We are travelling to India to spend the whole month of May over there. Do we need to start taking anti Malaria tablets before we leave North America? In other words, how critical is it to worry about Malaria? And apart from Malaria should we worry about any other issue, e.g., yellow fever?

Thank you kindly.

Kay

See cdc.gov for medical advice for travel. You should visit a Travel Clinic if you have one in your area.

The short answer is malaria yes, yellow fever no. I take Malarone for malaria, and you need to start it a couple of days ahead and continue for a week after. I tried Lariam but had bad effects from just one pill. There are probably some other things you need for India, like typhoid, but I don't remember off-hand as I've had all of those for other trips.

Part of the answer depends on where in India you will be. In the general course of staying in better hotels and doing the standard tourist visits, you'll be fine and Malaria pills are probably not needed for May.

The best practice is to bring mosquito repellant with you and make your best effort to avoid being bitten. Not all mosquitoes carry disease, but those with disease can be things other than malaria (such as Dengue fever and Chikangunya)! So the malaria pills can give you a false sense of protection.

The early morning and early evening are prime mosquito times.

The only other health issue is staying hydrated in the heat and be choosy about where you eat to avoid food borne illness.

From http://wwwnc.cdc.gov/travel/yellowbo...ophylaxis.aspx on malaria risk in India:

"All areas throughout country except none in areas >2,000 m (>6,561 ft) in Himachal Pradesh, Jammu, Kashmir, and Sikkim. Present in cities of Delhi and Bombay (Mumbai)"

Yes, mosquitoes carry other diseases - those with dengue are active ALL day.

Besides being careful about food, you must be careful about water - only bottled water, no drinks made with water or ice.

As per thursdays advice, do take a look at the cdc website: www.cdc.gov/travel

Make sure you have all of the appropriate immunizations (e.g. Hep A, typhoid, polio booster if needed, booster for MMR, tetanus as needed).

Some areas of India have substantial malarial risk, others do not, so read the website carefully and consult with a travel med professional.

If anyone tells you you need the Yellow Fever vaccine, that is a clear sign they don't have a clue. There is no Yellow fever anywhere in Asia. Only parts of Africa and South America have Yellow Fever.

mdtravelhealth.com India all your CDC info for India.

Short answer you do not need preventives in the mountains

or major metro areas but in the south and around Goa...

Usually pick up Doxycycline 100mg #270 for $12 at WalMart

works great... No need for YF Food/water precautions

essential... Do beware some travel clinics that will "churn"

you charging up to $1K for jabs and expensive meds like

malarone that you do not need for most areas.

Have fun do careful research and always insuremytrip.com

Thank you all for your kind suggestions. Last year when I went to East Africa, I took anti malaria tablets called Mephaquin. You take one tablet a week. You begin 2 weeks before departure, and continue throughout your stay in the malaria zone, and 4 weeks when you come back. I did not get malaria but I will never know whether it was because of the tablets or I was just lucky. But these are tablets that I cannot find here. I actually bought them in Nairobi as soon as I arrived (there is a slight change in the prescription when you start taking them in the malaria zone (you take one tablet a day for th first three days, and after that you take one tablet a week). So most likely I will go for Doxycycline.

Thank you kindly.

The right anti-malarial for Africa is not necessarily the right anti-malarial for Asia.

The antimalarial you are referring to, mabiasha is Larium, generic name mefloquine. It is effective in Africa and in India but not in SE Asia. It is also the antimalarial with the most (and most serious) side effects. But if you have been able to take it without problems in the past, it is likely it won't cause you problems in the future.

You are right Thursdaysd. It just so happens that Mefloquine (AKA Mephaquin) is effective for both East Africa and also for India according to CDC. The same is true with Doxycycline.

Kathie, it appears I will go for the Mefloquin because it's a weekly dose and I have had no side effect. My significant other has some cardiac issues in that case it's best to use the daily dose of Doxycycline.

Thank you both.

We took doxycycline when we were in India. It's true that you must take it every day, but we got a 23-day supply for about $8.

One side effect of doxycycline is increased sensitivity to the sun. Cover up!

This is true about doxy. Use sunblock as well. We were in India in late Nov.-early Dec., so the intensity of the sun wasn't so high.

You do also realize that doxy must be taken for a further 28 days after you are out of any malaria risk areas...

Hi Mabiasa
I agree with most of Jaya's comments, and surprisingly with thursdayd's. There are different areas of India that are affected with different types of diseases carried by mosquitos. Mosquitos are present everywhere, even in the metro areas. India is essentially a very dirty country and every corner harbours disease of some kind. When I lived in India I never entered a Hindu temple and never had any problem with foot infections. This time, taking my husband on the tourist route, we actually went into some temples, one a particularly dirty one in Amritsar and ended up with a foot infection having to walk through very dirty water inside the temple. Doxycycline is expensive in Australia but I would not go to India despite covering myself with various anti mosquito creams and sprays, without taking it. Mosquitos are attracted to me, but generally leave my husband alone! Sunblock is essential and we used hats. We also carried out own bottled water with us.
Mabiasa contact me on [email protected] for the driver's contact details.

KimJapan: Yup. We did, although our travel clinic didn't recommend it for 28 days. Can't remember how many days, but it wasn't 28.

"and surprisingly with thursdayd's" - dear me, what on earth brought on that snide adverb?

indianapearl, the CDC website says: "daily for 4 weeks after the traveler leaves [malarious] areas."

In Australia, they used to only recommend 14 days after leaving the malarial risk area, but research has found that the incidence of malaria is much higher with a mere 14 days of doxy post-exposure. So follow the cdc recommendation of 28 days post-exposure.

Wow! 28 days! Well, we didn't develop malaria after the fact.

The most common reason people contract malaria even though they took anti-malarials is because they did not continue the antimalarials as prescribed after leaving the malarial risk area. Melfloquine (Larium) must also be taken for 4 weeks after leaving the malarial risk area.

This is one of the great advantages of Malarone - you only have to take it for a week after being in a risk area, so people are more likely to follow the instructions.