My husband, 2 kids (7 & 9), and I will be in Thailand for about 1 month in July 2007. Looking for a good side trip- leaning towards Cambodia, but I'm a little concerned about having to give the kids malaria medicine. I've been to Malaysia (KL, Penang, Cameron Highlands) so wouldn't want to go there again. I would appreciate any suggestions. Thanks.

Well, most of the places I'd recommend are malarial risk areas: Siem Reap, Cambodia; Luang Prabang, Laos.

Another option (not malarial risk) is Hanoi. It's a fascinating city with lots to see and do.

Not a place to go, but about malaria meds...

We were going round and round about the malaria medication too, partly because of the issues of taking the meds to begin with, but mainly because neither Malarone nor Doxycycline are available in Japan. Perhaps what I've learned can help you...and of course, discuss the issue with your own doctor.

The only drug we can legally buy in Japan for prevention is Larium, which is not indicated for SEA, so that's out of the question anyway. We can legally import Malarone from the states for personal use; our insurance does not cover it. Cost to us is $8.00 - $10.00 per dose, times 3 people times 30 - 42 doses...$720.00 or more. Also, we would be taking the drug as a self-treatment, which would automatically exclude us from insurance coverage for treatment or consultation about malaria or drug side effects. A doctor in Japan can not and will not prescribe this medication to us unless we actually are sick with malaria.

Besides cost and insurance issues, it is still possible to get malaria while taking anti-malarials (as a real life example, Bella-Bluebell had this experience). Then, you cannot use the same drug for treatment. As Malarone is available as a frontline drug treatment of malaria in Japan (about 100 cases are treated per year, all are imported according to the data I've seen). It would be the first choice of treatment drugs for malaria contracted in SEA...UNLESS you were already taking Malarone as a preventive medication...in that case, Malarone cannot be used as a treatment.

So, after hours on the phone with the only pharmacy in Japan that dispenses malaria medication, 3 visits to the local public health office, many e-mails back and forth with the tropical medicine department at Nagasaki University, we have decided to carry emergency treatment doses (3 days worth) of Malarone for each of us to use until we can get to a hospital in BKK or Japan in the event we develop malaria symptoms. And we will use DEET and nets and cover skin.

I feel good about this decision because I am sure we can be careful to avoid mosquito bites and I can accept the small risk that we may still be bitten, and it only takes once. The risk in Siem Reap, and even all of SEA, is quite small, if you compare with the "malaria rich" continent of Africa. I have no idea whether this level of risk is OK for you, though...I would think you'd need to do your own research and discuss with your doctor.

Now the place to go ideas...ones without malaria risk.

You could stay in Thailand and go somewhere different like elephant camp www.changthai.com for 3 days. Or Chiang Dao Nest.

Vietnam might be good. It's another place on our list.

A week in Bali? That might be my top pick.

KimJapan-thanks for the information about malaria meds. I was just thinking today if my kids' pediatrician would write a prescription for it, but I don't know the costs. I think you have come up with a good solution. As for the Bali suggestion, have you been? Do you know how long a flight and the cost? Is it safe?

Wherever you decide to go, do consult carefully with your pediatrician or a travel medicine or tropical medicine doc not only about anti-malalrials, but also about vaccines.

I'm in the US, and my medical insurance paid for my malarone, with a $25 copay. If your medical insurance won't pay, generally the cheapest places to buy malarone in theh US is Costco.

bali came immediately to my mind as well and the kids would love it...july is high season there so the weather would be beautiful, but prices at their non holiday highest...

eddie at sea tours could help with air tickets (thai air has one daily flight)...i saved almost 50% using him...airfare is a bit high at about $350 from eddie...

hong kong is another alternative from bkk for kids...

luang prabang, laos would not be bad with kids if you found a hotel with a pool, like pansea or santi resort

kim---why don't you just buy malerone while in the usa...i think i read you were coming home quite soon....it is expensive however...you could also limit exposure by staying in doors at dusk and dawn, unless bugs get into your rooms...a can of room bug spray will also help...i think it is a huge risk however, imo...

Would Cambodia be cheaper than Bali in terms of the airfare from Bangkok? Bob, what would you tell your children if they wanted to take your grandchildren to Cambodia? Is it worth going, knowing the kids will have to take malaria meds?

yes the airfare would be less using the bkk air pass, but you have to have at least 3 segments to use it...otherwise it might be about only $80 cheaper using a regular ticket...

i just spoke with my RN wife about what she would tell one of our daughters should she want to take her kids to cambodia....she said, first she would have her consult with a pediatic travel clinic about the medecines....she would have no hesitation about allowing the children to take the meds once the doctor ok's it....
in your case she suggested the hasbro childrens hospital in providence...if they do not have a travel clinic as such, she suggested you contact their infectious disease department, who would direct you....otherwise a travel clinic at boston children's hospital might be an alternative

I have been to Bali twice, once pre-child, and then with our daugther in 2004/2005 winter holidays. Our trip as a family was one of the top holidays we've ever had. We cried when leaving Bali, and we all cried when our plans had to change for this past winter vacation and we went to Thailand instead of Bali. http://www.fodors.com/forums/threads...p;tid=34551824 is what I posted when we got back.

I think a really big part of what made the Bali trip so special was where we stayed. The staff at Alam Sari was excellent, the other guests lovely, and the experiences we had were just wonderful. Every day ended with Teaghan saying "that was so cool!" It's hard to put into words...it was just very, very, very good.

Our trip this year to Thailand was amazing with elephant camp and a dengue fever scare (not though) and gorgeous beaches and lots of interesting activities. But as much as we love Thailand, it isn't quite as, I don't know, amazing?, as Bali. Bali just does it for us, I guess. We made Balinese friends 18 months ago who we keep in contact with and can't wait to see again. It's a very special place.

I don't know the price of airfare from Bagnkok, but the 3 of us at Alam Sari spent less than $100.00/day total including room, food, drinks (including wine which isn't cheap), classes, transport, shopping...it is very affordable.

As far as the malaria medicine goes, I would have a problem giving Teaghan Doxycycline, as it needs to be taken for an extended period of time and one of the side effects is adult tooth discoloration...I'm very conscious of teeth. I would not have a problem giving her a daily dose of Malarone IF it were prescribed to us by a physician who knows our history and I could consult with face to face...and of course, if I could get it and use it without eliminating malaria treatment as a covered expense as well as elimating the best medicine we might get here in Japan.

Bob, I could buy the preventative course of Malarone for all of us in the US, or I could have it delivered here in Japan as a personal import. But our Japanese insurance will not cover malaria as an illness if we contract it while self-treating ourselves for prevention - sounds absurd, but it's true, probably because we've eliminated the front line drug for treatment for ourselves by taking it as a preventative. Malarone is the drug of choice in Japan for treatment of malaria contracted in SEA although it is still "experimental"...and not much else is available as many just don't get malaria...only around 100 cases per yer of imported malaria are seen. The cost of seeing a tropical medicine specialist alone is daunting...remember, we are using Japanese insurance which does not cover us outside or Japan. We buy travel medical emergency insurance for all travel, including travel to the states, and that does not cover a well visit to a travel specialist for malaria prophylaxis for a completely different trip.

I've done extensive research and consults with experts, and have come to the conclusion that FOR US, the risk of contracting malaria in SEA is small enough. By using DEET and being very careful to cover skin and use nets/air con and spray the room, we are comfortable with our plan of carrying emergency treatment doses of Malarone. It's not an easy decision...we've not gone to malaria risk areas before because of this problem. But I think we've got a good plan FOR US.

Kim, you did a great job of doing the reearch for you and your family on the malaria question. As you point out, it is different for different people. A couple of notes to tnnc to consider as you talk with your doctor:

First, go the cdc website, www.cdc.gov/travel and read about immunizations, then read the sectons on malaria and ant-malarials. There is also a section, I believe, on malaria treatment options. Kim is in an unsual situation because of Japan's position on anti-malarial drugs. Malarone is the newest anti-malarial and has the fewest side effects. It is very effective, in excess of 95% when taken as directed. In the unlikely even that you contracted malaria while taking malarone, there are a number of treatment options.

Thanks for all your responses. Bali sounds wonderful and would probably be my 1st choice, however, my husband said no-he associates it with terroism. I know its not logical thinking, but I don't think he can be convinced. He also didn't like the Vietnam idea. (He'd just assume stay in Thailand the whole time) I looked at Kathie's Borneo report- I would love to go there, but not with the kids. Also looked at Perhentian Islands in Malaysia, but it seems kind of difficult to get to. If we weren't travelling with the kids it wouldn't matter as much. So I'm back to considering Cambodia, unless you have other suggestions. My kids' pediatrician will prescribe Malarone and I think my insurance covers it.

Unless you plan on Luang Prabang in Cambodia you are probably missing options not thinking about Vietnam.

There are of course plenty of very varied and different places in Thailand, if you have a month you could include a train journey, you have the North, Isan ( North east ), the central areas, River kwai, the coasts and islands.

James, I'm not sure what you mean. She is thinking about Angkor Wat in Cambodia, I don't remember any mention of Laos and Luang Prabang...

I thought it was one of your suggestions and the others being suggested, it's 2 am(!), naturaly I meant Luang Prabang Laos.

I really think a lovely trip could be Siem Reap, Battambang, Phnom Penh. Of course I think it's lovely though, those 3 places are included for us. You might find travelfish.org and talesofasia.com helpful. I've found that they have great information.

i would find siem reap (angkor) difficult with kids....not so in luang prabang...

The trouble with flying to Siem Reap with a family is the cost of the flight. Unless you are going to use the third coupon of the air pass for a domestic flight there is no saving over the normal fare cost.

A cheap way to go would be by Air Asia from Bangkok to Phnom Penh and then by taxi for the five hour drive to SR, ariving around 2 in the afternoon. By getting your air tickets well ahead of time, the cost of oneway for 4 would be around $177 (air + taxi but not airport tax).

You could spend 3 days viiting the temples (the kids may be templed out after that time), take a taxi or bus as an alternative back to PP for 2 days. I would not suggest that you take the kids to see the Killing Fields or the Tuol Sleng Museum, just too gruesome for youngsters in my opinion.

Then take a taxi to the sleeply provinical town of Kampot for a couple of days, taking the kids up Bokor mountain by 4WD and visiting a fascinating ghost town that once was a French hill station in 1920, complete with a hotel/casino, old church, school house, etc. Then maybe a short boat ride down to Kep for the best seafood in Cambodia. No fancy accommodation in Kampot but good clean guesthouses or small hotels.

Then back to PP for a flight back to Bangkok.

Scotters, your way may be thrifty, but it sounds miserable with kids...

Don't know why travelling this way would be miserable with kids of this age Great way for them to see the real Cambodia not just the tourist oriented Siem Reap. They may enjoy this more than visiting the temples - kids can tire quickly of seeing ruins no matter how interesting. And anyway lots of people with a family just could not afford the regular airfare.