Malaria in PNG

[garycrano]

Hi
I am looking at going to either Walindi in PNG or to Raja Ampat.They both have malaria so I am wondering if anybody on this site knows of
actual cases of divers getting malaria.
Also do most people take drugs for it or just run the gauntlet?

 

[WetPup]

Just staying at the dive resort? Tropical strength insect repellent with DEET (Bushman's works well - available pretty much everywhere in Australia). And use the mosquito net that the resorts provide at night.

I only use actual anti-malarial medication (I take doxy) in PNG and Indo if I'm going into the jungle for a hike or something. Some people do this on their off-gas day before flying, some don't.

Please speak to a medical professional though. I am not a medical doctor. I am merely someone who spends a fair bit of time in PNG for work.

 

[JohnN]

Hi
I am looking at going to either Walindi in PNG or to Raja Ampat.They both have malaria so I am wondering if anybody on this site knows of
actual cases of divers getting malaria.
Also do most people take drugs for it or just run the gauntlet?

As if you needed an excuse for consuming multiple G&T's. . .

 

[Russoft]

Hi
I am looking at going to either Walindi in PNG or to Raja Ampat.They both have malaria so I am wondering if anybody on this site knows of
actual cases of divers getting malaria.
Also do most people take drugs for it or just run the gauntlet?

I'm not going to tell you what to do since I'm not a medical professional. I grew up in a Malaria endemic region, so I'll say what we did:
Regardless of whether or not I was on prophylaxis, I had one treatment of Coartem handy. If I came done with "flu like" symptoms any time 3-6 months after being in an endemic region, I treated the symptoms as malaria and took Coartem. Malaria (falciparum, at least) is deadly and the longer it goes untreated, the longer it'll take to recover. I'm not sure what type of Malaria they've got over there, so maybe someone else has better regional info.

 

[mikeycanuk]

Today is the last Malarone dose from our trip to the Solomon's.

I got the impression most people catch it going through the capital but you won't get concrete recommendations from anyone.

We met a couple at Uepi who lived in PNG for many years, he was born there. He told us a story where he ignored what he described as a low grade flu. Wife gets home where he tells her he's really not doing well. Gets a test and BOOM it's get to the hospital NOW. He has falciparum and they put him in a medially induced coma and his BP keeps dropping to the point where he is given last rights!!! His BP did stabilize around the 60 mark. His wife was then told he might have brain damage. Turns out he's fine but his kidney's are finished due to the medications. His daughter got him on traditional Chinese medicine and he gets his kidney function back. The staff called him the twice miracle man. And get this a few days out of the hospital he feels really off. Turns out he has vivax as well that got missed.

And another couple (he was doing private security) had to have his wife medivaced back to OZ to the point she went straight to the Brisbane's military malaria hospital for treatment.

Scary.

 

[Wingy]

Again, not a doctor but I use Doxycycline as Malarone gives me some rather unpleasant side effects. If im on a boat 99% of the time I dont bother - you would know if you are a person who mosquito's like or not - I tend to rarely get bitten so I guess its a personal judgement thing.

 

[Manuel Sam]

I don't know of people who have gotten it while traveling to these dive destinations. Myself, I have always taken malaria prophylaxis medication, and also taken the other usual precautions: long sleeves and long pants, repellents, and, where possible, avoiding the outdoors at dawn and dusk.

The Center for Disease Control (CDC) in the US has a good guide to malaria prophylaxis medications. Just Google "Malaria Prophylaxis".

This is what I learned from prepping for prior land-based dive trips to PNG and Raja Ampat. At least for me, Malarone was what I took and I didn't experience any side effects. Doxycycline is supposed to be effective but it supposedly increases sensitivity to sun exposure - making it a bit ironic that you'd hope for rain while on a dive vacation in the tropics (just joking). Lastly, what I learned was to avoid Lariam - it is purported to have side effects that resemble those of decompression sickness.

Back in the good ol' days when I had a "Cadillac" health plan here in the US, I could go to the local hospital's Travel Clinic, get a consultation based on where I was traveling to, and get a prescription - all of that, without paying thru the nose and also leaving three pints of blood and maybe a couple of toes.....but I digress. Perhaps there is such a clinic where you live, and as almost everyone else has suggested, it would be best to consult with a medical professional.

 

[Centrals]

The last time that I went to PNG was yrs ago and I took Proguanil and Chloroquine together without any side effect.
Chloroquine is bitter in taste.

 

[Kevrumbo]

Can't remember if I took Malarone or Doxycycline as an anti-malarial on my Dec 2001 PNG trip to Walindi and a Peter Hughes Liveaboard. I was told all the locals & resort staff at Walindi Plantation were functional physically yet suffering form low grade "endemic" Malaria at that time. (They apparently have developed their own immunity to the Malarial parasitic microorganism & life cycle).

Unfortunately I ended up contracting that other mosquito vector borne disease, acute viral Dengue Fever. Felt like having Influenza to the tenth power -so incredibly painful & debilitating the fever and chills lasting for 3 to 4 days! Now I know why they call it "breakbone fever"; spent the week's return trip from PNG in Palau's National Hospital being treated by a US Navy Corpsman with IV fluids & acetaminophen, letting the virus run its course and monitoring for Dengue Shock/Hemorrhagic Fever Syndrome complications.

Recommend anti-malarials as above (lots of sunscreen if taking Doxy); DEET spray/lotion on skin and Permethrin insecticide treatment for clothes; and a travelers mosquito net to hang over bed/sleeping area. Note that there is no vaccine against Dengue Fever yet, so your only protection for now is mosquito repellents & insecticides; and contracting one serotype of the four types of Dengue strains does not confer immunity against the other three serotypes, and may make you more susceptible to the more severe form of Dengue Hemorrhagic Fever if you get it again.

 

[reubencahn]

I know of one diver who contracted malaria on a trip to northern PNG (Wewak to Madang). However, he also spent a couple of days on the Sepik. His symptoms appeared several months after his return to the U.S., and he was incapacitated for over a month, perhaps longer. Myself, I always take prophylaxis (malarone) and have never had any ill effects. In light of the consequences, I can't see a good reason to not do everything possible to reduce the risk of infection.