We are going to be in Koh Chang in mid-Dec. I checked the cdc website, and also the advise from this site. I went to my doctor to get malaria pills. He also checked on some website, and then gave me a perscription for Doxycycline.
I am NOT asking anybody for medical advise, but rather if they had adverse side effects. I have read that the side effects can be an upset stomachs (risk reduced if taken with food), yeast infections in women, and sun-sensitivity.
I am concerned about the the sun sensitivity, as we will be on the beach. We will be using sun screen (always do) but our exposure to the sun will be pretty much all day, as we will be, after all at the beach, relaxing, water sports, snorkling etc.

we took malerone for our stay in koh chang and it also advises against sun exposure...we had no problem...

Even with sunscreen, you might wind up blotchy. And remember, you have to take the doxy for 30-days after returning home. We've used Malarone and never had problems with the tummy or sun and only needed to take for 7-days after returning. However, Malarone is more expensive than doxy.

Have recently been on doxycycline and if you use sunscreen, hat, sunglasses and don't just bake, you should be fine / some blotches at best but I had none. However, my doctor also gave me the pills for yeast infection, which is a common female reaction to antibiotics, so if the problem arose Iwouldn't have to scout out a Dr. - you may want to ask your Doc to give you that just in case. I wouldn't think he'd mind, the pill(s) depending on what he gives you, isn't a medication people would tend to want to abuse, but to take if necessary. Stomach upset, if you have it, you can take care of with otc drugs or your favorite solution ( take w/ food, not milk products, etc).

Joan5000, no advice here but a question. I see people asking questions about malaria prevention medication on this forum a lot and I am just wondering how healthcare in the US is organized when it comes to tropical disease. I live in the Netherlands and things seem to differ quite a bit between the 2 countries. From your post I gather that it was your family doctor who prescribed the pills? Is this true and is this the way most people would get them? As I said before, I am just curious as to how this works in the states

Many people tend to go to their family physician first as this person has your medical history on file. However, few family physicians have Tropical Disease/Medicine expertise and aren't always aware of the latest meds or protocols.

Others will seek out a Travel Clinic that specializes in just this - tropical diseases. And their specialty also comes at a higher price - for the visit; clinics are likely to prescribe every pill or inoculation available. You also have to go though the process of providing the Clinic with your medical history.

It is, therfore, a good idea for individual travels to do some pre-trip research on the CDC website, or those of the UK or Australia. Ask questions of previous travelers. Though the latter aren't professionals and all have individual needs or health issues, it's a place to start.

With information in hand you should be able to obtain better information from your personal physician or through a clinic. Then you can make the best decision for your particular destination, own health and personal medical/drug insurance. Unlike countries with National Health Care systems, in the US travelers depend on their own insurance and/or drug plans to cover payment. More often than not, Americans aren't covered and the expense is out-of-pocket (their own).

Depending on where one is traveling, this can run to $400... a good reason when selecting a destination, you check out medical requirements beforehand so as not to be surprised (shocked) after you've paid for your airline tickets and other trip expenses.

vakantie - How is this handled in the Netherlands?

Actually, I live in Canada (BC), so much of our shots etc are covered by our medical system. What is not covered, I have insurance through my work, so really, it doesn't cost me anything. However, the procedure sounds pretty much the same here as in the States. I did the research on the CDC site, and then went to my GP. As Sandi states, usually GP's are not very familar with tropical diseases. We also have Travel Clinics that specialize in this, but unfortunatly, the nearest one to me is about 5 hours away. The costs of this visit would also be covered by the medical system.

Joan -

5-hrs. WOW! Guess you need a car!

Many hospitals (especially large ones, with teaching facilities) have a Tropical Deseases department or Travel Clinic within.

Anything like this in Canada.

sandi and joan5000 thanks for your answers. Sandi, the procedure in the US as you describe it sounds logical. It is actually not so different from here as I first thougt.

Here you would typically go to the GGD which is a public healthcare institute which, among other things, has the task of giving advice on healthcare while travelling. There are also some private travel clinics, I think for example KLM has one. As far as I know people choose between these only on basis of convenience as there really isn't that much difference between them. Also the academic hospital in Amsterdam has a section with tropical disease as a specialty. Your family doctor here would, as in the US, not have the knowledge of tropical disease that these institutes do. I am very Amsterdam oriented so I am not sure how this is handled in smaller towns but a 5 hour drive here would take you well out of the country so I guess peopel in the Dutch countryside use the same facilities as I just described.

A vaccination for for example hep A+B would be 56 euros for each of 3 vaccinations that you need. If I remember correctly a 1 week prescription of Malarone is around 50 euros. I guess this is not really cheap either. For most people this will be covered by their insurance. However there are some major healthcare reforms going on in the Netherlands so I don't know how this will be handled in the future.

I guess the main difference is in the medical opinions... For example we didn't take malaria meds for Siem Reap and Ko chang. They did advice us to take malaria meds for other areas of Cambodia.