Has any of you travelled to China without taking the Malarone medication? After research it seems that the risk of contracting Malaria is very low as opposed to the side effects of malarone - what are your thoughts on this?

Well, I'm not raving about my "travel planner health doctor" but when I gave my itinerary, he did prescribe Malarone -- but not for China at all -- to wait till I leave for Vietnam and them start it.

You won't need malaria prophylaxis if your travel will all be in cities.

BUT

The last place you should be seeking medical advice is from a bunch of medically unqualified unknowns on a public discussion board. Even most qualified doctors have little knowledge of tropical medicine, and malaria prophylaxis is an area of constant change.

So please go and get reliable advice from a fully qualified professional, both on the need for prophylaxis and the likely side effects (I've never suffered any for instance), and then take that advice and don't try to second-guess it. This isn't like getting advice on hotels: a wrong decision may have a profound effect on the rest of your life, not merely a few nights' overpriced discomfort.

At least begin by looking at the malaria map application on the US Center for Disease Control's website, or similar public health information published by tropical medicine specialists of other developed nations.

Peter N-H

Well said, Peter. I am a nurse counselor in a travel clinic and would only throw in that malaria risk is fairly limited on most tourist itineraries in China; the biggest risk is in Yunan province. But see a professional, with a copy of your itinerary in hand, to look at the maps. (Please don't forget to take records of your previous vaccines with you too!)

Malarone has very few side effects, You should not make a decision about malaria prophylaxis non the basis of fearing side effects. You may be confusing malarone with melfloquine (larium) which can have serious side effects.

I agree with the above, you need to talk with a travel med professional. In addition to your immunization records, print out a copy of the cd recommendations for the areas to which you are traveling (www.cdc.gov/travel) or another reputable travel med website like the NHS Fit For Travel. Ask questions about any recommendations you don't understand or any recommendations that appear to be contrary to the cdc or NHS recommendations.

Good advice, Peter, but as much as we may not like it, many of us live in cities with doctors in the travel health business who are probably LESS equipped to answer this question than posters here who go frequently to Asia and who see savy doctors in major metropolitan cities.

I suppose you would also question Kathie's advice when she mentioned the antibiotic my "travel doctor" prescribed is probably not effective currently in SE Asia. I honestly thinks she probably knows better than any doctor I can find within a couple hundred miles of me.

Thanks for your input. From what I understand looking at the map is that while we are in Beijing, Xi'an, Pengyao, Shangai we are ok without the medication and should start to take it a couple of days before entering Yunnan. From there we will be travelling to Vietnam where we will continue to take it at least in the north. Basically we are travelling for 2 months and don't want to take malarone all the time if it is not needed.

Ladouca, that's the same situation I have -- the doctor did look at my itinerary, including some of Cambodia and Laos, but said to start taking Malarone two days before flying to Vietnam for 16 days and to keep it up a week after -- there is my 30 days worth. I was somewhat surprised he didn't say to start taking it before Siem Reap and Luang Prabang, which are about a week before going to Vietnam. But as I said, I'm not sure how much this doctor knows.

I thought Malarone was so expensive because it has far fewer side effects than most of the other meds. No? Guess I'll find out.

Patrick, Malarone is the anti-malarial with teh fewest side effects. It's more expensive because it is still under patent, so there is no generic.

If you have 30 tabs of Malarone, take it beginning a day or two before entering VN (for 16 days) and a week after, you still have tabs left. I'm also surprised your doc didn't have you start them before Cambodia and Laos. Count how many pills you have and count your days. If you have enough pills, I'd start them for Cambodia and Laos. In Siem Reap and in LP are lower risk than the surrounding countryside, but there is still risk.

The best malaria maps are from the NHS. Take a look at this:

http://www.fitfortravel.nhs.uk/desti...ia-(east).aspx

From that page, choose each country you are visiting, then choose malaria map from that page.

PS - Hopefully your docs gave you instructions for taking malarone. Take at the same time each day with food. Breakfast works well. Make sure you eat something with fat in it, as one of the components of malarone is fat-soluable.

Thanks Kathie -- here's the run down in order:
After China and a week in Bangkok:
3 days Siem Reap
3 days Luang Prabang
7 days Chiang Mai to Chinag Rai
1 day in Bangkok
16 days in Vietnam
1 day in Bangkok
on to London

So if I started them a couple days before Cambodia, I'd be out of them before my last day in Vietnam. Is that bad? Or should I really get another 7 do you think? My last three nights in VN are in HCMC, if that means anything.

By the way, I LOVE the idea of HAVING to eat something with Fat in it. How often do I get permission for that -- yet alone orders to do it?

Patrick, this is complicated. Neither I not anyone else here who knows about travel med will try to practice internet medicine.

I don't know exactly where you are going in VN. Parts of VN are low risk for malaria, other parts are higher risk. Go to the fit for travel link, and take a look at the VN malarial map.

Chaing Mai and Chaing Rai are not malarial risk, but the Golden Triangle area is. With your itinerary, I wouldn't take anti-malarials for any of the Thailand time.

Look at the Cambodia and Laos malarial risk maps. Both the Angkor temples and LP are in malarial risk areas.

If it was me - and it isn't - I'd opt to take malarone for my Laos and Cambodia time (plus the required one week after) and then for the VN time you are in higher risk areas and a week after.

Look at all the maps, and call your travel clinic if you feel they have given you the wrong number of pills. As we talked about before, I can only guess that the travel clinic has no experience with SE Asia, which is why we as patients all have to practice defensive medicine.

Yes, Kathy, that's kind of how I was looking at it too. But the 'week after' Cambodia and Laos would be the week I'm in Northern Thailand and part of it into the three days before going to Vietnam so I'd be taking it all that time regardless. So it does seem like if I want to start taking it three days before Cambodia/Laos and a week after plus through Vietnam and a week after -- then I need about 7 - 10 more pills. Just 7 if I include the three days in HCMC as part of the week "after" the rest of Vietnam.

I see my regular doctor on Monday and suspect he can write me a prescription for 7 or 10 more pills. What's $70 more? LOL