cruisin, thanks for the link to the NYT article. It's a good summary. As mentioned in the article, the mosquitoes that transmit dengue are different from the mosquitoes that transmit malaria, and have different habitats and different times when they are most active.

Kaneda

Why so agressive and so rude? You have your opinion, others will have theirs. There is absolutely no need to resort to personal abuse on this board.

http://vvv.com/healthnews/dsunscre.html
Interesting article. It DOES NOT say that sunscreen causes cancer. Like every other source it says that sun exposure increases the risk and can cause skin cancer. Sunscreen use can make people complacent about limiting sun exposure time. Sunscreen cannot filter out all harmful rays.

Bottom line. Limit sun exposure. Use sunscreen when in the sun.

I'm not at all bitter, kaneda, about the open jaw ticket issue. I'm right. I stand by my fares that I found, and can and do find open jaw fares to be similarly priced, sometimes cheaper than simple round trips. Once you've studied up on fare rules, fare buckets and routing, you will be able to see too.

But about any issue, stop posting gross misinformation. It isn't at all helpful to anyone.

Insect repellent works by either masking your scent or layering you in a scent unappealing to bugs. To be the strongest, you wouldn't want to cover those with sunscreen, so the sunscreen goes on first.

Of sunscreen or sun itself, it seems the sun would be statistically the greater source of skin cancer. Better though are lightweight long sleeves and pants. Pretty comfy really, and I'm of German descent - we don't do heat well.

Not that it has anything to do with the OP's trip, but I've seen mosquitos in downtown Phnom Penh. That said, I still don't know what amount of Deet was in whatever it was that I forgot to spray on.

And I've never been to Japan, but I've booked open jaw flights with some frequency that were a little cheaper than the round trip to either end points would have been. The latest was into Casablanca, Morocco and out of Granada, Spain.

Most of the time, an open jaw seems to be about mid-cost, between the round trips to the end-points, provided the same airline or alliance serves both cities (and your home airport). Open jaw for us, into Bangkok and out of Phnom Penh, was more expensive than round trip to BKK, but less than round trip to PNH. That's usually what we find. Now if your airline doesn't serve one of the cities and part of your ticket is through some other carrier, then all bets are off. So, you could both be right, depending on what cities you're talking about and what point of origin.

KimJapan. Possibly you overlooked this :

[Most chemical sunscreens contain from 2 to 5% of benzophenone or its derivatives (oxybenzone, benzophenone-3) as their active ingredient. Benzophenone is one of the most powerful free radical generators known to man. It is used in industrial processes to initiate chemical reactions and promote cross-linking(15). Benzophenone is activated by ultraviolet light. The absorbed energy breaks benzophenone's double bond to produce two free radical sites. The free radicals desperately look for a hydrogen atom to make them "feel whole again"(15). They may find this hydrogen atom among the other ingredients of the sunscreen, but it is conceivable that they could also find it on the surface of the skin and thereby initiate a chain reaction which could ultimately lead to melanoma and other skin cancers. Researchers at the Harvard Medical School have recently discovered that psoralen, another ultraviolet light-activated free radical generator, is an extremely efficient carcinogen. They found that the rate of squamous cell carcinoma among patients with psoriasis, who had been repeatedly treated with UVA light after a topical application of psoralen, was 83 times higher than among the general population(16).]

This shows that sunscreens produce known chemicals which are associated with causing melanomas/cancers.

As to the open jaw question, I used the details you gave within a few hours and got fares $1,000 more than you quoted. How is it possible to make such a mistake?

kaneda, note that the editors wisely deleted your earlier offensive message attacking KimJapan. Your further arguments do not increase your credibility, but merely serve to decrease it further.

You seem confused about the meaning of the article you cite, and you have repeatedly refused to understand the accurate and complex explanation Kim gave about open-jaw itineraries.

You might want to take a break from posting.

Kaneda,

We don't criticize KimJapan because we respect and trust what she says. Trust and respect go a long way on this forum and throughout life.

Aloha!

Anyway moving on....Clifton has it right about mosquitoes being attracted to you by your scent or actually the CO2 that your body releases.

Covering your head and feet and using long sleeves shirts and trousers will reduce your being made a prime target by the mosquito along with using the deet.

Aloha!

Another question along these general lines, the CDC also recommends taking malaria treatment if going to Angkor Wat or Thailand around the Burmese boarder, both of which I am doing. ANy thoughts on this in addition to the DEET?

I do follow the recommendations of the cdc. I took malarone for both a trip to Angkor and a stay in the Golden Triangle. Read the cdc recommendations carefully and consult with a travel medicine doctor.

Quoted from article "Researchers at the Harvard Medical School have recently discovered that psoralen, another ultraviolet light-activated free radical generator, is an extremely efficient carcinogen. They found that the rate of squamous cell carcinoma among patients with psoriasis, who had been repeatedly treated with UVA light after a topical application of psoralen, was 83 times higher than among the general population(16).]"

Psoriasis is often treated with UVA light. Notice that it clearly says that patients who were repeatedly treated with UVA light after a topical application of psoralen...you surely cannot discount the fact that repeated intense exposure to UVA light leads to skin cancers. There is no way to differentiate whether or not the subjects in this study were more likely to develop squamous cell carcinomas due to the UVA exposure or the psoralen. And that's just one of the holes...there are many more.

Also note that the article being discussed was published in 1991...over 25 years ago. Much research has been done since then...bottom line, UV ray exposure leads to skin cancers, and sunscreen use can minimize the risk, but avoiding exposure can eliminate the risk (but not without loss of benefits of sun exposure). It's all about balance.

It is possible to buy sunscreen products free of benzophenone if you prefer. Aubrey Organics is an excellent company that makes a good sunscreen, in addition to shampoos, soaps and lotions. We've been using their products for years. There are other companies as well that make good products without benzophenone.

If you are so worried about the small amounts of various chemicals in sunscreen and bug repellent, I also hope that you are very careful with your every day exposures, which surely have a greater impact than occasional use of DEET and sunscreen.

Of course, you eat only organically grown whole foods which are prepared in proper cookware that doesn't leech trace metals into your food. Don't eat in restaurants, because there are all kinds of dangers lurking in food and beverages there. Don't drink soda...enough said there. Shampoo...ever read what's in that? Toothpaste, deadly...have you read the labels on that and researched that? Your living space is chemical free? Are you sure? Carpets, wallpaper, wallpaper paste...the cleaning supplies under your sink are all deadly. How about your mattress...is it chemical free? Think about what you are sleeping on every single night. Drink the public water supply? Big mistake again...so many additives in that it would make your head spin. Shower in it...all those chemicals all over your body. Breathe...don't go there...the air is full of particulates and gases that will surely make you lose sleep.

Before you go to extremes and say don't use DEET because it's poison, think about the possiblities of disease from just one mosquito bite...malaria, dengue, Japenese encephalitis to name just a few. Think about it reasonably, and in context of the real world and just how many risks we take each and every day, and think about whether or not the risk outweighs the possible benefit.

Don't use sunscreen because it causes cancer? Extreme reaction to a minute risk, that can in fact be completely eliminated by choosing products without the ingredients you object to. Don't use DEET bug repellent because it's poison? Extreme reaction to a minute risk that far, far outweighs the benefit of short term use to prevent bites that may infect you with diseases that can be fatal. If you are so inclined to avoid DEET, there are alternative to that too.

The open jaw question...you failed to search properly, and you don't understand the intricacies of booking classes, fare buckets, fare rules and pricing strategies that are used by airlines. It was explained before by myself and others.

As far as malaria in the Golden Triangle area of Thailand and Siem Reap, I have been in touch with a friend who is a Lyme disease and malaria expert. He says the following:

"
Regarding your trip to Cambodia, just a reminder that malaria should not be your only concern, since the incidence of TB is as high or higher than that of malaria and may be of greater concern in the urban areas. As for /falciparum/ malaria in Cambodia (and other countries along the Mekong), this is the hot bed of multi-drug resistant parasites which is why artemisin, or more specifically, artemisinin-based combination therapies (ACTs), are often prescribed treatments. For prophylaxis, I think either malarone or doxycycline are good choices, but I would not skip prophylaxis altogether. Use your DEET and your bed nets to be sure, but take your drugs as well. The primary concern for side effects of doxy are the photosensitivity, i.e. susceptibility to sunburn. Doxy (like all tetracycline derived medications) can also lead to staining of teeth (and bones, but no one sees them) because the drug binds to calcium in these structures as they grow. Doxy is less likely to do this than other tetracyclines, so I would not be concerned too much about it. An advantage of Doxy is that it is prophylactic for many, many bacterial infections as well (including mycoplasma). Just as a side note, Doxy can be considered a "selfish" malaria treatment because it kills the parasites that make a person sick, but it does not kill the parasites that may be transmitted (to another mosquito and eventually another person), and for this reason, I think malarone is better choice for "Public Health".

Mefloquin (Lariam) is very effective as a prophylaxis, but given your predilections its probably best to avoid it unless you have an exposure, in which case it would likely be used as treatment with the artemisin.

DEET is a good mosquito repellant (but NOT an insecticide), and is quite safe. Get spray or ointment with the highest percentage DEET you can find (in US, this would be Cutters). Spray it on your clothes (especially your hat, which you should wear anyway). Permethrin is another personal protection you might consider. It is an insecticide (i.e. it kills bugs, not just repels them) and is effective also against ticks. Its considerably less safe than DEET, and you should use it to impregnate your clothes (several hours in advance of wearing them) instead of applying to your skin. You may have trouble finding it in Japan, but you can probably pick it up in Cambodia. Again, I would NOT consider use of any mosquito repellant or pesticide as a substitute for malaria prophylaxis, though it will help protect you against other nasties transmitted by mosquitoes (including dengue and Japanese encephalitis virus).

The only other thing I’d mention is that the greatest risk of malaria infection is in evening/night, so plan your protection accordingly. If you are going to be out and about in the evening, wear your personal protection (DEET) and cover your arms and legs to the extent you are comfortable. Of course, “you” refers to you, Rich and Teaghan . I also think wearing a hat helps, because mosquitoes tend to go toward the highest point, which is better to be your hat than you head. When I used to work with troubled kids, I would have them rub Vaseline on their hardhats (they were doing trail work), and the mosquitoes would zoom in and get stuck in the goo, it was pretty effective (but not for malaria, which is not common in New Hampshire ."

I was told by a very reliable source...get Permethrin to spray your clothes (open area or outdoors) one week before traveling to Egypt. I have some Off with DEET...the towelettes as well to take along. They were recommended beyond the normal Skin-So-Soft I use in NJ!
Of course I have my Malaria prescription as well!

Kim, I think it is interesting that your friend commented on the incidence of TB. TB is not as easily communicable as many diseases are. Indeed, travelers are at little risk for contracting TB even in places where it is rampant (Nepal, for instance has the second highest incidence world-wide).

Kathie, I thought that was interesting too, but I think his TB comment not a generalization but to us specifically, because we live in Asia where it is much more prevalent than in the US and where we might be more likely to have long term exposure to it than the average traveler.

FYI---The latest National Georgraphic arrived today and it features an interesting article on Malaria. And-don't forget to read the editor's notes about his own bout with the disease.

I don't need to bring my own mosquito netting for bedtime do I? That seems a little extreme for staying in a hotel, but I just wanted to make sure.

LynnieD: My travel doc recommended Malarone or Doxycycline (which I used to use for acne). I chose to take Doxy because he quoted the Malarone as being $8 a pill (or something to that effect) but I would only have to take a few of them. I went for the Doxy for financial reasons ($6 for 35 pills) but the tradeoff is that I will have to take them for a longer period of time and I shouldn't spend too much time in the sun.

Thank you to those who chose to address my original question and to not attack people's opinions or for irrelevant matters. I had no idea this topic would get so out of hand!

http://www7.nationalgeographic.com/n...re1/index.html is the National Geographic article. Very, very good. Thank you for mentioning it wintersp.

About using Doxycycline...it's a good prophylaxis, but note that though it does disable the parasites that make YOU sick, it does not disable the ones that will be picked up by a mosquito and then transmitted to the next bite victim. Though more expensive, if you can take it and can afford to take it, Malarone is a better prophylaxis from a public health point of view as it kills them all. This is what my malaria expert friend has told me, and in the end, this public health aspect is why we decided to spend a lot of money for Malarone for the 3 of us.

hoodlims, if you are staying in hotels with air conditioning you do not need bed nets. Bed nets are only needed in non-airconditioned rooms (the assumption being that with an air conditioned rooms, you keep doors and windows closed so there are no mosquitoes in the room).

Kim your comments about doxy are interesting, but I've never heard anything like that. I'll have to do a bit of research on that, as that is different from my understanding.

About doxy, the first time I heard it was from my friend. He is an expert, one of the best in his field. http://www.umass.edu/richlab/ is his lab at UMASS Amherst, where you can see him, his research, publications... His specialties are plasmodium falciparum, lyme disease, and borrelia. I implicitly trust what he says...not only is he an expert, but he is also our daughter's godfather, and was best man at our wedding.

I've just written him asking him for more info about this and references...or if I misunderstood his comment "Just as a side note, Doxy can be considered a "selfish" malaria treatment because it kills the parasites that make a person sick, but it does not kill the parasites that may be transmitted (to another mosquito and eventually another person), and for this reason, I think malarone is better choice for "Public Health"."