Anti-malarials in India

Nick-H

Not tiny at all! Probably the majority on my last flight back to India! And, if you'll excuse the necessary divide here, numerically it is 'them' rather than 'us' who are returning to UK with malaria.

Some stuff on immunity here. In fact a whole site on malaria there; much more than I could digest. Some people have a natural immunity given by the fact they suffer from something else! Acquired immunity is complex. I won't even begin to try to repeat any of the stuff i didn't understand on that site! It is not of consequence to travellers, anyway (except, of course, to those who think they are immune and discover that they are not.
That is not such a weird notion, and is to do with the fact that most of these traveller's tummy bugs are trivial, but caused by bugs are bodies are not used to.

I do not drink the tap water in my house until it has been through a rather expensive purifying machine. However, I'm not in the least bothered about the odd mouthful in the shower, on the toothbrush, or on the cup I'm about to use, so I probably could. I would not advise my foreign visitors to do so, though!

This immunity is real, but it is an immunity to trivial bugs; it would not protect against (taking a moderately wild for-instance) introduction of cholera into the tank because a flood has mixed sewage into the water!

It is also an immunity that is lost, as my friends found when they, having spent two years in London, tried drinking the water at their Chennai house as they always had before. They were hospitalised, but the doc confirmed it was nothing major, just bugs their bodies were no longer used to.

That doesn't mean that I'll touch the tap water in another district, or even house! No way is this immunity to India's water! We take bottles of our own water out with us.

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machadinha

I meant that in relation to overall malaria figures this is really insignificant. A couple of planeloads of tourists or remigrants have little bearing on the worldwide malaria situation or statistics. They might in the UK though (or fill in any western country). Like you said yourself, most casualties or sufferers even are not tourists anyway and have likely gone nowhere -- although (often very localized) economic migrations do play a clear role (there's that poverty again...).

We're talking an estimated couple of hundred million cases and a couple of million deaths each year folks, how many of those do you think were tourists? (I'm not attacking you Nick, I know you're aware of the issues. I sometimes wonder if people are aware of the scale of it though. Not because of their precious skin btw, which is probably fairly safe. And I'm not talking skin color either.)

That's exactly what I was saying yes; I find it worrisome that even good friends of mine believe that if they take in the water piecemeal or something this will save them from anything, and that if they then don't fall sick this "proves" something.

Whereas in fact save for y'r average Delhi belly, most of the serious diseases we're really concerned about one either contracts them or one doesn't, of course. There is no resistance or immunity to say cholera or amoebic dysentery and what have you. (Or not that I know of anyway, in case any disclaimer is needed.)

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Nick-H

The point is that, other than academic interest, it is malaria among those who are not resident in malarial areas that is of interest on this site --- not the majority of malarial sufferers who are resident in those areas. We may be a small minority, but we are the ones we're talking about!

My point about the huge majority of those at risk belonging to that resident group was in response to and in the context of a rather odd suggestion that foreign (not in India) doctors were, in some way, better qualified to deal with the issue in visitors than an Indian doctor, or better able to deal with other traveller's ailments than a local man.

In fact, although the conversation may have moved elsewhere, I still maintain that, for the long-termer, apart from being prepared for the first few weeks, it is better to get health advice on all these issues from a local doctor. Real, day-to-day experience beats access to a database!

machadinha

Yes; agreed on all these points, certainly.

grikoo

You can develop resistence to anything that you can be vaccinated against, cholera being one of those, and regular low-level exposure works essentiallly the same as a vaccine. Also, other similar diseases like typhoid, hepatitis, etc. Again though, it's not immunity, and more complex organisms like malaria, giardia, etc, tend to be more difficult for your body to become resistent to.

And of course, I wouldn't at all think about trying to build up resistence intentionally.

Anyone heard about the breeding of malaria resistent mosquitos? I had read several years ago that India had been considering the possibility of introducing a larger number of these in an effort to skew the mosquito gene pool.

edwardseco

Of course, that would be the idea of a potential vaccine. A goofy friend would suck on coins to get some advance contact with germs before travelling. No thanks..

grikoo

Or you could get a hug from ammaji.

machadinha

It (or something similar) was reported on here (for Malaysia) just recently, one can find other news reports on it: gm mosquitoes nearing release in Malaysia

edwardseco

Ho, ho, ho, good one. I'll take that..

all-one-heart

http://www.fitfortravel.scot.nhs.uk/...maps/india.htm

You suggested the above link. I went there, but I'm still not too sure...

I'm going to be in Pondicherry in July. From the looks of the map, if seems I might not need to do any preventive treatment?
Sure like to avoid all that stuff. Or is the season too wet?

Can you advise?

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all-one-heart

Nick-H

There are always mosquitoes, even though it is unlikely to be very wet.

Close to the sea there will be fewer.

The map you link to is advise from the British National Helath Service; there are those here who would say it is wrong.

As you want to be in Pondy in July, and it is already June, you probably do not have enough time to follow up all our controversies in all our too-many malaria threads!

As I say, you have already shown basic NHS advice: the decision is up to you!

grikoo

Or you could spend a couple of hours reviewing the malaria threads here for a more balanced, if not contradictory view of the subject.

Nick-H

hours?

He's got a month or so. Not long enough!

Frenchy

My wife and I are travelling through Kerela, Delhi, Jaipur, Then Dharamsala, Varanasi ans Bodhgaya From November to mid-December (6weeks). And what I surmise from the 5 pages of posts is that the risk is minimal but if you do contract malaria you'll regret not having taken preventive medication. Our nurse at the local travel clinic here in Canada suggested either Doxycycline (cheap but not so great for women because of yeast infections and some unpleasant side-effects) or Malarone (expensive at $5/day).

We will of course take all the nessesary precautions (deet, long sleaves, nets over beds...) and it sounds like we should take the malarone for the whole trip and dish out about $350.

That would be the safest bet I think.

Any opinions?

edwardseco

I love that map since it ignores weather and specific location. Hyderabad in general is safe. But, my people's area is besides a lake and floods so..