Anti-Malaria Nightmare

Old Apr 23rd, 2006, 04:20 AM
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Anti-Malaria Nightmare

My husband and I moved to South Korea last fall from the US. He accepted a teaching position here and I thought it would be the perfect opportunity for us to travel and see Asia. In January, we flew to Hong Kong and took a wonderful cruise which stopped in China, Vietnam,
Thailand and ended in Singapore. Afterwards, we flew back to Koh Samui, Thailand and stayed at the
Napasai Pansea (a beautiful resort) and then left there for Siem Reap and Angkor Wat. On the first day of our cruise, I became violently ill with what I thought was food poisoning. I had flu like symptoms and was in bed for two days. I was well again for the rest of the cruise, and on our last day in Koh Samui, I awoke with blurred vision in my right eye. I thought I had an infection. We flew to Siem Reap and our guide immediately met us and we checked into our hotel(De La Paix, wonderful)and set out to see the temples. My vision became progressively worse, and when I could barely see the sights, and while in a park couldn't see the adorable families of monkeys, I panicked. The guide took me to an eye doctor's office, which was in a house, and although he had a french diploma, had very limited equipment. He immediately diagnosed me as having a 60% detached retina and said I must leave the country for surgery immediately. I insisted that my husband go to the temples the next morning, while I stayed at our hotel, awaiting our flight. I thought maybe we'd never return there. He did go, and got some wonderful photos, while I pondered why this was happening to me. We left for an eye hospital in Bangkok where the dr. said I should return to Korea for the surgery, as the recovery period was very long. We went to Seoul and I endured two surgeries in two days, one with only a local anesthetic, and the pain was horrific.
There was virtually no English spoken, even though it was called an International Health Center. At the end of the week, we flew back to Busan, where we live, and I started to take the medications they gave me. After three days, I began to have seizures and was rushed by ambulance to a University hospital for treatment. Although, once again, English was barely spoken, the team of doctors saved my life. I was diagnosed as having hemolytic anemia, a condition where your immune system attacks itself.How could this have happened, when I was perfectly healthy before our trip? I was in the hospital for two weeks, and sent home two months ago on heavy steroids (prednisone) which is a nightmare in itself. The side effects are horrendous. I am gradually getting better, and once I'm weaned off the steroids, I hope I'll be myself again. Why did this happen? How did I get this condition? I have done much research, and it seems to point towards the anti-malarial medication our doctor in the U.S. prescribed for us before we left. I asked for it, as I thought we might need it in Vietnam or Cambodia.While my husband had no adverse reaction to it, I think that's what caused my illness. I discovered, upon doing research, that people who are of mediterranean descent (my family is originally from Italy) are lacking a certain enzyme, and should never take anti-malarial medication. They actually have a resistance to malaria. What can result from taking it? The first thing on the list was hemolytic anemia!
I have gradually gotten almost well, after nearly dying, and I will never know for sure if the melefoquine caused my trouble, but I want to caution people against taking anti malarial drugs unless it is absolutely
necessary. I was in a jungle for about an hour when we went to CuChi Tunnels in Vietnam, and hardly thinks that would be enough to take this medication. I regretfully wish I had gotten more information. I hope this might help someone else.
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Old Apr 23rd, 2006, 04:50 AM
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Thank you for your post. I have been to Asia many times. Under constant urging for others (You are going to take anti-malaria medication, aren't you?!?!?!?!)I started to take medication for my first trip to India. HUGE MISTAKE! I became so violently ill that my trip was a total disaster!!!!!!!!! After that experience, I decided never to take anti-malaria medication again unless I were going into the jungle for 5 months and sleeping in a tent.

On my last trip to India in 2001, many of my friends who were on anti-malaria medication became very sick, usually vomiting and diarrhea symptoms. They all could not believe I wasn't taking any medication. We were all travelling first class, staying in 5-star hotels, driving around in air conditioned mini-vans, etc. I really didn't see any risk. I wore long-sleeved shirts and pants, and applied mosquito repellent. That was good enough for travelling in mostly larger cities like Delhi, Agra, Jaipur, and Benares.

Later, I saw a news programme--I think it was 60 MINUTES--that discussed how anti-malaris medication can cause dementia in certain people. I think people really have to look at the benefits and risks of ALL MEDICATION before use.

Cheers,
JG
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Old Apr 23rd, 2006, 05:12 AM
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I am very sorry you had such a terrible experience. You might be interested to know that according to the CDC web site, mefloquine is NOT recommended for many places in SE Asia, including the western provinces of Cambodia that border Thailand - I am not 100% sure but I think that would include Siem Reap.
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Old Apr 23rd, 2006, 05:20 AM
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I could not agree more!! I've made nine trips to Asia and have never taken meds before traveling there. I have reactions to some things, which became apparent after my one and only flu shot 40+ years ago. I was so sick I had to be hospitalized for several days after just one flu shot. NEVER AGAIN!!

I get very concerned about all the ads on TV about drugs for this and drugs for that. People don't really stop to think about putting something in their body. They are just looking for a fast cure... it's just part of our fast food culture. A quick fix for anything!! Don't get me started!!

Anyway, I would agree completely with the cautionary note about taking meds.

Carol



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Old Apr 23rd, 2006, 05:57 AM
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maybe i missed it but what medication did you take...that might be helpful for others...

have you considered flying home to usa to be fully evaluated? it seems that i would choose to do something like that at this point
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Old Apr 23rd, 2006, 06:29 AM
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Wow, what a nightmare! Really hope you are recovering ok, poor you.

Thanks for sharing. When I took anti - malarials a couple of years ago, it made the skin on my hands and wrist all bumpy. yuk.

The best thing of course is to avoid getting bitten in the first place. Anyhow, like I said, hope you are ok now.
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Old Apr 23rd, 2006, 06:51 AM
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Bob - the drug was mefloquine (sold under the brand name Larium). She doesn't mention name of the med until the very end of her post.
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Old Apr 23rd, 2006, 07:15 AM
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So does Malarone do bad things to you? I'm not sure if I believe the labels.

Lloyd
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Old Apr 23rd, 2006, 07:23 AM
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There have been several discussions on this site regarding Malerone. As far as I can tell, I am the one of the few that has had problems with it - it upset my stomach. My wife and I use doxycycline as an anti-malarial with no problems other than skin sensitivity to the sun.
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Old Apr 23rd, 2006, 07:42 AM
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Geez, what a nightmare. We have Malarone that we're supposed to start taking next week. I hope for no side effects!!!
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Old Apr 23rd, 2006, 08:09 AM
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Larium is known to have horrible side effects. The "experts" all say the risk is small but I would say that at least 25% of the people I know who have taken it have had awful side effects. I refused to take it after reading about it. I do take doxcy which if it does have side effects it's sun poisoning -- so I am very careful. But it doesn't cause the awful stuff that larium does. I have avoided melarone as I do all new drugs because they really don't know what the side effects are yet. I prefer tried and true to new unless I have no option. One thing I've heard about melarone is it can cause diarrhea -- something I really don't want when I go on vacation.
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Old Apr 23rd, 2006, 08:29 AM
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Korea Princess: What an awful situation! Though even before reading to the end of your post, I could have told you that this was most likely a reaction to Larium. My husband and I travel frequently to Africa and of course Malaria medication is almost non-negotiable. After going on line and reading the horrendous side effects of Larium (a medication BTW that they no longer prescribe in most of Europe) my husband andI opted for Malarone other then some bizarre dreams and a mild headache we have never had any horrible reactions we have been on it for weeks at a time. It is truly amazing that some doctors still prescribe Larium do a quick internet search and you will read stories that are chilling! Paralysis, dementia, blindness reallly horrible stuff! Actually, when I first went to my regular doctor for my pre-trip medicine, she started to prescrbe Larium (I think most regular GPs are maybe not quite as up to date on travel related illness as we would like to believe, certainly not tropical medicine advancements)luckilly I had done my research and requested Malarone again, we were most fortunate as this medicine worked fine for us.. Malaria is a real killer and one should take precautions if travelling to areas where it is prevalent; Again, I am sorry Korea princess and I hope you are feeling 100% soon.
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Old Apr 23rd, 2006, 08:37 AM
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I have taken Malarone for 3 trips to India..I don't think i had any reaction..I got sick with stomach pains and vomitting upon returning home, but don't know if it was related to Malarone or not..
I just finshed taking Malarone again for 3 weeks, and didn't have any side effects at all..

Make sure you take it with food or right after you eat..

That is a horrible story about Larium..I would never take Larium..
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Old Apr 23rd, 2006, 08:46 AM
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"I discovered, upon doing research, that people who are of mediterranean descent (my family is originally from Italy) are lacking a certain enzyme, and should never take anti-malarial medication. They actually have a resistance to malaria. What can result from taking it? The first thing on the list was hemolytic anemia!"

Any reference?

And check http://linktrim.com/5e7
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Old Apr 23rd, 2006, 10:14 AM
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What sad story, Koreanprincess! As others have mentioned, Larium (mefloquine) is the anti-malarial that has the most side effects and the most severe side effects. It is also not recommended for the area you visited (Cambodia) as there is larium-resistant malaria in that part of SE Asia.

Just to note that larium is not the only anti-malarial available. Doxycycline and Malraone are both effective anti-malarials for which there is no known resistence anywhere in the world. Both have low incidence of side effects, and the side effects that people may have are quite mild (stomach upset for malarone and sun sensitivity for doxycycline) in comparison to some of the really serious side effects of larium. Nontheless, as other have mentioned, the majority of people taking larium do so without having serious side effects ( 25-30% of people have side effects from larium that are severe enough to discontinue the medication).

You make a number of excellent points. People should know, first of all, whether they are going to be traveling in malarial risk areas. For instance, someone on the board was prescribed an anti-malarial to visit Chaing Mai, which is not a malarial risk area. The area you visited that was the highest risk (as far as I can tell from your account) was Siem Reap, Camodia. One should always do their own research before a visit to a travel medicine or tropical medicine professional, so you can ask questions, and make sure you understand what you are taking, why and what the possible side effects are.

I wish you a smooth recovery.
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Old Apr 23rd, 2006, 10:16 AM
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I took Malarone for 6 weeks while in West Africa in 2004. Larium seemed risky, and I'm already very susceptible to the sun, so doxcy seemed like a bad idea too. Unfortunately I had a reaction to the Malarone. I think it was just because I took it for so long, but by the 5th week I couldn't hold much in after a meal (diarrhea), and I had some cramping. The last week (when you're home and you have to take it for another week) was awful. I would run to the bathroom after just having a drink of water. Two or three days after I stopped taking malarone I was able to eat as normal.
Nevertheless, I still think Malarone is a good anti-malarial, just perhaps for shorter time periods. I am traveling to Thailand this summer for a month, and am still considering taking malarone, but perhaps only for part of the trip when I would be at risk so as to reduce the amount of time I'm taking it. Doxcy still seems risky to me just because I am so susceptible to the sun at the best of times. Have people had much experience with doxcy and it's sun reaction?
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Old Apr 23rd, 2006, 11:58 AM
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Koreaprincess-
Best wishes for a continued recovery.

Regarding the use of doxycycline for malaria prevention, female travellers should note that as with other antibiotics, doxy can reduce the effectiveness of oral contraceptives.

http://www.hpa.org.uk/infections/top...oxycycline.pdf
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Old Apr 23rd, 2006, 01:36 PM
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Irish, note that most of Thailand is not considered a malraial risk area. Of the places listed in your other post, only Siem Reap and Luang Prabang are considered malarial risk.
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Old Apr 23rd, 2006, 06:09 PM
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Irish cheer-- I am highly allergic to the sun and have take doxcy for several trips without a problem.
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Old Apr 23rd, 2006, 08:01 PM
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I am certainly not knowledgable on this but have read many things about Larium. I last took any anti-Malaria medication probably 15 yerars back, no idea what it was but I felt unwell.
Unfortunately it isn't practical to take regular if you are living in regions as your home, experts might disagree, I simply have to do everything to avoid any 'bites', though it cannot be guarenteed it would be nice if anyone knows a site that expplains in 'very simple' terms the options open for anti-malarial (?)
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