[tomtom]

Off on Hols in two weeks and apparently its to a place where i'll need to prepare for Malaria risk..

So - there are 4 types available (apparently) - any advice? Recommendations?

[Fadanoid]

Non medical related but if the local shops sell them get some of these?
Tried most of the plug in repellent/killers over the years and these seem to work the best.

[gme]

Chloroquinine is the cheapest but a pain in the arse as you need to take it for weeks either side of your trip as well as during. I am not a fan of taking meds for that long and also end up forgetting.

Malarone is my preferred option as its one a day and only when your in the affected area, however its expensive.

More important than either is just avoid getting bitten. I have been going to Indonesia for 12 years now to areas where if you listened to the health warnings you are pretty much guaranteed to get malaria. The first few trips i was paranoid and took everything i could, but now i don't take anything i just avoid getting bitten. Sleep under a net and cover your self in repellent on an evening and early morning.

If you don't get bitten you cant catch malaria.

[chris j]

What gme said, basically.

First thing, don't get bitten - anti-malarials aren't 100% effective, I know this from unpleasant experience. Mallarone would be the preferred choice, although expensive. Take for 2 days before, during and 1 week after. Check that it is effective against malaria types where you're going as I believe it isn't against some (found in the dodgier parts of Africa). Doxycycline - you have to take for ages and can make you more sensitive to sunburn, also I believe it's less effective. Larium is not preferred due to the interesting side effects...

[tomtom]

Cheers all,
Malarone looks best (done some surfing about it) and I can get it from my local tesco's after a consultation there (apparently..)

Tom

[Stubbs]

Malarone mate, spend the cash and avoid the weird side effects of the others!

Can only echo what others have said about bite prevention: Mozzy nets or sealed rooms, long sleeves and trousers in the evenings, lots of jungle formula!

[slackline]

Drink G&T's, lots and lots of G&T's. 

[the_dom]

What gme said, basically.

I'll second (third?) that. Recently did a quick trip to Mozambique and didn't have enough time to get a prescription - rather be proactive about not getting bitten than relying on prophylactics.

[Fadanoid]

Drink G&T's, lots and lots of G&T's. 

Isn't that for if you've been infected?

I'm basing this on an episode of dad's army where Lance Corporal Jack Jones had a relapse of some kind and they made him drink tonic water? He was all shaky whilst driving the butchers van.

[tomtom]

Thanks All,
Just picked up some Malarone from Tesco's.

Some beta on what I found out...
1. If you go to your doctors - they will give you a prescription for the malarone, but you still pay for the drugs and you end up paying for a prescription charge too...
2. Some pharmacies (including the large tesco's near me) have a pharmacists qualified at the required level to dish out Malarone.
3. Malarone is now out of copyright (or whatever it is) so you can get the clone pill for about 60% of the branded cost at some places (probably well worth it if you're away for more than a week or two)
4. Mine cost £2.99 a pill... you can get them cheaper online - but you have to get an online consultation (or prescription) which some websites charge for... It was easier for me just to go down the road in the end...

TT

[Bubba]

Have you got some nasty strong DEET as well?

[slackline]

Drink G&T's, lots and lots of G&T's. 

Isn't that for if you've been infected?

Yes but theres no harm in drinking lots of G&T, especially if your in warmer climes.

[AMorris]

Malarone will work fine, no need to worry too much about resistance since its a combination of drugs, one of which has reported resistance problems and the other not so much. The most important thing is (as previously stated) to try to avoid getting bitten, bed nets and DEET are the best option here. Check bed nets for holes every night since the mosquito that transmits falciparum malaria (the 'worst' kind) is an almost exclusive night biter and is notoriously tenacious and voracious and will find a hole if its there.

Apart from that, enjoy! If you have to take Malarone before a trip, it is obviously to somewhere beautiful

[Falling Down]

Just watch the DEET on anything plastic or rubber.  I've still got some gnarly skin thing on my feet after spraying them with Jungle Formula and wearing my flip-flops which melted.  Careful with your sunglasses and glasses as it'll melt them too.

[tomtom]

Just watch the DEET on anything plastic or rubber.  I've still got some gnarly skin thing on my feet after spraying them with Jungle Formula and wearing my flip-flops which melted.  Careful with your sunglasses and glasses as it'll melt them too.

Yes - I realised the plastic erosive power of DEET when I used my computer after applying some and it took all the laquer off the plastic wherever I touched it!

[tomtom]

Malarone will work fine, no need to worry too much about resistance since its a combination of drugs, one of which has reported resistance problems and the other not so much. The most important thing is (as previously stated) to try to avoid getting bitten, bed nets and DEET are the best option here. Check bed nets for holes every night since the mosquito that transmits falciparum malaria (the 'worst' kind) is an almost exclusive night biter and is notoriously tenacious and voracious and will find a hole if its there.

Apart from that, enjoy! If you have to take Malarone before a trip, it is obviously to somewhere beautiful

Thanks - thats good advice - much appreciated.

[SA Chris]

Don't get DEET on clothes too, it can bleach them. Although if you go somewhere warm enough for mozzies, I'm sure you've be looking suave in a white linen suit anyway.

[tomtom]

Don't get DEET on clothes too, it can bleach them. Although if you go somewhere warm enough for mozzies, I'm sure you've be looking suave in a white linen suit anyway.

Are you taking the pith?

[Fultonius]

Just read all of the above - helpful.

Do you guys normally take your own mozzy net for sleeping?

I got 36 Malerone tablets from work. I'm not sure if I should just try and avoid being bitten and then I have them for treatment if the shit hit's the fan, or buy another few boxes and take them daily. We're only in Indonesia for about 20 days, then the area we're going to in China is not indicated as high risk.  I suppose we could just buy 1 more box and that would at least cover us for the Indonesia part.

Boots Travel Clinic recommended I get immunized for Japanese Encephalitis, but the 2 travel clinics that my girlfriend went to (one in Amsterdam and one in France - long story)  didn't even mention it.  Has anyone else bothered with that? It's another £150.

[tomtom]

Malarone were all fine.. (I felt bad one day but that could have been anything..).

Interestingly two German doctors staying at the same place took nothing - deciding the chance was so low they'd be better off treating it if it happened.

Malarone etc.. Are all prophylactics (stop it taking root/spreading) but the best prophylactic is not too get bit in the first place!

[Stubbs]

You must be a tight bastard if you are weighing up spending £20 with getting malaria!

I had the Jap Enceph jab when I went to PNG for work; I can't quite remember but I think you only need it if you're visiting farming areas, a travel clinic should be able to help you decide whether you need it or not.

[Fultonius]

I'm not a tight bastard at all - just trying to weight up the risks against the costs. If we just did eveything that Boots travel clinic recommended, it would cost us:

Jap Ence - £150 each
Cholera - £100 each
Rabies £150 each
Malaria 61 days - £240

That's £640 each 

So far I've discounted

-  cholera (if I don't already have immunity it's just a bad dose of the shits)
- Jap Enc (planning to avoid pig farms and rice paddies (especially at night)

We are both getting the rabies jabs and I think we'll probably just take the Malerone daily while in Indo, but China (and the week in Melbourne in the middle) should be ok.

[tomtom]

 Iirc all rabies does is buy you some time before treatment - so if you are going to be in places where you can get to a docs in 24 hours etc.. It won't make any difference. Plus it's a horrible injection...

[AMorris]

Sounds like you already have a plan, if you are going to be camping in unusual places (in the bush for instance) then bednets (possibly pyrethroid inpregnated) and DEET would be a good idea, even if you aren't DEET is a must and bednets are wise. If you already have malerone then use it, although it can be used as a treatment as well as a prophylactic there is no point in risking getting malaria and knocking out a few days whilst you treat, they are unlikely to be a relaxing few days of treatment!

[chris05]

Whereabouts are you going in Indo? I have spent quite a bit of time out there and have only taken them when I headed to the Timor region. I wouldn't bother in the more populated central parts and didnt bother for that region the second time. Just wore long clothes and socks in the evenings/slept under a mossie net and used sprays.