Malaria and Child

cp5

We are leaving for our big trip to India in 2 weeks. My 16 month old son is going with us also. His pediatrician gave him Mefloquine 1/4 tablet once a week! I took this when I went to India about 5 years ago and I got really ill! In fact I was so ill the day of our flight that I had to see a doctor in emergency to give me a shot to make me feel good enough to get on the plane! Nuts! Anyhow needless to say I stopped taking them and I didn't take it 2 years ago when I went either. So this is my 3rd trip in 5 years.

Okay so now the question! I don't know what to do with my son!? Should I give it to him and risk the side effects or just do all the preventative stuff like long sleeves+DEET+hat and shoes at all times! So the only part that would be exposed would be his face and hands!

Anyhow have any experience with giving a child mefloquin? I'll be predominately in Punjab (Jullundhar) and we may go to Pakistan for 5 days and maybe stay in Delhi at the end of Nov for 4 days before coming back home! Any thoughts? So I'll be there from Oct 16-Dec1.

Thanks in advance,

CP

Gayamom

Hi there:

You need to get your 16 month old to a travel clinic before leaving for your trip. See if you can find a recent copy of the American Academy of Pediatrics' Red Book at your local university library; it's on-line too, but you have to pay to view. The Red Book is the textbook everyone uses to guide them in matters of pediatric malaria prophylaxis (in the U.S.). You'll want to look at a copy that is dated 2003 or later.

Anyway, I took a look at the Red Book; either mefloquine or atovaquone-proguanil are the recommended agents at your child's age for malaria prophylaxis. The dose varies by weight.

This is not meant to be medical advice -- please see your travel clinic for that -- but you should know that malaria due to both P. vivax and P. falciparum remain endemic in the Punjab and Delhi/ surrounding area. Morbidity and mortality are highest in young children. DEET-based repellants need to be used with caution in those under age 2 -- please ask your travel clinic for specific advice in this regard. Long-sleeved clothes and bed nets in the evening/ night are excellent ideas.

Every year, my hospital takes care of children -- mostly of non-resident Indians -- who were taken to India, whose parents didn't follow recommendations and who come home with malaria. I won't vent here but . . . please go see your travel doc, follow his/her recommendations, and then you can relax and enjoy your trip!

I'm taking my four year old to south India this winter. She'll get her shots, take her prophy, and I'll take lots of precautions to avoid insect bites. I'll make sure her food is piping hot and home cooked if possible. She may come down with a febrile illness and will probably have a diarrheal illness (I had both, when I was an American kid taken there for the first time); I'll need to have a plan to take care of these possibilities.

Whenever I write these medical posts I feel like a fearmonger. That's not the intent! You'll have a fabulous trip, just take a few precautions (like malaria prophy for your little one, if the travel doc recommends it and he/she probably will).

Cheers -- GM

P.S. This post is general information and observation. It is not meant as specific advice to you and should not replace the advice of your physician. Please seek your physician's advice before making decisions for you or your family.

shanthi

Isn't this a copy of the same thread begun earlier today/yesterday?? I believe there were quite a lot of "answers" on that thread CP5

Callous

Hello we too were in Jalandhar in June with our children.We have travelled to India twice this year and we did not take any antimalarials at all.We took other measures and we had no problems.The mossies were quite bad at night in Srinigar but repellant and sensible clothing seemed to work.Enjoy Jalandhar,we loved our time there with 2 Sikh families,it is indeed one of India's friendliest states.

msague

I will be travelling for 2 weeks in Delhi, Agra and Rajasthan with two kids. Someone told me it will be about 21 Celsius (70 Farenheit) during the day. Should I be concerned about mosquitoes with that temperature?? I really don;t want to give my children malaria profilaxis. I live in Florida, USA and when we have similar temperatures in winter there's no mosquitos.

thanks!

Nick-H

Might be a really good idea if you did!

Probably the best-informed post in malaria, especially the risk to children, that I've ever read. We all seem to have our opinions on this subject, and I guess I've posted mine along with the rest but, apart from occasional words from someone who caught malaria, most of the stuff posted is not based in experience, personal or professional. Thank you Gayamom for your informed and experienced view.

Do you think that is too hot or too cold for mossies? They don't care, except when it gets really hot. That is about the only advantage of the hottest months here in Chennai; very few mossies.

I sleep under a net. I have netting over all my windows. It is far too hot here for socks or trousers (indoors ) and, anyway, mossies bite through fabric; they will even find the bit of your flesh that is lying next to the net at night. All these precautions just mean I get bitten less often than I did before

The only effect way to ensure no insect bites would be to live in a sealed box. Some precautions/repellents work for some people. Perhaps many of those who claim success (sticking out neck here... ) for their precautions are among those lucky people who do not attract mossies, or whose bodies do not react to the bites.

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wonderwomanusa

I suspect you will run into mosquitos at night and possibly in the day time -- the day biters carry dengue fever so you will want to smear some sort of DEET preparation over exposed skin on adults and children.

I like Cutter's which comes in "stick" form best; you may find it in hunting/fishing shops.

At night you may want to sleep with the fan on -- that makes it difficult for the mosquitos to land. You'll also want to light mosquito coils while you're out to dinner.

Don't try to translate your Florida "bug smarts" to India; the bugs will win.

cp5

Since I had similar questions while traveling to india with my then 16 month old I thought I'd write about my experience.

Yes give him the mefloquine or any other meds the doc recommends! I was so uncertain but he did fine on it and its the best thing I did because it really gave me peace of mind. Make sure your child is wearing long sleeve shirts, pants, socks and shoes at all times...! I made sure I put either a deet brand or natural repellant on him while we were outdoors. indoors we had the good night plugs on in every room, had the fan going at night since it was hot anyways.

Also don't take any bright colored clothes because that will attract the mosquitos. I always had my son in light colored clothing. Hope that helps! Its better to be safe then sorry!

CP

phobal

Just because you got sick doesn't mean your kid would get sick. You should consult your concerns with your doctor rather than a bunch of forum whores like myself. You should not have a child if you decide to take medicine into your own unqualified hands.

This is not a personal attack, I can relate to your concerns, but ineviatbly when I'm drunk at the airport, I tend to give more of an opinion than I normally would. And I normally give a pretty unrestrained opinion. Best of luck, let us know how it goes.

But whatever you do, don't be a jackass by throwing the dice hoping that you won't come across malaria in a region like India. That's like walking a blind man into a minefield, but saying everything will be ok because he has a white-stick.

cp5

Okay Phobal not sure what your excuse is for writing such a rude pathetic email but that may just be who you are!

I don't think you are in any position to tell me if I should or shouldn't have a child in the first place and secondly if you don't have anything constructive to write then maybe you should save yourself from writing...!

Thirdly I'm not sure if you are a competent reader or not because the last post on this thread is about my experience and what I ended up doing at the end with the meds!

GEEZZZ I guess we have all kinds of ignorant people in this world! We all have rights to make decisions and sometimes when it comes to our children they aren't easy decisions. If I didn't care so much about my son I wouldn't question everything that will go through his little body like the strong meds for malaria! My opinion! This forum is to get opinions from others that have been in the same situation...otherwise this forum wouldn't exist!

Have a very nice day!

CP

PeakXV

Phobal (fo-bal) - Canadian Hoser language meaning a little less than diplomatic & a little more than blunt - my way or the highway - especially so when stressed or intoxicated.

Best of Luck in your quest cp5!

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Don't go to India ~ Pre-trip Warnings & Misconceptions?

phobal

That was rude? Man, you don't know rude.

Wait for it...waiiit foooor iiiiiiiit.......


Sorry, I'll remember for your threads that "constructive" means "ego stroke"
and that "opinions" means "agreement"

cp5

Your not worth a response! Have a superb day!