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Malaria risk in Botswana, Zimbabwe, Caprivi Strip of Namibia, Vic Falls

Malaria risk in Botswana, Zimbabwe, Caprivi Strip of Namibia, Vic Falls

Old May 19th, 2009, 10:12 PM
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Malaria risk in Botswana, Zimbabwe, Caprivi Strip of Namibia, Vic Falls

Our travel doctor recommended malaria pills after looking at his list, but after reading the side effects and some of the forums from the past--I'm wondering if it's necessary in the winter season, when it's dryer.

We like to be smart travelers, but we don't want to ruin our trip being sick from the pills. (The list of side effects for Malarone sound like a terminal disease.....) Our prescriptions await pickup, so if you have some good information on this, please share.
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Old May 19th, 2009, 10:24 PM
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I work for a major US airline and fly to Africa frequently. We have had 7 crew members since November come down with malaria-one has died and another is in an ICU in a Minneapolis hospital not doing well.If there is even the slightest chance you might be going to an infected area-the pills are your friend. I always take Malarone on my trips.
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Old May 20th, 2009, 05:30 AM
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We just got back from Botswana and took Malarone without any side effects. Well, a bit of the enhanced dreams, but that was fine. I think Malarone is much easier on the body than Larium. I wouldn't risk it, personally.
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Old May 20th, 2009, 05:31 AM
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I could be wrong, but I thought Malarone was very good as far as side effects? Or at least compared to others.... You know what those drug warnings are like - they have to put every single possible thing in there to cover their liability.

I took it on my trip last year and it was like taking an aspirin - I had no issues, but I know everyone is different. The woman I was traveling with said she thought it might be making her feel a little "weird" but she wasn't sick. And please understand - she was super sensitive to EVERYTHING she ate or drank (one of those extremely picky types).

I would talk to your doctor and see what he or she recommends for your particular situation. I suppose you could always stop taking it if you had really bad side effects, but you should know that before you get there because I think you have to take it 2-3 days ahead.

CJ
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Old May 20th, 2009, 07:48 AM
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Husband and I were in Botswana, Zimbabwe, Caprivi Strip, Vic Falls, Hluhluwe in winter 2007. There were mosquitoes around, especially Vic Falls and along the Chobe River. Slept under netting and a high-powered spray was used by staff each evening during 'turn-down' but we still had mozzies in tents and rooms. Took the Malarone with no side effects we were aware of, except husband felt a little claustrophobic about the bed netting.

Before we went we had the same concerns about the drugs, went round and round, consulted others, read this and that, etc. But when we were there we were very glad we had decided to take the Malarone. A friend who is a tropical medicine specialist said those charts/maps/lists that the travel docs use show the areas of concern real-time, so if they say there's a malaria risk in the area, believe them.

I went to Iran last fall with my daughter. We both took Malarone for the time we were in the north, near the Caspian, and again had no issues with side effects.
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Old May 20th, 2009, 11:03 AM
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We took it, too - none of the five of us had any reaction to it.
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Old May 20th, 2009, 11:18 AM
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We went to S Africa last year (Botswana, Zimbabwe, S. Africa, & Namibia), took malorone with no problems. The only problem I had is when I came back, took it on an empty stomach and got severe heartburn, which was my fault I guess. Taking a trip to E Africa this year and planning on taking it again.
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Old May 20th, 2009, 11:59 AM
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Thank you so much for these replies. At least if we have side effects, perhaps they won't be imagined!! By the way, Costco had the best price on them, and my local pharmacy matched it for us.
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Old May 20th, 2009, 04:21 PM
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Might this be an OAT trip? The itinerary looks familiary.

I bought my Malarone today for an upcoming trip. Never had any problems with it or Larium.

You could purchase a few extra pills and start a few days early to see how you react at home so you aren't worried about a problem on the trip. Of course, who knows when the side effects would kick in. Maybe not until a week or two. But side effects are rare and you could always halt the meds if you had problems.

I'd take any preventative medication the doctor orders and prepare to have a wonderful time.
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Old May 20th, 2009, 05:44 PM
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I'm not a medical professional, but this is my personal opinion/experience:

1. You can only get malaria, when you are close to other people who are infected already; there are no people living in the Inner Delta, so your only risk is coming from camp personnel or other tourists; camp personnel is checked all the time. I would rate the risk as extremely low, as long as you fly through Maun or Kasane during the day; if you are spending one or more nights in or close to those towns, there is a higher risk, so that's why I don't do that.
2. The World Health Organization-map shows that the Okavango Delta is more or less the borderline of the malaria risk area, so you're not in a place that is rated as "high risk".
3. You can create additional protection by wearing long sleeves after dusk (malaria mosquitoes are only active between dusk and dawn) and by using mosquito repellent
4. During the local winter months (especially June-September) the risk for malaria is even lower, because it is getting quite cold at night (4 C / 39 F) and those mosquitoes don't like that
5. As mentioned already, camp personnel doesn't take malaria medication either; of course their situation is different, because they would have to take it all year long, but it still shows that there are more people staying away from those pills and willing to take the risk (because they are rating the risk as very low).
6. There will always be the exception, which is why doctors typically want to eliminate liability and prescribe medication, or why other people might feel the need to respond to this message, but to me the risk is as low as being hit by a car on my way from home to work (if not smaller).
7. On a final note, we have run into quite a few people with terrible reactions to malaria medication (and not just lariam); during one of our recent trips, one of the guests used the emergency horn in the middle of the night, because his wife had hallucinations and heart palpitations due to malarone, the most popular malaria medication these days.

In the end this is a personal decision; we have never had any issues during our trips to the Okavango, but we know that there will always be people who disagree. Again, it's important to keep in mind that it is key to fly in and out of the Inner Delta during the day and not spending any time near Maun or Kasane between dusk and dawn; that will increase the risk quite a bit, especially during the summer months (November-March).
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Old May 20th, 2009, 06:51 PM
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We have taken malaria medications (malarone, mefloquin) several times over the past five years and have never had a problem. We self-drove/camped our way through South Africa, Namibia and Botswana for 6 weeks in July/August 2008 and didn't see a single mosquito until we arrived in Vic Falls, where there were many - we did get bitten, despite precautions (bug spray, long sleeves). Take the pills - any side effects will be nothing compared to malaria! Low risk does not mean no risk! Robin
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Old May 21st, 2009, 07:26 AM
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Yes, it's OAT. These are the best responses I have ever had on Fodors. Everyone is to the point.

Now I'm changing it because you all are so knowledgeable and might check back: Two things: 1. OAT says wear no black or navy and I guess we're questioning that just because that's about all we ever wear. (Well, my husband's favorite color is RED, but we're not bringing clothing that color!) I asked them and they stuck to their policy closely!

2. Bring no traveler's checks bnecause they are too hard to cash, plus, VISA (etc.) cards are practically useless. (Joberg, Vic Falls, Botswana, Namibia)
They say all the small adventure providers at Vic Falls only take American dollars. Including tips, a heli ride, golf, and some souuvenirs, it seems like a lot of dollars to keep strapped on for three weeks. Has the above been your experience?
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Old May 21st, 2009, 08:27 AM
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OAT is telling you this stuff for good reasons, not just to annoy you.

No black or navy because those colors may attract Tsetse flies. You will read that only certain shades of blue or gray attract them. There are over 25 species of tsetses and, evolution being what it is, how is anyone to know which specific shades the tsetses you run into have come to prefer? You can put the whole group at risk if you wear something that attracts them, because of course they won't be biting just you, but also anyone else nearby. Talk about annoying!

No traveller's checks because they are essentially useless where you're going. Same thing with credit cards. That was our experience in Vic Falls, Zimbabwe, Botswana, along the Chobe in Namibia. Never saw an ATM, bank, none of the lodges accepted them, everyone was cash only, until Cape Town. Yes, it's a lot of cash. We both wore money belts the whole time we were there. We took about $100 each in $1 bills for small tips and a lot more in $5 and $10 and $20 bills for everything else. We were travelling on our own, no tour, so we also had meals to consider when we weren't in lodges or camps. If you're on a tour, I assume your meals are all included so you'll just have to plan for tips, excursions, other extras.
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Old May 21st, 2009, 03:20 PM
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I second Julia's comments on the colors and the cash.
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Old May 21st, 2009, 09:34 PM
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OK, I give. No black. No navy. No Traveler's Checks. Take the pills. Now I'm ready. THANK you.
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Old May 22nd, 2009, 04:07 AM
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Malarone made me a little tired and sluggish but it still beats the crap out of getting malaria. I would take it again and I'm glad you plan to do the same.

Have a great trip!!
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Old May 22nd, 2009, 06:53 AM
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The clothing color is important. The woman I was with ignored that advice and she attracted the flies. But they bit me and the driver and NOT her and she kept saying, "They aren't bothering me at all." No, she was just attracting them all! I could have strangled her!
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Old May 22nd, 2009, 08:57 AM
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The areas you mention have not TseTse Fly problem. Botswana praises itself of being TTF free since a couple of years. Botswana dedicated a lot of money into research and spraying getting rid of that problem.
The other areas are also TTF free.

I support avons' recommendations - and I can reason it:

We travelled to the mentioned areas numerous times in Oct but also in June and choose the following precautions:

- bug spray for neck, arms and feet
- long pants and sleeves during early morning hours and evening hours when mosis are very active.
- fit our own mosquito net (350 grams) when it hadn't been provided by the lodge/camp; many lodges/camps proclaim their accommodation is 100% mosquito proof which is complete non-sense!

We never ever ever had a problem.

Oversees doctors act according to their "lists" mostly without being to these destinations.
After I have read here on Fodors that an american travel clinic advised a traveller to africa to take her own bottled water with her from oversees I am questioning their "insight knowledge"

Have a safe trip!

SV
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Old May 23rd, 2009, 02:23 PM
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Looks like most of you have been taking Malarone. The travel clinic here gave us a prescription for Doxicycline. We're going to Vic falls/Zambia. Is there a reason for Malarone instead?
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Old May 23rd, 2009, 02:57 PM
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Doxy can cause extreme sensitivity of skin toward sun rays.
I had a bad reaction so that I could not stand ANY sun ray! Very unpleasant side effect!
It's an antibiotic and very cheaply available in South Africa. In Germany it's not allowed as a malaria prophylaxis.
Side effect faded when I canceled taking it.

SV
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