Going to Thailand (Bangkok, Chiang Mai, Chiang Rai) Vietnam and Cambodia.Know we need Malarone for Vietnam and Cambodia. Do we need it for hailand>
What kind of reactions have you had to the Malarone pills. Thanks for your input

Yes you will need malaria. I take doxcy rather than malarone. Side effects for malarone tends to be an upset stomach.

I used Malarone in India for about 3 days. Because it had a severe (!)laxative effect on me, I had to switch to doxcy which fortunately, my wife was taking. With the doxcy, we found that we sunburned easily so if you go this route, be sure to protect yourself.

Here's the best travel medicine resource: www.cdc.gov/travel

Do your reading before consulting with a travel medicine doc.

Your two options for anti-malarials for this area are malarone and doxycycline. There is larium-resistant malaria in the border areas.

Since you don't need anti-malarials for your whole trip, try to cluster your malarial risk areas together so you can take anti-malarials for the shortest time possible. Remember that you have to continue taking malarone for a full week after leaving the malarial risk area; you must continue doxycycline for four weeks after leaving the malarial risk area. Either doxy or malarone can cause stomach upsets if not taken with food. Both have relatively low incidence of side effects (I've taken Malarone on a number of trips and never had any side effects.)

Never had any side effects from Malarone--we've taken it for as long as a month at a time.

I took Malarone for two recent trips to Ghana,West Africa(Dec2003/Jan2004 and Dec2004/Jan2005)and the problem I had with it was stomach problems. The first time I took it I had a worse reaction than the second time and was in bed for a day and feeling queezy off and on the whole time. I always felt just out of it and was counting the days until the last pill so that my system could get back to normal. It wasn't an unbearable situation,however. The first time I also had a bit of loss of appetite and dropped about 10 pounds in 2 weeks.But, it beats Larium I hear. I personally would never take Larium. Happy Travels!

Guenmai- Just out of curiosity, why would you never take Larium. I am leaving for SEA very soon and I am taking it as of last night. My doctor said I could have side effects from any of the pills, and he feels larium is the best. But you are the second person who has said something about this drug. I would really be interested in what you have heard, and what any one has heard about Larium. I must say I do not feel sick as of now, but then again I just started taking it.

Larium can be extremely dangerous. If you have a side effect it can be a major psychotic episode or worse. I would never ever take this drug. Yes there are side effects with malarone and doxcy but they are mild and can be controlled. I know several people who were hospitalized because of larium side effects. Most doctors do not recommend it any longer.

Larium has a reputation for severe psychiatric side effects. While the majority of people can take this medication with no ill effects, when side effects do occur they can be serious. Consumer Reports did an article on larium side effects a year or two ago. I'd suggest that you read that (available on their website). Note that there is no one "best" antimalarial - the best one for you depepnds on your medical history, where you are going, etc.

I'd also recommend that you read the malaria info on the cdc website. Note there are parts of SE Asia where there is larium-resistant malaria. For that reason, many physicians will not prescribe larium for people traveling to SE Asia at all. The pockets of resistance are located in the border areas of Thailand/Cambodia/Laos/Burma. If you are going to these areas, do contact your doctor about this.

I won't take lariam either for the reasons mentioned above, but my husband takes it and has no side effects. I take malarone and have never had any stomach problems or any side effects but everyone is different. Malarone is supposedly the anti-malarial with the least side effects, at least according to the fancy travel medicine clinic I go to but some people do react to it. Unfortunately, you won't find out if you are one of them until you start taking it.

I also had an upset stomach for the first few days taking Malarone (I did take it with food), but it wasn't severe enough for me to stop taking it and went away after a few days.

My best friend has taken Larium several times without problem and has given it to her daughter without problem...which is great for them. Although I know that people react differently to different drugs...some with no reaction and others with bad reactions, I'm just not taking the chance having read so much info on Larium and having met and talked to a young woman in the Bangkok airport who was on her way on vacation to Vietnam and stated that she had ended up with permanent liver damage having been on Larium. Years before having talked to her I had decided to not take Larium. Happy Travels!

I've travelled to Bangkok, Hanoi and Siem Reap. I didn't take any malaria pills. I don't know if you'll need this in Chiang mai and Chiang Rai.

Purplefish, Bangkok and Hanoi are not malarial-risk. SIem Reap is, as is Luang Prabang. Chaing Mai and Chaing Rai are not risk areas in town, but the Golden Triangle is. The cdc website give accurate and up to date info on malarial risk areas.

Folks!

Lariam(Mefloquine) has a long list of contraindications for those who have had any previous psychological disorders, including depression and anxiety. It has serious side-effects above all among antimalarial drugs.

My suggestion is: Talk to your local International Travel Clinic to get the latest advisory warning and shots.

Personally, I am not an advocator for using drugs in prevention. Washing hands and use DEED bug spray, are much more effective and safer than those drugs. I am a health care worker who has spent considerable amount of times in SEA and Africa(working with the refugees), and never used any of these preventative drugs. Just use your comment sense: hand washing alone would eliminate most of the GI problems, including the Hepatitis A(food and water), bug spray and mosquito net would take care malaria and other infectious parasites that could transmit by mosquitoes. The latest warning from the Internation Travel Clinic: stay away from birds and poultry due to increasing numbers of Avian Flue cases in SEA. What most people do not often talk about, and they should, is TB. But that's another topic. Again, prevention an ounce, a pound of cure, folk.

Well, if you still want to take the drug so it makes you feel more prectected, please talk to your doctor First. You may need to have baseline blood work to check your liver function and others.

Enjoy the trip.

Bayon, you're a health care professional and you are encouraging people to simply wash their hands to avoid Hep A? There is no question that hand-washing is effective in reducing GI upsets and the transmission of a number of viral and bacterial illnesses. But Hep A is more likely to be transmitted by someone handling your food who has not done proper handwashing! (something the traveler has litttle control over) Hep A outbreaks occur not only in developing countries but also in North America and Europe.

While using a repellant that contains DEET (25-50%) is certainly advised to help prevent mosquito bites and reduce the likelihood of contracting mosquito-borne illnesses such as malaria, dengue, etc., it is not as effective as a combination of repellant and an anti-malarial. As a health care professional, no doubt you are aware that this is not only a personal health question but a public health question. Also, I'm sure you are aware that the "I didn't take an anti-malarial and was fine" argument is not useful infromation for anyone in making a decision.

The discussion on TB can be very short, as travelers are at low risk for contracting TB. Persons working with refugees are certainly at greater risk for a number of diseases not of special concern to the traveler such as TB and cholera.

As you correctly point out, everyone should consult with a travel medicine doctor as well as reading the info from the cdc before travel.

Volunteer workers working in malarial Asia and Africa (including health care workers) frequently don't take malarial prophylaxis drugs as most cannot be taken for more than three months - perhaps you fall into that category Bayon?

I don't take anti-malarials whilst travelling in Thailand or SE Asia but then have never been very far from good medical centres where I can pay to get treatment v quickly.

I have taken anti-malarials when undertaking short term volunteer projects in rural areas of West Africa - and contracted falciparum malaria when taking Larium. No drug is 100% effective! However, when I am in areas with a lower risk and will be near medical centres I prefer not to suffer the side effects of the drugs - I've tried them all and found them all pretty horrid (stomach upsets mainly) and I am not keen on burdening my body with pharmaceuticals! Nor do I take them if I am in a malarial area for longer than three months.

However, that is my informed choice and I am in good health generally. I agree that the best approach is to seek medical advice and undertake some research on the internet. The most up to date site for malaria info for international travellers is the World Health Organisation, part of the UN - http://www.who.int/ith/countries/en/

Actually, Bella a number of anti-malarials are fine for long term use. Whether you chose to take anti-malarials or not is your choice, but I would plead for accurate information to be posted on public boards rather than misinformation (which is why I felt compelled to respond to Bayon's post and why I feel it is important to respond to the portion of your post that says "most [antimalarials} cannot be taken for more than three months." Doxy can be taken for years at a time, as can larium (for those who do not have contra-indications). Malarone is only advised for shorter-term use, but only because there is not adequate research yet on long-term usage.

What I said was: by washing your hands alone would eliminate MOST of the GI complications, including Hep A. And as we already awared that Hep A is only transmits from person to person through food and water, which in turn from people who handling it.

To say that the tourist themselves have no control whatsoever is entirely inncorrected. The moment you step off that plane, you are handling moneys, passport, shaking hands, and whatever you touch the objects all around you (gifts at the flee markets) you become the carrier of the same germs like those who prepare the foods at the restaurants. You CAN control how this cycle of transmition by a simple washing hands. That's simply my message.

That said, for all the possible precaustions that anybody can come up, hands washing, malaria pills, many shots given by your travel clinic, etc..there is NOT an absoluted protection for travellers. The risks are there; that's why it called Adventure.

The safest way(100%), I know, is to get a flat screen HDTV and watching discovery channels.

I am going to Kenya & was told I need Malaria Pills. I was all set to get Larium but I've read quite a few articles not to get it. Is that the only one available that you only take once a week?