Yet another malaria in China question

May 31st, 2004, 01:37 PM
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Yet another malaria in China question

My daughter and six friends are travelling to China for one month at the end of June.All have consulted their doctors about malaria and have been given several different answers.One says there is no danger outside the large cities( they are travelling overland from Beijing to Hong Kong over the space of a month),an on-line check from MASTA says there is only a malaria risk in Yunnan and Hainan,One says chloroquine and malarone, Boots have sold a course for £2.35 which we think is chloroquine.
The majority of them are medical students and so have checked at their teaching hospital which says no risk!
How do they decide which advice to follow?
Frances is offline  
May 31st, 2004, 02:00 PM
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I assume that what you wrote about risk is a typo: there is no risk IN the major cities, the risk is in rural areas.

Here is what the cdc says:
China: Risk in rural areas only of the following provinces: Hainan, Yunnan, Fuijan, Guangdong, Guangxi, Guizhou, Sichuan, Tibet (in the Zangbo River Valley only), Anhui, Hubei, Hunan, Jiangsu, Jiangxi, Shandong, Shanghai, and Zhejiang. In provinces with risk, transmission only occurs during warm weather. North of latitude 33? N, transmission occurs July to November; between latitude 33? N to 25? N, transmission occurs May to December; south of latitude 25? N, transmission occurs year-round. Note: Travelers to cities and popular tourist areas, including Yangtze River cruises, are not at risk, and do not need to take antimalarial drugs. Hong Kong S.A.R. (China): No risk in urban areas. Limited risk in extremely rural areas of the S.A.R. The risk of malaria is so limited that taking an antimalarial drug is not recommended for travel to Hong Kong S.A.R. Macao S.A.R. (China): No risk.
Travelers to rural areas of the Hainan and Yunnan provinces of China should take one of the following antimalarial drugs (listed alphabetically): atovaquone/proguanil (malarone), doxycycline, mefloquine, or primaquine (in special circumstances - [it is less effective than others]).

What Boots probably sold you is primaquine. It is available in the UK without a prescription, but is less effective than other anti-malarials.
Kathie is offline  
Jun 2nd, 2004, 02:11 PM
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Thank you Kathie for this information. I have been on the cdc website which seems comprehensive but does not accord entirely with any one of the doctors who have advised! It is useful though to have reference to this.
Boots by the way have definitely sold a course of chloroquine.
Frances is offline  
Jun 2nd, 2004, 07:31 PM
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It's rather concerning that Boots sold you chloroquinine, as many areas of Asia have resistance (and have had for many years). Note that it is not one of the recommended anti-malarails for China.

One of the main reasons that the info is different from what doctors have advised is that most physicians have little/no knowledge of tropical medicine. They may or may not remember what they learned many years ago in medical school, but they are very unlikely to have current knowledge of tropical medicine issues unless that is their speciality.
Kathie is offline  
Jun 10th, 2004, 01:12 PM
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I can?t advise on whether one should or should not take precautions before leaving home, but I am in a position to say that tropical disease/travel specialists and not general practioners should be consulted. I have written the following before and urge precaution.

On a trip to Japan and Malaysia eight years ago, my husband contracted dengue fever, the symptons started to show on our flight home. While dengue fever may not be as severe as malaria, it can still be fatal and there is a worldwide epidemic in tropical and sub-tropical climates. The disease is also mosquito borne and the symptoms are similar to malaria. My husband was lucky and it only took a week for him to recover. On recent trips to China we have protected ourselves. I should add that mosquitos love my husband.

The travel brochure on Malaysia advised that no medical precautions were necessary. I think the doctors in the Tropical Disease Centre in Toronto (where my husband was treated) may have something to say about that. Do yourselves a favour and at least consult a specialist in Tropical Disease medicine if you haven?t already. For dengue fever and other diseases in Canada, go the our government?s travel health website.
michi is offline  

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