Malaria Tablets
 

Hello,

I am travelling to SEA (Nepal, Myanmar, Thailand, Laos, Vietnam, Cambodia, Japan, Singapore & Indonesia) for 6 months and want to protect myself against malaria. Obviously to follow the strict guidelines I would need to take malaria tablets for the entire duration of my trip, but realistically this is probably unnecessary.

Basically I'm looking for advice from people who have been to any of these countries recently on whether I need to take malaria tablets.

At present I only have a rough itinerary for each country but can be more specific if anyone has any advice.

Thanks!

Malaria and malariaprevention medicine are quite complicated topics.

First of all there are at least 5 different malariabug species. Some places in the world have only one specie of this bug, some places several.

There are also a least 5 different medicines preventing malaria currently on the market. Some of malaria bug species some places in the world has developed recistance to some of types of medicine used to prevent malaria. Thus some docktors now recommend a combination of different pills.

Bear in mind also that even taking malaria pills that actually works youre still not 100 % protected.

Bear also in mind that some of the malaria prevention medicines can give relatively heavy side effects.

You should also read about Dengue fever as I think thats a more common disease to catch in SE Asia.

Anyhow here is a link to some malaria prevention medicines with pros and cons and side effects etc issues by US health authorities.

CDC - Malaria - Travelers - Choosing a Drug to Prevent Malaria

Snakeboy has given excellent advice, which is to carefully review all of the information available from trusted sources such as the American Center for Disease Control.

I suggest that after you have done that, and thus become familiar with the general concepts (different types of malaria, urban vs. rural risks, etc.) you then search for a specialized travel medical clinic in your country, and book an appointment there. I'm not exactly sure what is available in Ireland, but I am certain that somewhere in that country you will find a specialized travel medical clinic.

Where I live, there is a tropical disease clinic at one of the major hospitals that also provides consultations to travelers. In Switzerland, where I used to work, Swiss Air Lines runs a travel medical clinic.

What type of prophylaxis (malaria-preventing medication) is appropriate for you will be heavily influenced by what kind of lifestyle you plan to lead whilst on your tour of Asia. If you will be staying in high end hotels, the risk will be lower than if you will be camping. The ratio of time spent in rural areas vs. time spent in urban areas also affects risk. So, when you visit the travel clinic, be prepared to explain what your lifestyle will be on your trip, this will assist the staff in making the most appropriate recommendations to you.

Michael

Maurice:

One other thing I forgot to mention in the post above: FOR SURE make certain that all of your 'basic childhood vaccinations' have been carried out and are up to date. If you were born after (roughly) 1960, be extra-certain that you have been vaccinated against measles, mumps, tetanus, polio, all those diseases that were once common in Western Europe and North America but are now rarely thought of. Those diseases are still common in lesser developed countries, and the consequences of catching them as an adult are far more severe than the consequences of catching them as a child (and thus developing lifelong immunity).

You might also want to consider getting a series of vaccinations against hepatitis. There are different forms of hepatitis (one transmitted via poor food handling practices, the other via blood and body fluids, etc.). Both require a series of vaccinations.

Finally, primarily for legal reasons (to avoid being refused entry to various countries), you will need to get a Yellow Fever vaccination and to obtain a little card that provides internationally accepted proof of this vaccination.

You can get all the above vaccinations at a specialized travel clinic.

Other, less common vaccinations that you might need, depending again on the rural/urban balance and the fine hotel / camping out balance, include Japanese Encephalitis and (less commonly) rabies and plague.

Michael

When I was on my trip a few months ago in Thailand and Laos I used generic atovaquone and proguanil. After I had done a bit of research I found them to be the better choice. They are not the cheapest but you don't have to take them for a long as some of the other types of tablet. Also I only started to take them when I was on the Thai Border with Laos and in Laos as you don't really need then in Thailand, only on the border area
Once I had done my research I ordered them from https://www.doctorfox.co.uk and had them delivered to my home address, very easy to do and hassle free.

Wayne

A travel clinic is of course the best place to go to get information, advice and if wanted medicines and inoculations.

Hello Maurice,
We never take any tablets for malaria and allways sleep under a impregnated decent mosquito net and use deet spray, but as soon as we get a serious fever we go to a hospital for a malaria check.( happened twice bot both times no malaria). In SE Asia we carry doxycycline and in India paludrine and in central america malarone. Before a trip we allways visit our familydoctor to find the newest info on behalf of that.
We traveled twice SE Asia on a motorbike. each time 5 months and alltogether 3 years in India.Happily the malaria in these area's is not of the falciparum type(the deadly form).
Dengue is more common. I had it once in Laos. Felt like a really old man, but recovered completely.
71 years young now,16 years retired and most of the time with my wife on route on bicycle, motorbike and Landrover
Metita

I talked with my doctor before I headed to SE Asia.
He said that normally for 1-2 weeks trip you can take pills, but for extended period it is not wise to eat them, because they are really strong medicines and can cause other problems.

I carried malarone tablets and my doctor said that if I start to have symptoms, then I should take pills and find local doctor who can take tests and see if it is malaria or something else.

Be wise
 

I think your doctor gave you excellent advice. You can't take anti-malaria tablets for a longer period of time. Apart from the side-effects, they'll ruin your kidneys.
I have been living permanently in SE Asia (and traveling around a lot of my time) for nearly twenty years now, without any prophylaxis. I never caught malaria, nor dengue. But I did get chikungunya (which is similar to dengue) once.
Malaria is only active in certain smaller areas (usually far into the rural countryside), and mainly during the wet season. Dengue is far more an urban disease, and normally much more of a risk for most travelers. But then again, no worry, because there's no vaccine, nor cure.
Nowadays, malaria can also be treated very effectively in a few days.
Hence, I wouldn't worry too much about it all. Just take sensible precautions: long sleeves, some mosquito repellent, and use a mosquito net at night. If things should really go wrong, malaria can be cured.
If you happen to get dengue (or chikungunya), that's the end of the trip. You'll have to sweat it out: (very) high fever for 4-5 days, make sure you drink a LOT of water, take a shower every couple of hours (to cool down), and use a ceiling fan at moderate speed. Once the fever breaks, the muscle pain will kill you. Fly home to recuperate (you'll be feeling terribly weak for a month or two, and the pain can last for up to six months).
Anyhow, let the above be not intimidating: when you take normal and sensible precautions, the risk to get sick is extremely low.
Worry about Delhi-bellie instead. Getting stomach trouble is almost guaranteed on any longer trip in a developing country. :=)