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Malaria


Malaria is a risk in most parts of the world. The regions that are regarded as free from malaria are USA, Canada, Western Europe, Japan, Austrialasia, Hong Kong and Singapore. For specific country information in other areas check out the world database. In most other areas therefore it is necessary to think about precautions. Its worth checking out whether the particular area of a country your going to travel in has a malaria risk since in some areas especially cities and tourist areas there is little or no risk of malaria.

Malaria is spread by being bitten by a mosquito. The incubation period once injected is about 5 days but if anti malarial treatments are being taken then this can take up to a year. It is therefore important to inform your doctor if you become ill within 12 months of arriving back from a malaria area.

If you get diarrhoea then remember the drugs may not be staying in your stomach long enough to work so extra care should be taken.

Symptoms

In its early stages the symptoms are similar to flu, aching muscles, fever and feeling exhausted. If untreated high fevers can develop with the patient eventually falling into a coma. It is therefore important that if there is any doubt at all then the patient is immediately taken to the local clinic for a blood test.

Prevention

There are two main types of prevention the first is not to get bitten in the first place cover all exposed skin in the evenings and at night (this is when the biting mosquitos are around) and use a mosquito net and repellent.

The second thing is to use antimalarial prophylactics these are not 100% as they do not prevent the parasites getting into the body they just help to suppress them. This is why you should continue to use the drugs upon your return for the prescribed period. You should also start taking the drugs at least a week before travelling.

Chloriquine & Paludrine This mixture is the most used and the usual dose is 2 chloriquine tablets once a week and 2 paludrine tablets daily. They are safe to take long term.

Mefloquine (Larium) This is a newer drug and the dose is one tablet per week. It should not be taken by pregnant women or those who may become pregnant within three months of taking it. The side effects are fairly severe and can even cause behavioural disturbance. Therefore read the label and also take a pill a few weeks before leaving then if you do get side effects you have time to get a different prophylactic.

It is important to check the latest details on malaria as areas where drug resistance occurs are changing constantly

Standby Treatment

Medical help should be sort whenever malaria is suspected but there may be times when that help is not immediate and ways of slowing malaria down or curing it need to be taken. The two main methods are 3 Fanzidar tablets taken together or 2 mefloquine tablets followed by 2 more 12 hours later. Seek guidance on using any drug you think you might need before leaving home. If the symptoms appear to go away after treatment medical help should still be sort at the earliest opportunity.

Repellents

Repellents can be used to help prevent getting bitten but they should never be used in place of a prophylactic. The best types are DEET based they come in various forms sprays, creams etc. Be careful as DEET can attack man made fibres so read the label carefully before applying to clothing. In your room or when outside burning a mosquito coil is a good idea.

Mosquito Nets

Since the mosquito that transmits malaria comes out in the evening and at night a mosquito net is essential to sleep under. You should use it in doors and out doors. If your staying in a hotel which has nets check them for holes before assuming their safe.
When buying a net make sure that it suits your purpose the best type to go for are the wedge shape ones as these are easy to attach to walls, trees etc.
You should also go for a permethrian impregnated net. This is a naturally occurring chemical that will kill or deter insects. The protection usually lasts for 6 months but if the net gets dirty then the effects will obviously be less. You can get kits to re-impregnate the net from good camping shops and for long trips they make a good investment.
Before you go get the net out and check how you need to attach it. Outdoors usually you'll find a piece of paracord essential to attach to the top of the net to a convenaint tree and you'll also need some pegs to hold the base of the net out. The net should have eyelets for pegs, check this before you buy a net. Tent pegs can be used but you'll find 6 inch round headed nails a much better option especially in hard ground. Remember to take care when handling your net so as not to hole it.
Some of the smaller light weight nets are only just big enough to cover a sleeping bag so if your tall double check the size remember you may need to keep your rucksack and other possessions inside as well.
Nets also prevent you from being bitten by other insects so even in none malaria areas the can be great. Shame they can't prevent bed bugs.
Finally nets are great for when your eating or resting during the day in insect infested areas.

Personal Experience

The reality is that however careful you are you may get malaria. I know 5 people who have had malaria all survived but in every case medical help was obtained as quickly as possible.

Some where taking Larium and others Chloriquine / Paludrine. So it seems one drug is as good as another. There seems no correlation between the number of bites and the instances of the malaria, some people where bitten once and contracted malaria while some people have been bitten hundreds of times and never had malaria. Women also seem to get bitten more often than men. So just stay covered.

A couple of the cases did occur after the person had been back home for several months. Fortunately in both cases they informed their doctor of the possibility of malaria and after a short stay at the Hospital of Tropical Diseases they recovered.




K.Vans-Colina 1992-99