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Is there a doctor in the house? Are anti-malarial prevention drugs necessary now in South Africa?

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Sep 16th, 2005, 03:36 PM
  #1
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Is there a doctor in the house? Are anti-malarial prevention drugs necessary now in South Africa?

Sorry for the long title, but I'd like to get a medical opionion on the anti-malarials. Are they needed in October in South Africa?
My husband and I will be driving from Joburg to Cape Town (spending about 2 weeks on this trip.
My primary physician didn't think the Lariam that we took on previous trips was necessary; but I don't think he's ever been to Africa.
We will be spending time on the coast and inland, so the little monsters might still be around as summer approaches.
Does anyone know that malaria is still a danger in South Africa??
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Sep 16th, 2005, 04:10 PM
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Hello,

Malaria is most definitely a danger in South Africa, but the risk depends on where you are going. The main areas of concern are those in the lowveld, i.e. Sabi Sands and the Kruger National Park. It looks as if you will not be entering any malarial regions, so malaria prophylaxis may not be necessary for yoru trip.

Whilst I am a doctor, I'm not a travel medicine or tropical medicine specialist, and some areas may have seasonal risk. You are best advised to consult a travel medicine specialist before you go, bringing your itinerary with you.

Cheers,
Julian
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Sep 17th, 2005, 01:18 AM
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The only malaria-endemic area is in the North-East. And certainly doesn't include the Jo'burg/Cape Town route, nor either end of that. Not any of the Coast, except for Northern KwaZulu-Natal.
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Sep 17th, 2005, 01:27 AM
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Sorry, typo. "Nor any of the Coast . . .".

Here is the "Malaria Risk Map". There is also a link on that page to the S.A. Dept. of Health guidelines and other malaria info, should you need it some time in the future.

http://www.malaria.org.za/Malaria_Ri.../risk_maps.htm
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Sep 17th, 2005, 05:43 AM
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Thank you, jasher and ArthurSA. I will check with the Atlanta CDC, they should have good information; and I'll try the link you gave me to the SA health dept.
My husband and I are in our late sixties and early 70's, so malaria does't sound as if it's something we can handle at this stage of our lives.
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Sep 17th, 2005, 01:29 PM
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Treasures, I'm reassured to hear you'll take antimalarials - and forgive me if I sound patronising, but do take care not to miss a dose - from reading I've been doing, one of the reasons there is such a myth about the antimalarial drugs not being effective/ masking symptoms is because of people missing doses and therefore NOT being properly protected, but then somewhat interfering with the parasite's normal infection patterns.

PS My dad is early 60s and very fit for his age, with high stamina. This has really laid him low. It's only now that I really can see how this disease is such a killer world wide.

It sure contrasts with the slightly proudly related tales of backpackers who have caught what must be a much lighter form of malaria, sweated with fever for a day or two, in the care of their travel companions, and then carried on with the trip!
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Sep 18th, 2005, 01:54 AM
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I couldn't agree more about taking antimalarials, if relevant. Even though many South Africans tend to be fairly blase about it even in places such as Kruger.

But we've yet to hear what is meant by "spending time on the coast and inland". And to me it simply doesn't make sense to spend money unnecessarily (and suffer possible side-effects from Lariam/Mefliam, although I seemingly don't myself), if you're not going anywhere near a "Malaria zone".

To repeat, the vast majority of South Africa is NOT such an area and many tourists are therefore never affected. If you do travel to places such as Kruger and the Northern KwaZulu Natal Coast, use antimalarials and also take other precautions. Especially in October, the start of Summer. In fact Summer seems to have already arrived and I read just today that we're going to be in for very hot one here. The SA Weather Service says that August and September has had temperatures of 3c higher than last year.
So take a look at that map, and if you're not travelling in that area be advised by the authoritative advice on that site. And save some money and possible inconvenience.

BTW, Iím just passing on the information, Iím not a doctor, or even a wannabe! And even Julian, who is a doctor and who has travelled extensively in S.A., qualifies his advice. But advice from your Doctor, who might think that ďAfrica is AfricaĒ, might be suspect.  (I said MIGHT, and not because he perhaps hasnít been to Africa.) You also mention consulting the CDC. Even the CDC on their website tends to generalise, by lumping several countries together. It then dispenses blanket recommendations such as donít drink the tap water (which is nonsense in S.A., if itís from a regular municipal source), donít use ice cubes, etc. But in their website they also refer to those specific ďrisk areasĒ:

ďRisk in the low altitude areas of the Mpumalanga Province, Northern Province, and northeastern KwaZulu-Natal as far south as the Tugela (Thukela) River. Risk in Kruger National Park.Ē
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Sep 19th, 2005, 03:50 AM
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Just a clarification to my last post. I didn't read your OP properly, clear though it was. I thought your doctor was saying that prophylaxis WERE necessary. So perhaps he DID research it, in the context of your route. My apologies to him!
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