Korean Job Discussion Forums

[nene]

I'm going to be travelling through Southern (rural) China, Vietnam, Cambodia, Thailand and Laos for a total of about three months. Think I'd be crazy to skip the malaria meds and count on DEET? Malarone definitely looks the least bad of the lot, but for one who shuns meds when at all possible, that's a lot of drug. On the other hand, it's malaria, am I fucking crazy?

[Antrugha]

[HamuHamu]

It also might depend on how often you get bitten by mosquitos?

I mean, my fiance can have a dozen moggies land on him and sit there for hours and not take even the slightest nibble. For me, if there is one within a mile, he will sniff out the tiniest piece of skin possible that I've not sprayed, bite me, and then invite all his friends to come join too...

[crazylemongirl]

probably a question best discussed with your doctor rather than a bunch of idiots on the internet!

[nene]

[b_canadian_eh]

My wife's a nurse and there is no way she would skip the malaria pills. Even I, who never sees a Dr. or takes anything I don't have to would probably take the malaria pills. That's just not something you want to mess with, could really put a dent in your trip.

[friendofIgnatius J.]

The thing about malaria medication is that it messes you up. Like it really kills your liver to start with, that's without the possibility of aggrevating possible psychosis (PC, Lee HY, Tan CH. Mefloquine-induced mania in a 22-year-old Chinese man. Singapore Med J. 2006 Jun;47(6):549-50.)

I went up the Amazon River without taking the meds. Although it is generally recommened that you take malaria meds for that area, I talked to a local doctor who said it wasn't a problem where I was specifically going. That being said, I took sensible precautions like sleeping under a net and wearing mesquito repellent.

So I would suggest thinking about exactly where you are going and then checking the CDC (Center for Disease Control) website to see if it extremely recommended.

http://www.cdc.gov/travel/regionalmalaria/seasia.htm

The following is an article about some of the side-effects of the medications

Lakartidningen. 2002 Jun 27;99(26-27):2939-44. Links
[Many travellers suffer of side-effects of malaria prophylaxis]
[Article in Swedish]

* Rietz G,
* Petersson H,
* Odenholt I.


There is still uncertainty about the frequency of side effects associated with the use of malaria prophylaxis. The biggest concern has been that of meflokin. The aim of the study was to compare different symptoms in travellers taking different prophylactic malaria drugs with a control group travelling to the same area. Travellers seeking advice at a vaccination clinic in the south of Sweden were asked to fill in questionnaires before and after returning from their travel. 303 participants returned both questionnaires, a response rate of 62%. The results showed that a greater proportion of the travellers taking malaria prophylaxis reported symptoms in comparison with that of the control group (59% vs. 41%). Also, in comparison to the control group, travellers taking chemoprophylaxis more often felt that their trip had been negatively affected by the reported symptoms. Neuropsychiatric symptoms were most common in the group taking meflokin although no significant difference between the different regimes was found. These symptoms were very rare in the control group. Gastrointestinal symptoms were most frequent in the group taking chloroquine and proguanil. A low proportion of those symptoms were connected to the chemoprofylaxis according to the travellers. Travellers taking meflokin more frequently associated their symptoms with the drug. The travellers, being most worried about taking malaria prophylaxis prior to the trip, reported symptoms more often than those not feeling any anxiety.

All this being said, malaria is forever.

[nene]

Thanks... I've been thinking about maybe just trying to be super-vigalent with the DEET and sleeping under a net, but how do you hang them? I figure I'll be sleeping in all sorts of weird places - I can't imagine there'll be hooks over the beds...

[Mary-Jane]

OP ought to read about the available anti-malarials to get the full facts straight. for one thing, there are several kinds of antimalarials available so can you really make broad statements like 'anti-malarials kill your liver'? And malaria kills your liver too!

In my opinion, if you're travelling through several SE Asian countries for more than a month, you really need anti-malarials. I think the risk of exposure, considering the length of time you're going for, outweighs the risk of side effects.

From what I have read from official websites, there are at least 3 main types of antimalarial medication.

Larium (Mefloquine) has had some bad press. The risks are depressive episodes, anxiety, seizures, however these are not guaranteed side effects and people with a history of mental problems are advised to stay away from it. My friends have told me some urban horror stories... not really reliable but still influential. I would personally take physical side effects over psychological ones, so I wouldn't take Larium, but that's just me.

Doxycycline has possible side effects listed as thrush in women, some nausea, higher risk of sunburning, maybe some others. This drug also offers some protection against other infections... can't recall the details, some parasite / bacterial infections which are present in SE Asian countries. From what I've read, there are reports of mefloquine-resistant malaria cases in Eastern Thailand and some other countries. I haven't read about any doxycycline resistance. I'd go for this one but you need to take it for longer periods before / after you finish travelling.

Malarone... I know less about this one, but in Lonely Planet at least it appears this offers the least amount of side effects and is best for short term trips to high risk areas, since you only need to take it for a week before going there.

Basically, malaria is a serious and potentially fatal disease, so why take the risk? Just because you might not contract malaria, but you probably will get some mild side effects? You need to read about the places you're going to and read reliable medical advice about the medication.

[Delirium's Brother]

[articulate_ink]

I wasn't gone as long as that, but I did the doxycycline prophylaxis in June, before visiting Cambodia, and it worked out fine. Got all my other jabs first, too. I didn't get malaria. I did get lots of mosquito bites. I also didn't get anything else the whole time I was there, interestingly enough. Not even digestive woes I couldn't trace back to excesses of gin. When I bashed my head on a vending cart and walked around downtown Phnom Penh dripping blood from the scalp wound, I didn't actually worry... with a veritable pharmacy in my bloodstream, I didn't think there was much chance of infection, and I was right.

You can buy medicine -- pretty much anything -- over the counter in Cambodia with no prescription. If you get there and change your mind, duck into a pharmacy and buy some pills. Better safe than sorry.

[atlhockey]

I'm taking Mefloquine to go to India on the recommendation (read: order) of the doctor in my family. I'd rather tax my liver with one pill a week for six weeks than get malaria. But I also get bitten by mosquitos a lot. Yes, the side effects are psychological, but just like every medication, most people don't get the side effects or just get mild ones. Of course, if I start acting differently, I'll stop taking it...

[dbee]

Don't take the pills ...

I travelled all around SEA and china and never enocountered any malaria problems. But if you are unlucky enough to get malaria, then just take natural quinine tablets. They cost about $1 and you can just throw some in your bag.

Malaria isn't that serious a diease if you treat it nowadays. Just a couple of days rest and you'll be back on your feet again. The pills on the otherhand range from nasty to savage.

I've known people who have done seriously fucked up things caused by the side-effects of the pills. If I was going to the heart of Africa, where I knew that I definitely would get malaria, then I'd think about taking something short-term. But SEA (South East Asia) and china aren't that bad.

In the case of malaria, the cure certainly is worse than the disease. And I have a doctor friend at home who tells people the exact same thing.