Malaria - what would you do?

as some of you may know i'm about to embark on a 2month trip through s/e asia.

i went to the doctors today for my shots and was told that she doesnt particuarly reccomend taking anti-malaria tablets given my medical history but its up to me if i want to take them.

so what would you guys do? i dont want to take them if the side effects are going to haunt me. a family friend who took malaria tablets went on to develop mental illness as a result (her doctor agreed this was probably the tirgger).

does anyone have any advice/stories?

what is malaria?

I think it would depend on exactly where in Asia you would be going as to the risk of malaria. If you are staying within cities I doubt if you would really be at high risk of getting malaria - just my opinion since I don't really know for sure, but worth asking your doctor about.

i'm going to a travel clinic for a second opinion as the doctor said she wouldnt nessicarily reccomend it for *me*

its kinda a damned if i do, damned if i dont situation.

Please remember to get tested. There are two forms of tablets (I believe). The cheaper and the more common one and the alternative which is more expensive but is for those who are allergic to the first one. There may be more than two but I do know that it can be tested. Also do if you want to take them you have to take them before (I believe it is a week, it could be more) entry into the affected areas and I think for a month or maybe more after it.

The pills do not always prevent malaria but when it does occur, a person who has taken the pills will suffer less and be easier to treat.

If you're afraid of side effects (I didn't even know there was a malaria preventative,) you might just want to be extra careful about making sure that you stay slathered in insect repellant. In fact it probably wouldn't be a bad idea anyway.

I would suggest going to a clinic that specializes on travel innoculations. They will tell you what you should do. And if you have a travel itinerary, take that along, there are very specific recommendations based on the places you will be going.

My grandfather got malaria when he was in the service and he recovered safely. I don't really know anything about it though.

I do not know your medical history or why the physician would not recommend it. I can only cite my own history. I have served in many war torn countries in the developing world with Doctors without Borders and even though I have a myriad of medical problems, I opted to have the vaccinations each time. (They only last for a certain period- just as our first vax when we are children do not last forever) - so I have had to have many vaccinations over my lifetime. Theanti malaria vaccine did make me ill for a bit but I was fine by the time I got to Africa or Bosnia or Sumatra or the Middle East or South America or Asia. (I've done this OFTEN! )

Unless the vaccine will be life threatening, you are probably putting yourself in greater danger if you do not have the vaccines. If I were you, I would ask my GP top refer me to an infection control specialist. If you live near a med school, contact any one of them there. Our former Dean of Medicine, a specialist in infectious diseases, has participated in many studies which all show most vaccines to be quite safe. (There is this urban legend out there claiming childhood vaccines may be responsible for the high number of autism we see these days; it's all nonsense.) A specialist will be able to give you more comprehensive advice.

I have an aunt who as a nun worked in Central America and she developed malaria. She was ill for the rest of her life tho she did continue to work. Another man I know, a Priest who belonged to the well regarded White Fathers who worked in Africa, also contracted malaria in spite of the vaccine. He too had to live with it for the rest of his life. Vaccination against malaria is often not an option, The disease is inciduous and very prevelant in developing countries- esp Africa. Get good advice from someone knowledgable in the field of infectious diseases and perhaps in your own health situation and how malaria would impact it.

the reason why the doctor wont reccomend i take it is because it has been known to trigger of psychosis, mood swings, depression and other mental illness. as my family has a history of mental illness and i have been treated for depression it will more than likely effect me in that way.

i have only just now in recent months begun to feel stable and normal and am scared that the malaria tablets will throw me off balance again. especially since any course i go on will have to be taken now, (three weeks before i reach thailand) and for two months after i return.

plus, they are only 50% effective against malaria.

i am going to see a specialist saturday who can advise me further, but please keep your opinions coming as i really dont know what to do.

Originally Posted by Sammie5

I would suggest going to a clinic that specializes on travel innoculations. They will tell you what you should do. And if you have a travel itinerary, take that along, there are very specific recommendations based on the places you will be going.

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Yup, agree. The travel clinic gave me anti-malarials because we were going to India, but at the last minute decided to go to Thailand. We took them for half our trip and then decided that we weren't at risk because we were just in major cities. But something wierd started happening with my skin after taking Doxycycline and being in the sun, and now I have something called "macular amyloidosis". I don't know too much about it, but it came when I took the Doxy, and now won't go away and it looks so ugly on my legs and arms. if i had of known i wasn't at any risk, i never would have taken it.

So, the point is. The travel clinic will know the risk depending on the places you go and plan to go. Are you going treking out in remote places, or staying within cities? where exactly are you going?

www.imtravdossiers.com/sasb.pdf
www.imtravdossiers.com/samb.pdf
www.imtravdossiers.com/sava.pdf

going on these three tours then going it alone. think going to be mainly in cities.

I too have travelled a lot in the tropics and whether you take the tablets or not I would make sure that wherever you go you wear long sleeved cotton shirts (they can be loose for the heat) and socks, and use plenty of jungle strength mosquito repellant several times a day. I bought a number of light muslin tunics that were protective but cool and guarded against both sun and insects. Don't forget to put repellent on your neck and face as well as arms and legs. And don't do what I did in India - I left my window open and the light on when I went out to dinner and came back to a room full of mozzies! And that was in a city.

Definitely get a second opinion from a specialist on the malaria pills...when I was in the Navy we were given the tablets once a week for a period of time before and after going to Kenya, but when I went to Thailand on another trip years later we did not have to take the tablets at all (we only went to Pukhet).

I don't have the same family history as you, but the only side affects that I had from the pills was some stomache discomfort and loose bowels. It was inconvenient and uncomfortable, but worth it in order to avoid Malaria. IMHO.

One way or another, if it is optional and not required then you are going to have to decide whether the risk outweighs the benefit.

the areas i'm going to are fairly low risk. from what i've read the risk is slim to none but if its slim someone must get malaria and i dont want to be that someone!

Just a note on the insect repellent--be sure to read the directions carefully. My uncle was just in the hospital having his spleen removed after major problems that would have killed him had he been alone at the time, and the doctors were concerned inappropriate use of insect repellent may have had something to do with it. (They are still not sure why the complications developed, but apparently he had used some repellent under his clothing, and it was only supposed to be used on exposed areas.)

A clinic that specializes in tropical travel innoculations will tell you exactly what the risks are. It is an important health issue, you really musn't depend on information you get from the internet, either advice from us, or from other things you are reading.

Doxycycline should never be take if you are going to be in the sun. Every pharmacy printout will say this (In Cnaada, there is a boiler plate instruction pamphlet docs and pharmacists can give to patients in the CPS directory) so I do not understand why your pharmacy did not point this out or even give you this med if they knew you would be in the sun? That's very bizarre!! All the tetracyclines are like this - they have other side effects too, esp for children and adolescents (yellowing teeth for another).

I think anyone travelling to the tropics needs to be cautious and use common sense. If the anti-malaria meds interact adversely with your meds, then it's prob best that you restrict your visits to areas not known to have much malaria and not have the vaccine. But it is not worth it to expose yourself to malaria!!

well, i went to the expert and got the malaria tablets but am really un-happy with them and still not sure if i'm going to take them.

for a start when i went in the clinics there were signs everywhere stating that the malaria tablets were no refundable or exchangable, so many as to make me think many people had reconsidered their choice after purchasing them (or maybe thats just me?)

secondly, the doctor was very rude and dissmissive and actually ignored many of my questions! i really felt bullied into buying the tablets.

the tablets he has prescribed are actually antibiotics used to treat acne and a side effect or added benefit is they can prevent malaria. the problem is, and this is the big problem for me, is that they prevent the contraceptive pill from working.

without going into details, my partner and i cant use barrier methods so a hormonal device is the only contaceptive we can use. its too late for me to change to an injection or a patch (which my doctor said she would not reccomend for me any way).

so my dilemma is this; do i take the malaria pills and risk my contraceptives failing or risk malaria?

the areas i'm going to are not too high risk, as on paper there is no risk at all.

all the travellers i have spoken too have told me not to bother with the pills as they make you really sick and dont protect you 100% from malaria (these pills i've been prescribed even less than some of the other brands).

i am so confused and unhappy about this. going to another clinic tomorrow for further advice but would appreciate your input as i trust you guys and everyone here had given me great advice in the past.