/window frames of hostel rooms ...

If you go trekking and need full-day protection against other diseases like dengue for example, then you need to worry about 8h+ chemicals, but I don't think that many people are subject to this risk. Get up to date information about the area of travel.
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  #3  
Old 12 Jul 2009
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Another note on Malarone for treatment: this very much depends on the specific area you are in and the local resistances that may be present. On average, Malarone fares fairly well, but if you have the opportunity then consulting a local hospital will be very much preferable to make sure you can start treatment with the right medication immediately and not lose valuable time trying out things that don't work. If they recommend Malarone and you trust your own more, fine. Otherwise I would reserve it for areas with limited access to medical facilities before you can get qualified help. Speak to a doctor who knows about your area of travel - there are many varieties of malaria, and resistances vary locally.
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Old 13 Jul 2009
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FFS! How many times do I have to say it!??

Don't piss about with malaria. It can kill you. Quickly. If you think you have it, you need proper medical attention pronto. The fist thing to do would be make sure you actually had malaria and not, for example, Dengue Fever. Hoofing down a few of the pills you were taking for prophylaxis blindly is not a great idea.

Get sick, see a doctor. Simple.

SW
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  #5  
Old 13 Jul 2009
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Yes, a great many of us end up in precisely that frustrated state of mind, DocSherlock. It seems such a simple truth: Malaria kills millions of people per year! Unless you're eager to join them on the other side of the river, don't mess around!

For whatever reason, lots of people prefer to mess around. Some do this following lots of research, others after hearing a few far-fetched stories or reading silly claims on the internet. And the fact is, most of them do survive. In fact, even most of those who contract malaria survive....from which some of them conclude that this means they were doing the right thing all along, or evaluating the risks correctly. "I'm ok, so I must have chosen wisely." Or worse, "I heard that my friend's cousin's neighbor was ok, so I'll be ok if I do the same thing he did...."

These people, it is apparent, are often not convinced by "How many times do I have to say it?!!" Blame it on whatever you want, up to and including AMA collusion with the pharmaceutical industry, which teaches that medical professionals are all incompetent or on the take, hence not to be trusted. Hell, I don't trust the medical profession much anymore either--and that includes medical professionals (or wanabees) posting anonymously on internet forums.

On the other hand, if you want to be taken seriously, you might want to work on your reading comprehension. No one's suggesting--unless I missed it completely in my hurry to move on to more rewarding topics--taking an increased dose of the same stuff they take as prophylaxis; they're talking about not taking any anti-malarials at all but carrying a curative dose of Malarone for use as needed. This might not be wise in your estimation, but a lot of folks travel unprotected, trusting a treatment dose of their preferred antimalarial, including people who live and work long-term in malarial areas. Some of them do seem to know what they're doing. The questioner above was asking whether Malarone is suited for this purpose, to which another poster responded, very reasonably, "it depends."

What's more, at least a few of the people who post here--myself included--routinely get far, far from any sort of western medical care. "Get sick, see a doctor" doesn't work under those circumstances. Even worse, "Get sick, see a doctor" sometimes doesn't work even when doctors are readily available; they also need to be competent, paying attention, and they need to know their own limitations as clinicians, which many demonstrably do not. I speak as one who almost died (of malaria, it happens) while trying to convince my own doctor that indeed malaria was what I had, and that he did not need to wait for blood tests to come back from the hospital up in Boston before begining treatment. Ah well.

Best of luck with your frustration (and mine).

Mark
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Old 13 Jul 2009
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Yawn.......this has been covered ad nauseum in these forums.

FYI, Mark, local doctors are often the best ones to see when you are in their country as they know the local illnesses and sensitivities to drugs and where to get the good ones.

Anonymity - no more so than you.

Frustration - none; couldn't give a toss actually. You can lead a horse to water etc etc....

AMA - not a member
BMA -not a member
Pharma industries associations - not a member

Happy now?
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Old 13 Jul 2009
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Shoot, Doc, I don't know or care whether you're really an MD, much less what professional organization you might belong to (or not). It happens I agree with you about malaria and anti-malarials. But I think people's general mistrust of medical professionals is often justified, and I think mistrust of what's posted on internet forums is sometimes a healthy thing.

It was not me who said, quote, FFS! How many times do I have to say it!??, unquote. Sounds like frustration at not getting your point across, but maybe that's just me misinterpreting.

If ever in Bellingham, become less anonymous. I'm in the phone book.

Safe journeys!

Mark
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  #8  
Old 13 Jul 2009
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Quote:
Originally Posted by markharf View Post
Even worse, "Get sick, see a doctor" sometimes doesn't work even when doctors are readily available; they also need to be competent, paying attention, and they need to know their own limitations as clinicians, which many demonstrably do not. I speak as one who almost died (of malaria, it happens) while trying to convince my own doctor that indeed malaria was what I had, and that he did not need to wait for blood tests to come back from the hospital up in Boston before begining treatment. Ah well.
In my humble opinion, this is the one greatest dangers of malaria to western folks. Due to incubation times involved, it may break out when you're back home, and at first you might put it off as a cold/climate change etc. Discover it's not a cold, go see your GP, who tells you you've got the flu, gives you paracetamol and tells you to sleep it off ... If you think diagnosis may be a problem, then self-quick tests are available from overlanding shops. Otherwise the cyclic nature of the disease is a very strong indication, but don't rely on internet hear-say as your only safety net ...

Anyways, trying not to derail this thread further, one more comment about mozzie nets: make sure you have the correct mesh size. Mozzie nets aren't all created equal, and some places/mosquitoes require very fine mesh, so get the correct info about where you are going. If you don't require fine mesh, of course it won't hurt having it, but it will also be hotter.

And last but not least, although it gets said many many times: covering up and not getting bitten is still the best prevention. That includes wearing light coloured clothes on which you can see the buggers, socks that go up over your ankles from dusk onwards, long sleeves, etc. Standby medication/prophylaxis or not, if you are in a risk area, then flip-flops, shorts and spagetti-tops are asking for trouble (during the times at which the mozzies are active ...).
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Old 14 Jul 2009
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Thankyou Sirakor, considering I was asking advice not to be lectured by two people who seemingly hate each others guts, I appreciate your sound advice re mozzie nets etc.

My question as was said, was to ask if this pre treatment doses are advisable, not that we wouldnt be taking Malarone as advised so many days before etc. Same with Natrapel - it was a question, not one that needed lecturing.

Again thanks Sirakor
:confused1:
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Old 14 Jul 2009
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Sorry if I sounded lecturing, and even more sorry if it sounded like I hate anyone's guts. Neither was my intention, and neither is, from my perspective, true.

Enjoy your trip.

Mark
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  #11  
Old 14 Jul 2009
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julie,

no-one hates anyone's guts on this forum - at least not on this thread
mark and i were having a bit of a banter, that's all
i guess that's the problem with forums, no body language etc can make posts come across the wrong way....

mark,

don't worry - you didn't come across badly at all - i hope i didn't....it was all just banter from my end....
i do get down to Bellingham from time to time for various stuff - will look you up for that !

morning all,

Sean

ps don't piss about with malaria. if you get it badly, it will take more than just a few tablets to get you through it - you may need ventilation, dialysis, icu support etc etc. messing about in the bush could cost you your life; so........take prophylaxis & proper precautions, the most important of which is bite avoidance as stated by another poster above and if you get sick and are worried about malaria, see a doctor. safe travels
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