Malaria in Bunaken, North Sulawesi

[BlueDevil]

Hi Guys,
we will be going to the Bunaken Marine Park in North Sulawesi in a few weeks. I am wondering if others who have been to this region have taken anti-malarial medication?

We will be staying on the island of Siladen. The resort managers say there is no malaria on their particular island. We will also be passing through Manado.

The CDC website is not really clear cut on the risk in this area so I am wondering what others have done when travelling to this region. I guess I would sooner be safe than sorry.

 

[frogfish]

I have been several times to Manado and never took malaria pills - Talking to local expats they said that there is very limited risk, especially in the dry season. Have a great trip !

 

[AlanWald]

I concur with Frogfish.

In general you always want to take precautions against mosquitoes especially in the rainy season when there may be transmission of dengue.

However other parts of Indonesia do have serious problems with Malaria such as the island of Ternate in the nearby Maluku Islands. In Bunaken I met an American who worked in Ternate on Malaria control and he said abut 30% of the population has malaria. I also met a Canadian who caught Malaria on the island of Flores.

The CDC web site probably not going to have detailed information on different sub-regions, so your best information is usually your dive operator.

 

[BlueDevil]

Thanks for the helpful replies. Would still like to hear from others who have spent time in the region.

 

[kilo_fox]

Northern Sulawesi during the dry season is indeed not posing a very high risk for malaria, but still, there is a risk. The nearest hospital with proper care for severe malaria would be in Singapore.
When I dived in Bunaken last year, I didn't take any malaria prophylaxis but applied the other "usual" precautions (bednet, repellant, ...), but then, I'm kind of used to it since I've been living and working in tropical countries, mostly in Africa, for the past 11 years.

So if you are new to tropical countries, and, as you say, want rather be safe than sorry, then you might be better off taking it (though I would not recommend Lariam if you never took it before).

 

[SnappyTheDiver]

I go three times a year for a month each time. I have never taken any malaria medications. Is it possible to have a problem. Yes. Personally I do not think the risk is high but you should judge your personal level for risk.

 

[Mike Veitch]

I live in Indonesia, bali mostly, have spent time in Lombok and Ambon.. i don't take malaria meds, nor will I... but i did get dengue here in Sanur..

 

[pelan-pelan]

Frogfish and AlanWald - I agree with their comments. Expats in Manado are not taking malaria meds.

Getting bitten by mosquitos is always a bad idea. There are other problems apart from malaria. So, careful use of mosquito repellent should do it. And watch out for your legs under the table in bars, cafes etc, and the locker rooms at dive centres. It isn't true that mosquitos don't bite during the day - they do in shady places.

 

[AlanWald]

Various antimalarial medicines have some problems, the newer ones are expensive, tetracycline has the side effect of making one more sensitive to the sun and others (Mefloquine) have side effects that can be confused with some of the signs and symptoms of decompression illness.

As pelan pelan said, avoid getting bit by mosquitoes. I have spent a month each year for the past four years in North Sulawesi and never had a serious problem with mosquitoes.

Some people are more attractive to mosquitoes than others. I don't know why but I have observed this in many countries around the world. If you can find these people and have them stand outside your room that is a great solution (seriously, one technique used when the mosquitoes are zoophilic, meaning preferring animals over humans, is to have a cow next to your room and let the cow get bit)

Long sleeve shirts and pant at dusk or twilight will be helpful. Mosquito nets and fans help. You can get mosquito coils to burn. The village shops will have these. And of course mosquito repellent (containing DEET). Thin socks will help. When I do get bit is is usually on the feet.

Also always where shoes or sandals at night. Bunaken Island has millipedes and the bite is quite painful.

Also when putting on your bathing suit, always shake it, once in Thailand I found a scorpion in mine.

Also turn over and shake shoes and boots before putting them on (especially when camping in the Southwestern part of the USA where there are plenty of scorpions who love to hide in shoes and boots)

 

[BlueDevil]

Thanks for the feedback guys. Taking the information from here combined with the fact that the resort says there is no malaria on their island (and their guests never use anti-malarials) I feel quite confident that there is no likely malaria problem. I had a chat with my doctor yesterday and we agreed that there would be no need for anti-malarial medication.

We will of course take the usual precautions against mosquitos that we would normally take in any tropical area (dengue fever etc). Over the years we have worked out almost precisely how much repellent we need to take to cover the whole family for the duration of the trip (plus a bit extra in case).

Some people are more attractive to mosquitoes than others. I don't know why but I have observed this in many countries around the world. If you can find these people and have them stand outside your room that is a great solution

Fortunately my wife is one of those people who attracts mozzies - I guess that lowers my likelihood of getting bitten considerably!! (Hope she's not looking over my shoulder as I write this!)