Malaria and Dengue in North Sulawesi?

[chillyinCanada]

Holy crap! Maybe I am not remembering correctly, I will go over the paperwork she gave me again. I was asking about Polio, so maybe I am confusing what she said.



"Asking locals" is exactly why I'm here right now. I asked the resort, but of course they play everything down. They said mosquito nets are in every room. I am bringing my own in case there are holes in the provided net, etc.

Thanks for the recommendation of the Sofell. I have packed some Woods Off with DEET. I've heard I may not actually be able to bring this with me though. Can you confirm that?

We may do a night hike with the Tarsius Monkeys. I assume this would be high-risk for Dengue?

Dengue is from the Aedes aegypti mosquito that bites primarily in the day.

My father got dengue at his own house in Jakarta.

 

[chillyinCanada]

About 15 years ago, I took Chloroquine for a trip in central America. I did become so sick that I nearly died. Not proven but specialists determined it was likely the med.

Now that's entirely anecdotal and not even the prescription in your case.

Larium, iirc, is not to be used by divers.

DEET up

 

[Dan]

About 15 years ago, I took Chloroquine for a trip in central America. I did become so sick that I nearly died. Not proven but specialists determined it was likely the med.

Now that's entirely anecdotal and not even the prescription in your case.

Larium, iirc, is not to be used by divers.

DEET up

So you understand why I call the malaria medicine poison.

I'm also allergic to sulfa drug. It made me itch inside the body where scratching the skin near the itch won't help. It drove me nuts. I was recommended to try different malaria med, sulfadoxine & Fansidar, when I was in Medan (North Sumatra) for visiting Orangutan sanctuary.

https://www.sciencedirect.com/science/article/pii/S1368764698900607
"The sulfonamide and sulfone (sulfa) group of antimalarials has been used extensively throughout malaria endemic regions of the world to control this important infectious disease of humans. Sulfadoxine is the most extensively used drug of this group of drugs and is usually combined with pyrimethamine (Fansidar), particularly for the control of Plasmodium falciparum, the causative agent of the most lethal form of malaria...."

 

[stepfen]

There is an easy solution that hasn't been mentioned I think yet: Keep diving and you are guaranteed you will not get mosquito bites, for they don't live underwater neither they can pierce through neoprene

I've been in total 3 weeks in Raja Ampat (homestay Gam area) and I saw maybe 10 mosquitoes in total. Don't ask me why, but there are very few of them there. Also they are the type of very fluffy, fat and so slowly moving that they are very easy to spot and get rid of.
I've also been to Bunaken for a week during raining season. There are quite a lot mosquitoes there. I've also lived in Jakarta (similar density with Bunaken) for few months here and there.

Every time I bring with me a repeller and it is very effective. It is a natural ingredients one. Here in Greece you can find them in any pharmacy. It usually has lemongrass, mint, eucalyptus or similar main ingredient(s) with the corresponding smell and it is supposed to be child safe. Mosquitoes are supposed to dislike these scents hence they just don't bother going near you.

I sprayed my bare skin (hands, legs, neck) around sun set, before I went to bed and maybe one more time during the night if I happened to wake up to pee or something. Also I used (the provided) mosquito net over the bed just in case. These proved to be very effective. Use these or similar basic precautions and I think you will be fine.

All the best

 

[drjtprice]

If you take an antimalarial then you need to know which ones are effective in the area you travel to. Malaria develops a resistant over time (and the resistance to malarone is spreading, unfortunate as malarone is often used as the drug to treat the disease after the fact). You can't rely on locals for advice as no antimalarial can be taken for long. If you live in the area you aren't taking an antimalarial, you can't. Doxycycline can still be an option in many parts of the world. It is cheap, has co-benefits (to works against some tick-borne diseases and other bacterial illnesses). The downside is that it make some people sun sensitive (a real problem for divers) and you should generally avoid alcohol.

 

[Indah]

Denque is a typical city disease. Worst in bigger cities. Mosquitoes also bite during the day. Serious risque but probably 100 x less than hiring a motorbike at Bali, trying home made alcohol or spending a night in a cigarette smoke filled bar. Not to mention falling asleep on the roof of the boat. But the risk at Denque is real and by personal experience I agree: no fun at all. The risk for Malaria is decreasing everywhere in Indonesia. Even in the highest risk areas such as South Sorong district Inot Raja Ampat) and South Manokwari district (700 kilometers from North Sulawesi) it is far less than it used to be.
But Malaria can kill fast. Many people receiving proper medication upon getting ill die anyway.

 

[Indah]

We hardly know anythin

If you take an antimalarial then you need to know which ones are effective in the area you travel to. Malaria develops a resistant over time (and the resistance to malarone is spreading, unfortunate as malarone is often used as the drug to treat the disease after the fact). You can't rely on locals for advice as no antimalarial can be taken for long. If you live in the area you aren't taking an antimalarial, you can't. Doxycycline can still be an option in many parts of the world. It is cheap, has co-benefits (to works against some tick-borne diseases and other bacterial illnesses). The downside is that it make some people sun sensitive (a real problem for divers) and you should generally avoid alcohol.[/QUOTE

We only recently become aware that we know hardly anything about the effect on our microbiome of antibiotics.

 

[Luko]

You can easily get the information online from several different Government agencies (UK, US, Australia).

You can't rely on locals for advice

Isn't that a bit of a colonial statement : Locals... hmmh... what do they know?

 

[Indah]

You can easily get the information online from several different Government agencies (UK, US, Australia). The UK considers North Sulawesi low risk (but Halmahera is high risk). As I recall I did not use malarone (which is what I typically use, have never had any problems and have had vertigo in the past, YMMV) in Sulawesi (where I was in the jungles) but did on Halmahera. This is from the UK (NHS) - "antimalarial tablets are not usually recommended, however, they can be considered for certain travellers who may be at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen" for areas classed as low risk. Especially try to avoid being bitten between dusk and dawn. US is a bit more vague. Malaria incidence in most of the region, and even in Halmahera has been going down in recent years. But, with anything, it is a risk decision. Malaria can be exceptionally nasty, so one has to decide how much risk they are willing to take.

I did not hear personally of any case of malaria on central Halmahera for years. Nobody of our staff, nobody in the nearest villages and no family of our staff.

 

[billt4sf]

Good Thread.

TBH we have almost completely forgotten about mosquitos on our LOB and resort diving in Indo and living in Bali and roaming around SEA - even though Emily is a mosquito magnet. We should be a bit more attentive & careful going forward.

The other day I went into the clinic in Taipei with a cold, and casually mentioned that I had just returned from Bali and their ears sure perked up! But after I described my symptoms I heard them say "me-yo" (sp?) [impossible] so I was relieved.

- Bill