Malaria in Yunnan
 

I'm leaving in 2 weeks for Yunnan Province. I would like advice on how necessary it is to take Malarone for Malaria. We will be traveling south to the Myanmar border and in the area for three days. The medication is quite expensive and has a reputation for causing nausea and vomiting. I've also read conflicting information about how long to take the Malarone before and after being in the area. I hate to take something that's going to make us sick and wish we'd stayed in the hotel.

Thanks

Malarone has few side effects. Malaria has many. You should read the malaria info at www.cdc.gov/travel then consult with a travel medicine doctor. The cdc website gives info on how to take malarone. The malaria in the border regions with Burma is resistant to larium, so your two choices for effective anti-malarials for the area are malarone and doxycycline. You have to continue any anti-malarial after leaving the risk area. For malarone, you only have to take it another week, for doxy, you have to take it another month.

My comments are a brief summary of the much more detailed info on the cdc website.

As somebody always remarks in response to queries like this, Internet chat areas are not the place for medical queries. You need to speak to a qualified medical professional with the latest recommendations to hand.

But I will say that having just returned from exactly that area, the advice given to me was that it was a high-risk region at the moment, especially in the countryside, and that prophylaxis was strongly advised.

But exactly what drug, and for how long, is something only a medical professional should advise you on.

You might also find useful information at www.cdc.gov, or www.who.int, but there's no substitute for going to a proper travel clinic and taking their advice. Getting malaria would be a great deal more expensive still.

If it's any consolation, I have to take a variety of anti-malarial medication far more often than I'm comfortable with, but I've never had any side-effects at all.

Peter N-H
http://members.axion.net/~pnh/China.html

Have to agree with the other posters. After consulting the cdc site and seeing their recommendations, discuss with your personal physician or a tropical disease specialist that knows your medical history.

We have taken Malarone "with food" and none of us have had any reactions. Yes, the meds are expensive, but if you have a drug benefit with your medical plan the price will probably be half that if not with a plan.

Remember, this is not an inoculation and there is no guarantee that even with meds you won't contract Malaria, but the intensity should be less. That is why you should have repellent with Dheet and apply on exposed skin during mosquito biting time - dusk-to-dawn and during that time wear long pants, sleeves, socks.

The Malarone protocol is to start pills two days prior entering area, during time there, then for one-week after. But do discuss with a medical professional.

Just two more pieces of data :

Travelers who return home with malaria most frequently have not taken anti-malarials, but a substantial number took anti-malarials for some period of time, but discontinued them when leaving the malrial risk area or took them inconsistently. Taking an anti-malarial inconsistently not only exposes you to the rsik of developing malaria, it may also contribute to the development of treatment-resistent strains of malaria.

Both Malarone and doxycycline have efficacy rates in the 95-98% range when taken according to instructions. This is a comparable efficacy to many vaccines.

One more piece of info.

If you happen to be a regular blood donor, know that you will be forbidden to do so for a minimum of 1-yr from having taken any malaria meds, and for good reason. The malaria bug can actually reside in the body for up to three years.

Do be honest if a donor about what meds you have taken for malaria or any travel to foreign countries.

Sandi, a good point. I don't know where you live, but where I live the issue is whether you have traveled to a palce that has malaria, not whether you have taken anti-malarials that determines whether you can donate blood. That makes sense to me. But I do know that in some locales, the question is whether you have taken anti-malarials.

Kathie - I'm in NYC and it was a personal experience, when having returned from firs Africa trip ('96)there was a message from the Blood Bank asking me to come in - they needed my O. Once they saw the indication that I had been in Africa, was asked what meds I had taken - the doctor shook his head and said "sorry, you cannot donate for at least a year."

Since the malaria meds, especially, then, the Lariam, has a very long "after life" it remains that much longer in the bloodstream, which was actually indicated in the package insert and stated in the PDR.

I had only 1-year between trips to Africa and then Asia that I hadn't taken anything - was visiting France - but had taken Malarone for Thailand, and again on return asked to give blood - was again refused. So gotta assume those are the rules. And that's fine with me, besides, regardless how often I've actually been able to donate - I don't do well afterwards, I've fainted twice. But hey, I keep going back when I'm "clean" enough for the blood bank to accept me and do the human thing for those who need my O.

Just something to keep in mind.

Interesting, Sandi. I'm in Seattle, and the question on the printed forms is to which countries have you traveled in the last year? If you have traveled to any countries where malaria is endemic, they won't take your blood. As you mentioned, the malarial parasite can live undetected for a long time.