Doxycycline Question

TurkP

I plan to move to Delhi in the next few weeks and my doctor and the travel doctor are recommending Doxycycline, one a day as a malaria prophylactic.
As I am going to be there just in time for the monsoon and will be all over the sub-continent it probably is a good idea.
So my question is can one just take the pill once a day and not lather on the deet?
Not that I want to take a pill and sleep outside next to a swamp or bog or anything but just how much protection does a pill a day provide.
Thanks

bruce3404

I don't think any responsible health care practitioner would suggest that you do anything other than protect yourself as well as possible against potential bites, so this would mean (as a minimum) using DEET at dawn and dusk unless you're going to be in an air-conditioned space. You should surely ask this question of your travel Dr, though I doubt if any studies have been done. Who would volunteer for such a study?

Nick-H

Being bitten is not fun, and mossies carry several other very unpleasant diseases.

An antimalarial is not a substitute for a repellent.

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TurkP

Thanks, I'm coming from the tropics and get bitten all the time but there is no malaria here and dengue is all but non-existent.
I'll take the pill and the usual precautions.
Was on Malrone whilst in Africa last year no side effects.
Two year contract in India this time and don't really relish taking the dox. for that long so maybe just during the wet season and until i get used to all the new bugs.
You have centipedes there I presume, don't like those guys at all.

machadinha

You should really realize no prophylaxis that I know of offers 100% protection from getting the disease; it just offers some protection and slows down the symptoms in case you do get it, thereby buying you some time to seek proper treatment. (Some would argue against them as it makes it harder to diagnose those symptoms.)

So, no, the one should never replace the other, and you should seek protection and prevention as much as you can no matter what other measures you've taken (and, of course, proper treatment in case of any symptoms). I'm afraid there's a false sense of security in many takers in that sense; you should still try to avoid being bitten.

Staying long-term you'll really want to look into the side-effects of whatever you're taking, yes, of course. I'm not aware of any drugs that can be taken for as long; I take it some expats on this board will just take them at times of increased risk, which could be something of a compromise.

Tropical centipedes, yes, yikes... We feared those more than scorpions (which weren't very harmful btw, would get you sick for a day or so though) where I grew up. Don't know too much about those in India, but I'd assume they have them yes. It could be the South American variety if that's where you're from are more venomous. They pack an impressive punch (hospital visit normally required, and a bite is potentially lethal if not treated), better steer well away from them. What doesn't help is they're aggressive too.

Never got bitten mind, I mean what are the odds. Give your shoes a good shake before putting them on, which is good avice most anywhere in the world and certainly in the tropics anyway. Ditto before lying down in your hammock or bed and such.

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TurkP

Thanks

"So, no, the one should never replace the other, and you should seek protection and prevention as much as you can no matter what."

Sage advice.

Nick-H

My favourite Malaria publication, from UK's Health Protection Agency covers advice for long-termers as well as for those returning to their native country on top of the usual travelling crowd. It does cover the question of long-term usage and the possible side effects. It also has a more-than-usually detailed map of India (ie it isn't just a 'malaria exists here' small blob) and, if I remember correctly, Delhi is not considered high risk by that particular authority. It does say that the problem with taking some of the drugs long-term is not so much that there is a problem, as that they have not been tested and licensed for long-term use.
PDF, Link Here.

Are you immune to the effect of your local mossie bites? Many Indian people hardly react at all to Indian mosquitoes. Be interesting (err... especially for you I suppose) to see if you react differently to the mossies of another country.

Bite avoidance is great, in theory. Like one can actually avoid getting bitten! But one can minimise the bites. Anyway, sounds like you are pretty familiar with mossies already!

grikoo

I agree with all that's been said so far, and only add the following:

Learn to love long sleeves. That way you can usually get away with only DEETing your neck and shoulders (they'll bite right through where the fabric lays flat on your skin, like on your shoulders). You can always roll up the sleeves if it gets too hot.

Nick-H

Mossies love ankles! They'll even go for fingers. They'll bite anywhere! .

Long sleeves help to protect your arms from the sun too.

grikoo

Yes, ankles too. I forgot that one, being the lover of socks that I am.

Hands and face too, but generally you're going to shoo them away from your face whether you have deet on or not, and your hands are usually in your line of vision too.

edwardseco

Nick is the champ on getting bitten.

Least of your worries by far! Ahead of that is the cat sized rat species that I encountered one evening in the garden. In the interest of the environment I turned on my heels and fled. Touts are worse..

Nick-H

Saw one big rat here a couple of weeks ago: our cats were just sitting looking at it!

Have seen much bigger though: I remember watching one from a second-floor window, thinking, at first, in the night, that it was a dog!

Cockroaches are worse than the centipedes!

machadinha

So what are centipedes (and millipedes -- more harmful because of their excretions though I think, not their bite) in India like anyway?

Funny enough, studying up some on it a while ago, I gathered centipedes are quite poisonous (and aggressive) in the Netherlands even. Yes, that's those tiny things you find in the garden. Can't say stories of victims fly around the place though, far from it. Never heard of any cases, in fact, and never had nor was brought up with any awareness of this.

Nick-H

Not seen many. The few I did see were interesting colours, not huge at all.

machadinha

Hm, yes. I'm not sure if size equals dangerousness. Although those Caribbean ones: Did I say yikes, already? They're huge, man.

btw Cockroaches: just a pest yes. Not harmful as such, though. Although they're said to be carriers of some 70 diseases or so. They mostly just clean up the place though. That I don't like them has been established before, one just has to learn to live with them I guess (and to keep one's surroundings tidy).

Maybe a common trait in both species is they're practically indestructible. We emptied full cans of hairspray on those centipedes and they'd just crawl on.