physicians suggest different options but i'm wondering the experiences of those of you who have been in southeast asia.
never taken them, never worried about it. If you look at the statistics you probably have more chance of being run over by a bus, or certainly crashing in a tuk tuk!
"Four countries had an incidence > 1 case per 100,000 traveller visits; Burma (Myanmar), Indonesia, Cambodia and Laos (range 1 to 11.8-case per 100,000 visits). The remaining six countries rates were < 1 case per 100,000 visits. The number of visitors arriving from source countries increased by 60% from 8.5 Million to 13.6 million over the 6 years.
DONT do it, I've heard horror stories of girls who have lost all of there hair because of it and people who have actually felt sick and have gotten nauseous the few days they were on them..I never took them and have made it through asia just fine. Plus if you get malaria, they prescribe you the same pills so you mine as well take your chances
Been out here for a while. Never taken anything. But results may vary.
I would strongly urge you to listen to a doctor, or go to one of many reliable medical travel websites ( like the CDC)
http://wwwnc.cdc.gov/travel/
Malaria can be fatal for travelers- who usually do not have any partial/ prior immunity.
The risk depends on your specific itinerary- where you go, when you go.
If you just are staying in Bangkok and the resort islands... then no- not needed.
But if you plan on going to rural areas, trekking, Laos, Cambodia and other locations- you will be foolish not to.
It would be crazy to go on what should be a amazing adventure, and risk your health.
Malaria - all of Burma, Cambodia, Laos and Vietnam outside the major cities are considered high risk. All of Thailand is safe except for the rural and forested border areas.
Dengue Fever - same as malaria for risk. No vaccine. Equally nasty mosquito-born illness.
Your best defense is to prevent bites in the first place. Wear long sleeves. Load up on DEET or Neem. Avoid going out at dusk and dawn as much as possible. If you don't get bites, you don't get sick
My experience with various antimalarials:
Doxycycline - makes your skin hypersensitive to the sun. Wear loads of sunscreen. WOMEN - this is an antibiotic and has the potential to disrupt horomonal birth control.
Lariam/Mefloquine - great because you only have to take it once a week instead of every day. Can have some wicked neuropsychiatric side effects. Not safe to take while scuba diving. I had some seriously trippy hallucinations on this stuff.
Malarone - the drug with the least side effects. Some people I travelled with had digestive issues with this one, but nothing major.
Artemisinin - the most effective anti-malarial currently known to man. As far as I know this is still not available for prevention, only for treatment. That may have changed since I last looked into anti-malarials though.
The most important thing to understand is that anti-malarials are not 100% effective at preventing infection. Their primary purpose is to slow down the infection to buy you time to seek medical treatment.
Malaria is not something you want to mess around with. I caught it in Africa while on Lariam. Despite being treated for it, to this day (8 years later) I still suffer from random fevers and illnesses about once a year. Not fun.
Good comment tales-
And no - artemisinin is not for prophylaxis- just treatment
( As an aside, there are now some reports of emerging resistance to artemisinins in some areas of SE Asia. Still uncommon though)
ON different trips I have taken doxycycline and Lariam - for several months each.
Everyone is individual, but I did not have any side effects.
On paper Malarone has the least side effects- but can be somewhat expensive.
I would second your comment that malaria is not something to take a chance on.
People can die from malaria...
Yes - good point. I should have clarified, the above were only my specific experiences. Many people have no side effects at all on any of the antimalarials.
Despite the issues I had with Lariam, I would still take it again. For me it wins on the cost/convenience scale.
I was on it for close to 6 months and the hallucinations didn't start until the 5th month. Alcohol was a strong trigger and always made the hallucinations worse. I never had waking hallucinations - they always happened at night in that twilight stage between being awake and asleep.
Also for the diving, the safety concern is that if you're going to have a psychiatric episode, 100ft underwater is really not the best place for it. I did still dive while taking it, but it's a risk that needs to be taken into consideration.
I remember going to India and my doctor prescribed Lariam. At first, there was hesitation in taking this medicine because of the possible side effects.
I started taking Lariam a week before my travel and continue to take once every week (exactly one week) until the week after I arrived. And... did not really have any side effects...
So I think it depends but you MUST see a doctor before taking this medicine.
I do take Doxycycline when I am in areas where it may be needed.
In Thailand you can buy Doxy cheap from around 4 baht to 10 baht per capsule depending on where it is made. When you buy this item, and any meds in Thailand, check the expiration date and read the little data sheet for how to take and when to start the meds.
I do not use Doxy in Bangkok or Pattaya. However, I do think there is a slight possibility of getting bit by malaria infected mosquitoes that were trapped in freight trucks, trains and ships which are loaded in malarial areas and unloaded in Bangkok! Although you probably have a better chance of winning a big lottery than getting bit by a hitchhiking mosquito that also is infected.
Just a couple years ago I was bit by something on a plane flying into Tokyo over a thousands of miles from BKK. Whatever it was had to get on in Bangkok! Same thing can happen on flights from Laos or Cambodia or even trains and buses from suspect areas that unload in Bangkok.
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