cytrav2000

We are planning a trip to a Thailand island and to Siem Reap (Cambodia) for August. We will be in Cambodia only 2 days. We are taking our two kids (7 and 11 years old) with us. I'm very concerned about the kids having to take those anti-malaria drugs for a month. Will this affect somehow their future health. What do you think?
Since this is my third trip to Thailand it would be hard to miss to see Angkor.

sandi

Your first stop should be to your pediatrician for advise. If he/she doesn't have information on how children react to Malaria meds, then contact a Travel Medicine Clinic - often affiliated with a teaching hospital; or your Public Health Clinic.
A final alternative is to contact the CDC directly.

With the exception of the doxycycline (a generic antibiotic) often recommended as an alternative to Malarone, this latter is only taken daily from 2-days prior entering SEAsia the for 7-days upon your return. It's the doxycycline that is taken for a month, and doxy has it's own side-effects, especially sensitivity to the sun and yeast infections for females.

If it is "not" recommended that the children take these meds, then remember that they'll have to use repellent all the time, and reapplied after they've been swimming. You cannot afford not to use these repellents. Even with the meds, they'll have to use repellents from dusk till bedtime, as will you. And if your hotel provides netting, sprays, coils, etc. definitely use them. Since you're traveling in August, it's going to be raining often - even more possibilties for mossies.

So asks the professionals.

Kathie

As Sandi pointed out, you do need to consult a professional. However, instead of talking with your pediatrician, I'd recommend a travel medicine or tropical medicine clinic (most medical schools have them) as your pediatrician likely has no experience with anti-malarials.

As you noted many anti-malarials require that a person continue to take the medication for a month after leaving the area (doxy, larium, chlorquinine). Malarone only requires one week after leaving the malarial risk area. There are child doses of malarone.

Do make sure you take an effective mosquito repellant and use it diligently. Deet based repellants are best (25-50% deet, extended release is most effective). Mosquitos that spread malaria bite at dawn and dusk. I'd recommend not eating outdoors by the river at night (I gotten bitten despite deet, a burning mosquito coil beneath the table and pytherin-based spray on my clothes!). The mosquitos that spread dengue bite during the day, and there is no innoculation or prevention other than preventing bites.

The travel medicine clinic can also recommend any additional innoculations for your children.

cytrav2000

We have here in our country a public travel clinic which deals with tropical diseases prevention. I 'm well awared about all kinds of prevention. My question is whether the antimalaria drugs have medium or long term effects on childrens health.

bonniebroad

The truth is that you can't be sure of the long-term effect of meds on children. I probably would not risk it.......... I would take them somewhere that I did not need to worry about this problem! Good luck with your decision.

mjs

I should think that an infectious disease specialist would best help you with this question. If it is doxycycline, I would not worry about long term effects as thousands and thousands of teenagers have used it on a long term basis for acne and we have never heard of any specific long term issues. You also however need to balance your concerns about the possible long term side effects of the drugs with the real possible long term effects if your children get malaria.

sandi

cytrav2000 - apparently none of the posters have so far had the experience with Malaria meds with children. That said, there was a post on the Africa/Middle East Board yesterday about Yellow Fever taken from the CNN board which very concisely and in clear english explained the issue.

I just went to look for it and it seems to have disappeared. But why not try the CNN site, probably under a title of Travel (what to know before you go, or something like that) and see what you find. What was of interest is that the article had various links to follow-up on. These links might provide some more answers to your questions.

If not - it's back to a professional in tropical deseases for answers to your questions. Generally, malaria meds do have a long half-life, the reason people cannot donate blood for at minimum 1-yr after having had these meds in their systems.

But anyone of us can go on and on - this questions has to be directed to the people who should know - where not the ones, except for our own experiences. Check the CNN site and then go from there.

Kathie

Actually, the half-life of anti-malarial meds isn't the reason one can't donate blood, the reason has to do with being exposed to the risk of malaria. That said, larium and chlorquinine do have long half-lives, that's why you only have to take them once a week. Doxy and malarone have much shorter half-lives, which is why you have to take them daily and at the same time each day.

You are concerned about the effects of taking anti-malarials on your children. Talk with a travel med or tropical med doctor about this. Plenty of children have been precribed anti-malarials, so there is certainly some data on this question. You must, of course, balance this info with the effects of contracting malaria on your children's health.

Again, even the health professionals on this board cannot provide you with the expert advice you need, as everyone's situation is different.

mjs

I just need to add that there are teeth discoloration issues with Doxy with children under 8 so you may not wish to use this medication with your youngest. Every medicine has some not uncommon possible side effetcts and some rare and unusual possible side effects, You need to balance the possible side effects of any of these anti malarials with the possible consequences of contracting malaria. Each drug may also be different in it's effectiveness against malaria and there may be differences in different malaria strains in different areas of the world which might tend to make some drugs better than others for prevention of malaria for your travel plans. Again someone who prescribes these drugs on a regular basis for travel or an ID specialist would best help you sort out your concerns. The CDC in Atlanta may also be of some help with information for you and I would imagine there would be good sources for this type of information in places like England, Australia and Singapore.

Kathie

The cdc website is helpful: www.cdc.gov/travel

Note that in Cambodia, usually only either doxy or malarone are prescribed due to malarial resistance to other drugs.

cytrav2000

Thank you all for your comments. I decided to cancel my trip to Siem Reap.
Since I go another time to an island in Thailand and I will come a long way from Europe, I would like to see something new. I ve been already in several southeast asian countries, like Thailand, Vietnam, Malaysia, Indonesia. I'm considering now to go to Yangon. Do you think that it is an interesting and exotic city that deserves 2 days in there? What are the highlights? Is it less interesting that Angkor? Is it safe for kids and especially is malaria free?

Kathie

Yangoon won't be anything like Siem Reap. If you want temples, you'd have to go to Bagan. There is malaria in Burma. You would need to exercise the same precautions there as you would in Siem Reap. Check out the website I noted above, it gives you malaria information all over the world.