# Malaria



## HughR (Aug 29, 2013)

To anyone: Do you use malarial prophylaxes in Central America?


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## gamayun (Aug 20, 2009)

This will probably depending on which country you're going to and how far off the beaten path (urban versus jungle). It might be best to check with a travel clinic. Most cities in the US have them, presuming you're in this US...if not, they might be able to give you this info over the phone. The CDC has a table on malaria by country: CDC - Malaria - Travelers - Malaria Information and Prophylaxis, by Country.


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## Frogwatch (Jan 22, 2011)

If there is an possibility of encountering mosquitoes, take the anti-malaria meds in all countries below Mexico. Even if they tell you that you do not need it you should consider it. I got malaria in Belize in 1987 and it was no fun. Got back to the states and nobody knew why I was getting 105 degree fevers every other day. My bed would be soaked with sweat so I had to sleep on towels every night. A friend called one afternoon and was so shocked at my incoherence she called my wife and told her to get me to emergency room. Docs had no idea what i had and tried to send me home. Wife refused to leave hospital with me (I do not remember any of this, I was out of it). Apparently an army doctor (this was in Huntsville Alabama) happened to walk by, saw my symptoms, he had been in Panama and declared "He has malaria". He told them to stain the blood to see the parasite.
During this two week period, I went from being already very thin to looking like death itself losing 20 lbs.
Once on the synthetic quinine, I recovered quickly but had two relapses.
Fortunately, the CA version is normally not the really bad strain and I am probably free of it. I get conflicting opinions on whether or not I can donate blood so I do not. 
Take the meds.


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## MarkofSeaLife (Nov 7, 2010)

I have been in Panama and also (different years) Brazil, Argentina; Venezuela and didnt have or need malaria or yellow fever vaccine. But I dont 'know'.


Mark


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## aeventyr60 (Jun 29, 2011)

The equation differs if your spending most of your time on a boat, where exposure is going to be a lot less. We have taken anti malaria pills but did not like the side affects.

For us defensive measures have seemed to work. Mosquito netting in the V Berth, mosquito coils in the cockpit and salon. Long sleeve shirts and pants while ashore. Liberal use of DEET. Try to avoid being outside just a before and after dark when they seem to come out in droves.

If I was going to spend significant time inland then I'd consider taking something. Malaria can and will have long term consequences on your health, especially your liver.


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## MarkofSeaLife (Nov 7, 2010)

aeventyr60 said:


> mosquito coils in the cockpit and salon.


No mosquito coils inside... nup nothing to do with gassing yourself, its the brown goo that sticks to the ceiling! Yuk! And hard to get off.

Mark


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## aeventyr60 (Jun 29, 2011)

MarkofSeaLife said:


> No mosquito coils inside... nup nothing to do with gassing yourself, its the brown goo that sticks to the ceiling! Yuk! And hard to get off.
> 
> Mark


No ours are green...no goo yet. Another hazard of cruising the Caribe?


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## glymroff (Apr 2, 2009)

No I haven't, but when I go I will. 

I will do whatever is the prevailing medical prevention technique at the time. 

Malaria is not the flu. I think you should look at it as a risk vs reward problem. I sail w/ a gal who gets motion sickness in a car. She loves to sail. She takes the prescription level med, plus bands. Sure it makes her a little tired sometimes. Yep, sometimes she isn't 100%. But she once didn't take it and hurled for 8 hrs straight.

This maybe is a bad analogy, but I think appropriate. If the side effects are minimal, and allow you to have a cruise through an area w/ out the potential on set of a serious problem, then I think it's worth it. JMHO.


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## zeehag (Nov 16, 2008)

these days the actuality of dengue i s more probable than the possibility of malaria. 
i know of no one taking prophylactic antimalarial drugs other than gin and tonic


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## JimMcGee (Jun 23, 2005)

zeehag said:


> i know of no one taking prophylactic antimalarial drugs other than gin and tonic


But only for medicinal purposes


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## aeventyr60 (Jun 29, 2011)

glymroff said:


> No I haven't, but when I go I will.
> 
> I will do whatever is the prevailing medical prevention technique at the time.
> 
> ...


One of the other issues is the long term affect of taking anti malaria medication. Sometimes the cure is just as bad as the bite. Sure a few times might be ok, but for years and years? Not sure. The preventative measures most assuredly. As Zee pointed out Dengue is a much bigger risk factor in Mexico and the same holds true here in SE Asia.


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## Frogwatch (Jan 22, 2011)

Since getting malaria (My strain was called "p.vivax"), I have taken the anti-malaria meds so I didnt get the other strains in my travels. I had no significant side effects.
Trust me, you do not want to get malaria. If that army doc hadn't happened along, it coulda killed me and it was seriously unpleasant unlike something like the flu which is merely a discomfort.
I did get mine in the jungle of Belize. Before my trip, I inquired of the local health dept what I should take and they never mentioned malaria. Later, they told me they thought i was going to some resort on the coast and not wandering in the jungle looking for caves.
However, I see that the type of skeeters that cause p. vivax can also be found on the coast.
The med side effects are minimal. the disease is a killer.


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## zeehag (Nov 16, 2008)

JimMcGee said:


> But only for medicinal purposes


by the gallons.....


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## Dfok (Apr 11, 2010)

Many meds, even prophylactic gin and tonics have some side effects. Going to Panama City or vacationing in Costa Rica or the mountains anywhere I'd take my chances avoiding mosquitos. 
Hacking a new Panama Canal through the jungle I'd get everything they got ( memory loss, insanity, insomnia and impotence be damned).
That said, I'm more afraid of dengue ( it will make you wished you died as opposed to make you dead) than I am of malaria and some malaria meds. There are bats that bite in the night and fish that swim up any handy urethra to worry about, not to mention havoc spawned by deforestation, global warming and the possible bites of returning dinosaurs.


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## Dfok (Apr 11, 2010)

Frogwatch said:


> Before my trip, I inquired of the local health dept what I should take and they never mentioned malaria. Later, they told me they thought i was going to some resort on the coast and not wandering in the jungle looking for caves.
> .


Ye gads man! Caves?!? That is where the bats and the bat guano are. Willingly going into caves (unless you are a miner) is a bit crazy, but hell, have at it. Willingly going into a certifiable "bat ****" zone without mask, meds and a lot of counseling trying to talk you out of that is nuts. 
I went to Costa Rica, visited a volcano. Did not jump into the lava even though the local health department never mentioned I was not fireproof.


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## lowtide (Mar 23, 2008)

My Dad got a strain of Malaria in the Philippines during WWII.

Believe it or not, he got one 24-48 hour attack every February, just once a year, until he died almost 50 years later. I never understood the February thing, it wasn't because of cold weather (Miami). ???

He was a big strong tough man, and as a kid it was scary as hell seeing him reduced to a quivering chattering ball under every blanket in the house (Miami), or alternately soaking wet with sweat, blankets on the floor, AC wide open. Like timing a tide, he would have to wait for a slack time to even get up and to the bathroom. He would lose a visibly noticeable amount of weight from dehydration in just those few hours. The relentless torture during the episode would leave him exhausted, like he had gone running for 24-48 hours, sapped and drained.

I agree that there are lots of awful critters to catch out there, and won't let that stop me, but we should be smart and prevent the preventable. You can see why I personally put malaria on the serious list. 

Don't depend on a Doctor, do your own research and find out what is currently floating around at your destinations. Your Doctor probably hasn't been there, will check his book from whenever ago, and off you'll go. I have no problem offending the Doctor with my own good information, and if the Doctor has a problem with it I need a new Doctor!

I just realized the irony, Dad got his in the Army, Froggy got diagnosed by an Army Doc, maybe that's why he knew.  Frogwatch's story ruins all the Fox Army Hospital (Redstone, Huntsville) jokes I heard in 20 years around there. I know, they are generic military doctor jokes, but they were usually mixed with a real horror story or two.

If you're going to the jungle, take it, some things are better safe than sorry.


'


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## Frogwatch (Jan 22, 2011)

I doubt that quinine water still has enough quinine to actually be a malaria prophylactic but it's a good excuse for a good SG&T (Sundown Gin and Tonic).

Yes, caves, my other obsession (or used to be). I have even managed to combine sailing and caving by taking my caving buddies to the Abacos to look for caves. I really want to go to Cat Island in the bahamas to look for some deeper caves. I'd thought my caving days were over but now my 17 yr old daughter is seriously into it so in spite of the fact that my knees are worn out from caving, no way I'd allow my daughter to be alone with any cavers, true low lifes.

Ahhhh, bat guano, smalls and tastes like adventure (if you get over the histoplasmosis)


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## smackdaddy (Aug 13, 2008)

lowtide said:


> My Dad got a strain of Malaria in the Philippines during WWII.
> 
> Believe it or not, he got one 24-48 hour attack every February, just once a year, until he died almost 50 years later. I never understood the February thing, it wasn't because of cold weather (Miami). ???


I was on Guadalcanal for 2 years. At the time there were two basic strains: falciparum and vivax. I got the falci after blowing off the meds for 6 months and relying solely on G&Ts (much more fun).

The vivax won't typically kill you outright, but it stays in your liver forever and keeps coming back. That's probably what your dad had.

The falci can kill you, but once it's gone, it's gone. I hammered it with chloriquine and did okay. Super high fever and hallucinations, but not too bad.

I was there during the 50th anniversary of the battle for GC and met many vets, US, Solis, and Japanese. After seeing all the holes blown in hundreds of palm trees and imagining working my way through that kind of steel blizzard at 19 - I had nothing but respect for all of them.

(The prophylax sucks. I won't take it. But I'm willing to take my chances in places I sail. And I won't be sailing to Mali.)


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## lowtide (Mar 23, 2008)

Frogwatch said:


> I doubt that quinine water still has enough quinine to actually be a malaria prophylactic but it's a good excuse for a good SG&T (Sundown Gin and Tonic).
> 
> Yes, caves, my other obsession (or used to be). I have even managed to combine sailing and caving by taking my caving buddies to the Abacos to look for caves. I really want to go to Cat Island in the bahamas to look for some deeper caves. I'd thought my caving days were over but now my 17 yr old daughter is seriously into it so in spite of the fact that my knees are worn out from caving, no way I'd allow my daughter to be alone with any cavers, true low lifes.
> 
> Ahhhh, bat guano, smalls and tastes like adventure (if you get over the histoplasmosis)


I assume you have done sunset on the water at the Bat Cave on Lake Guntersville, down near the Dam. Still one of the coolest things I've seen, innumerable bats, like a cloud, spreading out over the water.

If you Great Loop on the Tennessee, that is not to be missed.

'


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## Frogwatch (Jan 22, 2011)

Yup, the Falci is the really bad kind. They mostly have it in Africa. When people decry that Africa does so poorly, they fail to take it into account. Malaria has killed more people than all other plagues combined. It reduces the economies of stricken nations to the poverty level and is the most significant barrier to economic development of those nations. You can hate Microsoft all you want (and I do) but Gates has given his fortune to developing a malaria vaccine because he realizes this. People who have malaria simply cannot function even when it is in remission (without meds).
Until swamps were drained. much of the Gulfcoast of the USA was uninhabitable.
AIR CONDITIONING was invented by John Gorrie in 1854 in Apalachicola, Florida (really, 1854) because he was a doctor who wanted to cool his malaria patients (steam engine driven compressor compressing air that was then cooled with brine. Ice formed on the coils and he hung a pail of ice beneath a tall chimney over a patients bed. Gorrie died poor, after all who cared about anything in Apalachicola, FL in 1854.
Two towns in N. FL in the early 1800s were wiped out by combined yellow fever and malaria. It is weird that HIV kills less than .001X the number of people malaria kills but HIV research is funded so much more.


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## Frogwatch (Jan 22, 2011)

Yes, I learned to sail on Lake Guntersville and have seen the bats fly several times. Still make annual trips to that part of Alabama to go caving.


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## aeventyr60 (Jun 29, 2011)

We explored the Mulu caves in Borneo. Another good reason to set sail for Asia. Damn the mosquitos, full speed ahead!


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## Frogwatch (Jan 22, 2011)

When I first took my caving buddies to Abaco, we had to take this old cruise ship MV discovery from Lauderdale to Freeport (my boat was there). The ship was crowded with tourists catching rays up in the sun. My caving friends abhor the sunlight and gathered under an awning being bored............until they discovered the tiny access hallways and other supposedly inacessible places.

Later, when we finally got to Marsh Harbor there was a sailboat whose captain kept complaining about a stuffing box leak because nobody could reach it. Never tell a caver that "Nobody can crawl in there" cuz he'll prove you wrong.
Matt went in under the oil pan and Chris over the top of the engine. No problem tightening that stuffing box.

Of course, they are the reason I drove the rental car down that 4wd road to Hole in the Wall lighthouse (30 miles of it). There are caves at Hole in the Wall. We later spent two hours buffing out that old chevy Malibu rental to hide the scratches and dents. On a later trip with my wife, I asked the rental car guy if I could drive one of his cars to Hole inthe Wall and he looked at me like I'm crazy and yelled "HELL NO" and acted like he was gonna hit me.

There are also caves at Little Harbor near Petes Pub, impressive entrances but unimpressive caves.


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## Capt Len (Oct 9, 2011)

I hear that some of the pills for sale in rural SE Asia have so little active whatever in them that they're worse than useless. We always stock up in Canada for any unforseen and also expected medical situations.Mosquito born bad things? best avoid the bite. Camping from Belize to Laos for 18 years and the worse I got was toe fungus.


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## gerrycooper (Dec 1, 2002)

Doxycyclin taken daily is probably the most common antimalarial with the least side effects - the biggest I found was increased sensitivity to sunlight. If I was taking Doxycyclin I would also have a malaria test kit as the drug doesn't always stop the disease.


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## tdoster (Feb 21, 2012)

I had issues with Larium both times and only took it in West Africa when the concentration of Malaria was high. I have not taken it anywhere else and never had an issue as long as used DET and careful with nets and screens. I don't think I slept during the first two doses of Larium and when I did, the dreams were awful. I think I will be super careful and take my chances, but the prophylactic drugs are out for me.


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## Coquina (Dec 27, 2012)

How much tonic water do you have to drink to keep malaria away anyway?
A whole bottle?


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## PCP (Dec 1, 2004)

zeehag said:


> these days the actuality of dengue i s more probable than the possibility of malaria.
> i know of no one taking prophylactic antimalarial drugs other than gin and tonic


I agree, Dengue is terrible and it is spreading.

HealthMap | Global Health, Local Knowledge

CDC - Dengue

With me that would be a problem, mosquitos love my blood, smell or whatever. I am always the one with more bites, by far

Regards

Paulo


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## krisscross (Feb 22, 2013)

Coquina said:


> How much tonic water do you have to drink to keep malaria away anyway?
> A whole bottle?


There is not enough quinine in tonic water to make a dent in the Plasmodium population. And the sugar in the tonic just feeds them. Quinine tablets are by far the best because the parasites can't become immune to such complex chemical mixtures (quinine contains several active alkaloids that kill plasmodium parasites). It is still drug of choice for the most severe cases of malaria.
Malaria is no joke - it is likely #1 killer of people over the ages. 
Quinine is also effective for other tropical parasites. It can be taken in smaller doses when you are exposed to malaria carriers. As a side benefit, when you take quinine or any other bitter herbs (like neem or wormwood), your blood is less appetizing to mosquitoes and you don't get bitten as often. Sugar has the opposite effect.


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## Coquina (Dec 27, 2012)

When we went to Belize we didn't take any pills because we were on an island. Then my wife wanted to see some jaguars (cats, not cars) and we went inland for awhile. We were lucky I guess, April didn't seem to be prime for bugs there. We got bit a LOT less than you would on a summer day on our island at home.


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## tankersteve (Jun 22, 2007)

I'm currently in Afghanistan, and we take doxy every day. We have had several cases within our unit, always of guys who blew off the daily pill. I was in Haiti many years ago and took Larium. The dreams (and hallucinations for those who would intentionally take too many) were pretty unreal.

The Army is pretty active on preventative treatment. With the doxy, we are warned to keep taking it several weeks after redeployment. Apparently it only counters the parasite in the blood. The liver can retain them for a certain period of time.

Steve


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