thailand (railay) = malaria?

[wfinley]

Question to anyone who has been climbing in Thailand recently: Did you take malaria pills when you were in Thailand? Do you recommend taking them?

 

Thanks!

[miller]

First and foremost, talk to a doctor about this.

 

But I did take Malaria drugs there - however it was about 10 years ago and I don't remember if the doc prescribed them for that region specifically or if they were prescribed for other areas I was visiting on the trip.

 

I would imagine that different drugs have different side effects, but whatever it was that I took didn't really bother me at all - increased susceptibility to sunburn was the only thing I noticed.

[wfinley]

Thanks -- We talked to a doctor and he said that we didn't need to take them but wrote us a prescription anyways. The doc was basically was getting his information from the lonely planet as opposed to actually knowiing what he was talking about so I thought I'd ask around.

[cj001f]

If he was really getting his info from the lonely planet... find a doc that doesn't quack.

 

http://www.cdc.gov/travel/

 

Thailand: Limited risk in the areas that border Cambodia, Laos, and Burma. No risk in cities and major tourist resorts (Bangkok, Chiang Mai, Chiang Rai, Pattaya, Phuket Island, and Ko Samui.)

[Toast]

Anywhere in Thailand where there is a real threat of exposure to malaria you will hear warnings from the locals and other travelers. If that happens, get what you need from the local pharmacy rather than dragging a drugstore's worth of pills around just in case. Haven't been to Railei in years, but it's sandwitched between Krabi and Ao Nang. If there is a real concern, you can find out from the real time discussion on LP.

 

Your doctor did the right thing. You even know what you need to ask for at the pharmacy if you need it.

[JosephH]

This is a lot like not wearing a helmet - probably nothing will happen, but it will be a drag if you becaome a statistic. There is more risk in the North and along the Burmese border, but even Bangkok has a high rate due to the number of infected people who come to the city from areas with high rates of infection. The odds depend on where you go, but I'd take appropriate precautions and try not to be bitten anywhere in the region. I do take anti-malarials when I travel in Indonesia or Thailand...

[cj001f]

you can find out from the real time discussion on LP.

the lp board makes cc.com look erudite and accurate ... increasingly their often shoddily researched and written guidebooks match.

 

As said above and below, long sleeve shirts & pants and DEet. Buzzoff clothing has not prevented mosquito bites for me. They've even bit through the fabric.

[Toast]

Yep, I agree, reduce your exposure to getting bittin in the first place, wear long sleeves, pants and socks at dusk. Make peace with DEET spray. Listen to the beat on the street. Otherwise, don't sweat it too much.

[iluka]

Prevention (long-sleeve clothing, DEET etc.) is very important but not 100% effective.

 

The CDC website is probably your best source for advice about whether or not prophylaxis is necessary. When you go to a travel clinic or another physician's office, more often than not, they're giving you advice based on info they already looked up on the website.

 

Not all of the prophylaxis meds are terribly expensive so it might be better to purchase your meds here rather than having to find them over there. Doxycycline is cheap as is Chloroquine (it can only be used, however, in areas that don't have chloroquine-resistant P. Falciparum (one of the malaria parasites). Malarone is expensive but easy to take and with not a lot of side effects. Larium is expensive but only has to be taken once a week. It's main downside is that a lot of people get bad psychiatric side effects ranging from vivid dreams in most cases to frank psychosis in rare cases.

[wfinley]

Thanks all! We have a prescription for Malarone and after reading all this I think we'll just buy it here and decide once we're there whether we should take it or not. I already feel like a walking prescription (this week we get to take oral typhoid vaccines ) so I might as well keep it up!

[chelle]

Malaria pills make some people a little psychotic and that can be pretty scary when you're in a foreign country (for you and your friends). Best way to protect agaist any mosquito borne illness (malaria, dengue, west nile...) is to avoid getting bit by using an effective repellent.

[marylou]

This is a little o/t, but didn't they just have a bloodless coup the week before last? Does that affect travel there at all?

[wfinley]

No travel advisories as of yet. Apparently it's business as usual over there (the new Thai airport even opened up on schedule).

 

PS -- After reading up on the Malarone I'm beginning to wonder about the whole helmet comparison. As my wife said "Hmm: malaira or suicidal episodes..."

 

Of the 483 who received Lariam, 29% suffered mild to severe psychiatric side effects, compared with 14% in the Malarone group. GlaxoSmithKline PLC, which makes Malarone, sponsored the study.

 

http://www.lariaminfo.org/information/WSJ20020904.shtml

 

[rob]

Don't they have Doctors and anti-malarial medication in Thailand?

[cj001f]

PS -- After reading up on the Malarone I'm beginning to wonder about the whole helmet comparison. As my wife said "Hmm: malaira or suicidal episodes..."

 

The Gates foundation and others are spending millions to eradicate it for shits and giggles, really it's no big deal.

 

And yes, Thailand is one of the booming medical tourism destinations

[chelle]

The malaria prophylaxis are the same drugs used to treat the disease, so why not wait to take it until you actually get it. You should be more concerned about dengue fever (for which there is no prophlaxis or medication) and use good repellent IMO. Been there 3 times and never taken anti-malarials, without any issues.

 

I know 3 people who have taken anti-malarials and 2 of them had to stop the drugs because of side effects (one had psychotic dreams, the other ended up hospitalized in full blown medication induced psychosis). For those scientifically minded folks, I already know this is a small sample. But based on this data and my own experience, I plan to not take the drugs when I go to Thailand for my fourth trip this Feb.

[markharf]

If you hang in the usual touristed areas, chances are you won't get malaria, with or without taking the antimalarial of your choice. On the other hand, if you do get the disease, you'll definitely be miserable and possibly in real danger. I ran a fever of 106 and almost died my first time, but did better when I got it again a couple of years later. Both times, I'd been taking Lariam, so I've since switched to Malarone. Anecdotes notwithstanding, most people do just fine on Lariam (aka mefloquine), just as most people survive doxycycline without third degree sunburns.

 

Best bet: read the CDC and WHO sites, and try not to take anyone posting on the Lonely Planet too seriously (except someone named NutraxforNerves or something similar—she's pretty good). Basically, once you've decided to take the drugs, you've got only four or five realistic choices, each with distinct advantages and disadvantages. Don't trust locally-bought drugs in Asia—there are too many counterfeits.

 

If you've got Malarone and decide not to take it, I'll buy it from you on your return, discounted appropriately. PM me if interested. How long are you going for?

 

enjoy,

 

Mark

 

Edit to add: I got malaria once in the states (returning from Papua-New Guinea) and once in Mali. Neither time was I given one of the standard prophylactics as a cure.

Edited October 4, 2006 by markharf

[Dechristo]

So like, do you have to unroll the prophylactic over the mosquito's nose for it to work?

[ken4ord]

The malaria prophylaxis are the same drugs used to treat the disease, so why not wait to take it until you actually get it. You should be more concerned about dengue fever (for which there is no prophlaxis or medication) and use good repellent IMO. Been there 3 times and never taken anti-malarials, without any issues.

 

I know 3 people who have taken anti-malarials and 2 of them had to stop the drugs because of side effects (one had psychotic dreams, the other ended up hospitalized in full blown medication induced psychosis). For those scientifically minded folks, I already know this is a small sample. But based on this data and my own experience, I plan to not take the drugs when I go to Thailand for my fourth trip this Feb.

 

I have been living in Rwanda and I have yet to take any prophlaxis. Basically I just do all the other precautionary steps like bug dope, sleeeping under a net, long sleeve shirts and pants. I have yet to get it.

 

There is only one of the prophlaxis that causes pychotic dreams, at least that I am aware. Most people really get freaked out about the dreams. Then there are individuals that I know that love how crazy the dreams are.

[wfinley]

Thanks all -- We have the drugs but are still on the fence about taking them. As a child I lived in Thaaland and never took malaria meds so we'll see. Markharf we're gone 6 weeks (until T-Giving); if we don't take it I'll PM you when we get back.