Malaria pills or not?

[Mossman]

Are there no locals on this forum?

You could ask your question in the local forum, i.e. Indonesia.

 

[ScubaBB]

My indonesian is quite bad, but I will ask the local diveschool.
Let you when I get answered.

 

[jefffalcone]

$6 a pill at my local CVS. In my opinion, tolerating side effects to the point that you don't believe you have any side effects means there are no side effects. I might have had a little tummy trouble once or twice, but then again that could have easily been "side effects" from the beer, cocktails, wine, and spicy Indo food.

Even the CDC, which I understand is not a drug company, says "Well tolerated—side effects uncommon ". And given the price of booze in Indonesia, $6 for a daily pill is nothing.

(On the other hand, here are the "side effects" of contracting malaria, according to the CDC: "Malaria is characterized by fever and influenzalike symptoms, including chills, headache, myalgias, and malaise; these symptoms can occur at intervals. Uncomplicated disease may be associated with anemia and jaundice. In severe disease, seizures, mental confusion, kidney failure, acute respiratory disease syndrome (ARDS), coma, and death may occur.")

If I did catch malaria, I'd really wish I hadn't listened to your advice.

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[h=1]Malarone Side Effects[/h]Please note - some side effects for Malarone may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

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[h=2]Side Effects of Malarone - for the Consumer[/h][h=3]Malarone[/h]All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Malarone:

Cough; diarrhea; dizziness; headache; loss of appetite; mouth sores; nausea; stomach pain; vomiting; weakness.
​

Seek medical attention right away if any of these SEVERE side effects occur when using Malarone:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest or throat; swelling of the mouth, face, lips, or tongue; unusual hoarseness); dark urine; fever, chills, or persistent sore throat; mood or mental changes; muscle or back pain; pale stools; red, blistered, swollen, or peeling skin; ringing in the ears; seizures; severe or persistent vomiting, diarrhea, or stomach pain; shortness of breath; unusual fatigue or weakness; weight loss; yellowing of the skin or eyes.


Gosh, that doesn't sound like nothing to me??? Side effects are rare. So are mosquitoes at resorts where they have been sprayed for. CDC and everyone else who has anything to say about side effects of any drug are reliant on studies done by the companies who make and sell the drugs. Obvious conflict of interest there. What they don't tell you is frequently when you get the rare side effects, you get all of them. Most people wont get them, just like most people wont get malaria. Doctors are pretty good at dealing with malaria these days. How good are they at fixing whatever causes these side effects?
​

 

[Mossman]

What I did was procure and bring along the more "scary" drugs for the non-chloroquine areas (sorry, I forget which one it was now), and then I waited (which was a slight gamble) until I got there and could see how the mosquito situation was in my location (on the water where I had heard there might not be mosquitoes). As it turned out there were no mosquitoes there, so I never had to take that drug. I did take a risk but with the information I had, I deemed it to be my chosen risk over the risk of having a negative drug reaction.

That's even more of a gamble with drugs that have to be started weeks before entering the malarial area, since you'll likely be back home before the treatment is effective. Even Malarone needs a couple days of advance notice.

That said, it's all a statistics game. As you say, some areas are light on mosquitoes. If you're heading from an air-conditioned airport terminal into a vehicle then directly to a liveaboard boat that soon heads out to sea, chances of encountering mosquitoes are much smaller than if you stay in a ventilated bungalow in a rainforest. Meanwhile, 17% of adults taking Malarone in one study reported abdominal pain, plus there are less reports of other mild side effects and even a small risk of major side effects. On the other hand, 1,500 Americans contract malaria from traveling each year. There's no telling how many Croatians get it

As the CDC says:[h=4]Conduct an individualized risk assessment[/h]Prevention of malaria involves a balance between ensuring that all people who will be at risk of infection use the appropriate prevention measures, while preventing adverse effects of those interventions among people using them unnecessarily. An individual risk assessment should be conducted for every traveler, taking into account not only the destination country, but also the detailed itinerary, including specific cities, types of accommodation, season, and style of travel. In addition, conditions such as pregnancy or the presence of antimalarial drug resistance at the destination may modify the risk assessment.

CDC - Malaria - Travelers

Lots of good information in there, even if it's really just propaganda spewed by a large drug company as another poster pointed out.

 

[Blue Sparkle]

Hey, contact the CDC directly. Or, visit a travel medicine specialist. Counting votes here is only going create more angst driven by folks who are relying on their own experience or hearsay.

Just to clarify (for my post at least), I did do my primary research on the CDC site. But, since (at least at that time), some of the anti-malarial drugs (for certain areas) had some pretty hefty possible side-effects -- and since some "sub-areas" of the larger CDC areas were reported to have no mosquitoes/very little risk -- it was not perfectly clear cut.

That's not to say that one should base important decisions purely on Internet forum posts, but more to clarify that the OP and others can read the CDC recommendations and still have questions.

In my case it turned out that the "internet hearsay" I got from people who were actually there turned out to be correct

 

[Blue Sparkle]

That's even more of a gamble with drugs that have to be started weeks before entering the malarial area, since you'll likely be back home before the treatment is effective. Even Malarone needs a couple days of advance notice.

Yes, I understand that. However in my case I was going to be there for months, and I had the option of staying "barricaded" inside, with screens, for the first few days if I arrived and found out there were mosquitoes. So waiting two days to find out how things really were was the choice I made considering all the information I had.

I also did not have quick access to doctors or hospitals, so I had to weigh the possibility of mosquitoes/malaria against the chances of dangerous drug side-effects. In my case not taking the drug at all (in THAT area) turned out to be the correct choice - I never saw one mosquito the whole time I was there.

(On the other hand, I did take Chloroquine the whole time I was in western Central America; in that case I judged the risk of the drug to be much less than the risk (however slight) of malaria.) So, it all depends.

This though, is why I mentioned that my case was more about explaining why it can be confusing and not clear cut when you read and get many different answers. I knew my specifics were not probably going to apply to the OP, while some of the principles might.

Blue Sparkle

 

[ScubaBB]

I've just sent the divingschool an email, so I'll see what they have to say. I suppose they don't sell pills.

 

[Mossman]

Gosh, that doesn't sound like nothing to me??? Side effects are rare. So are mosquitoes at resorts where they have been sprayed for. CDC and everyone else who has anything to say about side effects of any drug are reliant on studies done by the companies who make and sell the drugs. Obvious conflict of interest there. What they don't tell you is frequently when you get the rare side effects, you get all of them. Most people wont get them, just like most people wont get malaria. Doctors are pretty good at dealing with malaria these days. How good are they at fixing whatever causes these side effects?

To fix most of the "common" side effects, you stop taking the drug and you risk contracting malaria. The most common side effect is abdominal pain, which 17% of people in the drug company's study reported. If you believe the drug company falsified the data, please report your findings to the FDA at once. Otherwise, I'll believe that 83% of people taking Malarone report no abdominal pain and I'd guess that most of the 83% don't report any of the other side effects as well because, as you say, if you get one you're likely to get 'em all. I'd take an 83% chance of having absolutely no side effects from the drug versus even a very small risk of contracting a disease like malaria which is not 100% curable and which can lead to "complications, including death". But that's just me. I also wear my seat belt and do safety stops, just in case, even though I have airbags in my vehicle and safety stops are purely optional.

 

[Mark Derail]

Latests news...hope for the future!

Mosquitoes Genetically-Engineered to Self Destruct Could Wipe Out Dengue Fever

 

[ScubaBB]

But will they be ready with selfdestructing before february?