Avoiding Malaria
 

Hi there
I would like to ask those of you who have traveled SEA ,what's the best way to avoid Malaria ? Have you used insects repelent all the time ?
Unfortunately,I can't use pills to prevent the disease since in my case it's going to cause strong side-effects as my doctor instructed me.I can use Maleron only when being infected.
I'm seriously concerned about the issue and I would like to know what have you done yourselves on everyday life ? Have you used the repelent 24 hours a day ? Day & night ?
Thank you very much

Eli - most people can take doxycycline, so I'm surprised you can't take that one. In terms of avoiding mosquitos, it partly depends on the time of year you're there and exactly what areas you're in. During February in northern Thailand, Laos and Cambodia (Siem Reap), we found the mosquitos to be pretty minimal. We did use repellent many of the days when we were in more rural areas - my daughter was especially concerned because she always seems to attract mosquitos and gets bitten a lot (less of a problem for me). I'd suggest that yes, you use repellant (one with a fairly high concentration of Deet) daily. Mosquitos are worse after dusk and also in the early morning. Try to keep bare skin (especially legs/ankles)covered during those periods. These are just suggestions from a layperson - I'm not a doctor - but I think they'll help. Good luck. At night, by the way, we never had a problem - but we always stayed in air-conditioned rooms. If there's mosquito netting over the bed - do use it.

I'd second the advice on Doxycycline - the only real side effect that is rep

..reported is some possible photosensitivity.

If your travelling to the Golden Triangle Doxyclycline is currently the recommended drug in the UK (I know I've just picked up mine!)

Different drugs work better in different areas!

My doctor thinks the most important drug you can take if visiting a malerial area is Malerial tablets. Thant may sound daft, but he tells me so may people now don't bother and that maleria is still a massive killer worldwide. Some Maleria tablets can make you feel sick for 30 minutes because they are so bitter, my doctor said he thinks that's something worth putting up with to reduce your chances of getting maleria.

Places like Phuket, Penang, Bangkok, Singapore and Hong Kong - Maleria tablets are not normally required.

Best advice is to prevent yourself getting bitten. I'd agree with everything that Althom1122 has said.

In addtion I'd say -
Perfumes are said sometime to cause a problem.
A Dr friend tells me that fair skinned people are also more prone.
I would invest in a mosquito incense burner and tablets for any beach and hill resorts - hotels often provide these anyway - but they're cheap and its best to be sure.

The burners are old fashioned but they 'work'! You find them everywhere in Asia and they are cheap.

First of all, check and see whether you are visiting any areas that are malarial risk. There are large parts of SE Asia that are not considered malarial risk: much of Thailand and Malaysia, Singapore, most of Bali... If you are visiting malarial risk areas, repellant is the first line of defense. Mosquitoes of the type that carry malarial are active from dusk until dawn, so sleeping in an air-conditioned room does reduce your risk. Of course, the mosquitoes of the type that carry dengue are active during the day, so use of repellant will halp prevent that as well.

Larium, which is the anti-malarial that has the most side effect (though many people can take it without problems) is not effective in parts of mainland SE Asia (the Thai/Cambodian Thai/Laos and Thai/Burma border areas, and very likely all of Burma). There are two anti-malarials that have no resistance worldwide: doxycycline and malarone. Either of those drugs would be appropriate anti-malarials for a visit to mainlamd SE Asia. There has been documente chlorquinine resustane in the are for decades so any chlorquinine based anti-malarials are not recommended.

I'd recommend that you read the cdc wensite for more info: www.cdc.gov/travel

By the way, did you see a travel medicine or tropical medicine doctor? I'm suprised that he would say you couldn't take any antimalarial for prevention. Malarone, which is used for treatment at doses much higher than prevention doses is well-tolerated by the vast majority of people at prevention doses. As mentioned above, doxycycline is also well-tolerated by most people if taken as instructed (with food), but cannot be taken by people with allergies to tetracycline.

does anyone know if the phuket/khao lak area is a malaria risk? Krabi was just 5 months ago..

Jim, as you probably know the whole Phuket area was considered quite low risk up until the Tsunami. There was a surge of malaria in the months after that. I do know that the incidence has gradually declined, and I believe it was taken off the risk list. Perhaps someone like JamesA who is in Thailand knows for sure.

Thanks, Kathie.. I hope so...leaving in 10 days, so I guess I'd better call the travel clinic to make sure!

My pharmacist advised me that Doxycycline was preferred over Malerone in the Golden Triangle at the moment

If I were you, I'd purchase a few Buzz-Off clothes. You can get them through travelsmith.com and magellans.com and also through the ex-officio company. Distant Lands Travel store in Pasadena,California(distantlands.com) and Adventure 16 travel stores in L.A. adventure16.com(?) also sell them. Happy Travels!

Walter, both Malarone and Doxy are effective worldwide against malaria. There is no reason to prefer one over another in terms of effectiveness. The best antimalarial for you depends on your individual situation.