Malaria Meds?

[scubadobadoo]

My wife and I are heading to Roatan and then Costa Rica soon. We have visited these places before but only for one day at a time and without malaria meds. I notice the CDC says to take malaria meds for both places. I'm guessing that most who visit don't, but we still got a prescription for them. Even our Doc was surprised by the suggestion from the CDC but she doesn't travel much to that part of the world. Any opinions? Better safe than sorry I guess!

 

[opalobsidian]

Scuby do-

Taking anti-malarials is not necessarily playing it safe! Did you get a prescription for Lariam? It can have some heinous side effects that could make you really very sorry indeed! Check this out...

FDA Requires Direct Patient Warning of Anti-Malaria Drug Side Effects

Lariam, a common anti-malaria drug, has been linked to serious mental problems and suicidal tendencies and the Food and Drug Administration (FDA) is requiring doctors to warn patients of these possible side effects directly.

Such a requirement has only been made by the FDA 17 times in the past and is reserved for drugs that "pose a serious and significant public health concern." The side effects, which include serious psychiatric adverse events including reported episodes of hallucinations, delusions, suicidal thoughts, sudden, uncontrollable rage, homicidal urges and suicide, may persist even after the drug has been stopped.

Although some say the move by the FDA is long overdue, the FDA says that the small risk of suicide associated with Lariam may have to be acceptable since malaria is such a deadly disease.

:11:

And for even more big fun with information about Lariam, just Google "Lariam" and see all the scary articles that pop up!

Pamela

 

[bradshsi]

The World Health Organisation (WHO) has some good advice on the subject. I've tended to use their advice in the past when travelling to areas with a malaria risk.

According to their advice (which I've posted below), both areas are type II which means they recommend taking a basic chloroquine prescription. This medication doesn't seem to have much in the way of major side effects (at least when I've taken it).

The Lariam (mefloquine) mentioned by opalobsidian can have some pretty evil side effects which last a long time. The problem is you only take one pill a week, so the medication takes a long time to be flushed out of your body. That said, I've taken it on several occasions when travelling to high risk areas (East Africa) and had no side effects. The WHO doesn't recommend it for the places you are visiting.


WHO advice:
Costa Rica: Malaria risk-—almost exclusively due to P. vivaxoccurs throughout the year in the provinces of Limón and Puntarenas, with highest risk in the cantons , Guacimo, Limón, Matina and Talamanca (Limón Province) and Garabito (Puntarenas Province). Negligible or no risk of malaria transmission exists in the other cantons of the country.
Recommended prevention in risk areas: II

Honduras: Malaria risk—predominantly due to P. vivax—is high throughout the year in the provinces of Colón, Gracias a Dios, and Islas de la Bahía; and moderate in the province of Atlántida.P. falciparum is highest in Colón, Gracias a Dios, and the Islas de la Bahía.
Recommended prevention: II


Malaria Risk Type of prevention
Type I
Very limited risk of malaria transmission. Mosquito bite prevention only

Type II
Risk of P. vivax malaria or fully chloroquine-sensitive P. falciparum only. Mosquito bite prevention plus chloroquine chemoprophylaxis

Type III
Risk of malaria transmission and emerging chloroquine resistance. Mosquito bite prevention plus chloroquine+proguanil chemoprophylaxis

Type IV
High risk of falciparum malaria plus drug resistance, or moderate/low risk falciparum malaria but high drug resistance. Mosquito bite prevention plus either mefloquine, doxycycline or atovaquone/proguanil (take one that no resistance is reported for in the specific areas to be visited

 

[Doc Harry]

CDC Traveler's Health

I recommend that you follow the CDC's advice for vaccines and regional travel.

Other things to consider include mosquito netting for you bed at night and plenty of mosquito repellent.

 

[Dave Zimmerly]

We have been to Roatan twice and plan to go back. We always get innoculations for malaria, Hep A, polio, typhus and a tet booster. Better safe than sorry.

Dave (aka "Squirt")

 

[Allison Finch]

As I travel in the Pacific region quite a bit, I am used to taking malarial meds. I've taken Larium, Doxycycline, and Malarone.

Larium- Taken once week. Vivid bad dreams and it tampers with your temper. Definitely not worth it.

Doxycycline-Not too bad. Taken daily and it causes bad photo sensitivity. That means you must be careful to stay out of the sun. Again, hard to avoid sun while diving.

Malarone- The new guy on the block. Taken daily. I had no side effects at all. You don't have to start taking it as early before the trip as Doxy, and not for as long after your trip. This drug is my pick.

I have seen many ex-pats with malaria, and I will not risk it.

 

[gangrel441]

I have been to Costa Rica (Playa Hermosa). I have not been to Roatan, but I have been to the Atolls in Belize, not geographically too far from Roatan. In both cases, I did take anti-malarials.

Typically for travel to that part of the world, the prescription is going to be for chloriquine. Side effects are rare and mild, but can put a damper on your trip. My wife took Chloriquine on our trip to Riviera Maya, since we also toured a bit through the Yucotan. A few days into the trip, she developed what seemed to be a stomach flu, but we later were convinced was a reaction to the chloriquine, based on the timing of when she took the meds.

On our subsequent trips to malaria hot zones (Belize is considered to be as hot of a malraia zone as it gets in Central America), she received an alternate med, Malarone. This med needs to be taken more frequently, but over a shorter duration, and has less incidence of side effects.

Hope this helps!

 

[Blitz]

Follow the CDC. I speak from experience; you don't want it! But have a fun trip.

 

[mdb]

My wife and I are heading to Roatan and then Costa Rica soon. We have visited these places before but only for one day at a time and without malaria meds. I notice the CDC says to take malaria meds for both places. I'm guessing that most who visit don't, but we still got a prescription for them. Even our Doc was surprised by the suggestion from the CDC but she doesn't travel much to that part of the world. Any opinions? Better safe than sorry I guess!

scubadobadoo: As others have said, follow the suggestions from the CDC. I had a good dose of Falciparum malaria, 105F temp, emergency medevac etc. One good thing is it cured my nicotine habit. Take the proper meds and have a safe trip.

 

[Charlie59]

Last November I was in Roatan and took Chloroquine, I was almost the only one taking anything. No one I know had problems, but I would not risk it. An infectious disease doctor I consulted recommended prophlyactic antibiotics since it was only the chloroquine.

Unfortunately you need to remember to take before you go and several weeks after you are back.

Going back in October, will take again.