malaria protection

angiec18

we are off in 2 weeks to HAMPI (Southern Karnatika) Mysore, Nagarhole, Coonor, Madurai, Kerala. We have been told by one chemist no need to take medication for southern india?? Another chemist seemed a little unsure? Can i ask what others have done, and any tips please - to take or not to take? angie

Shaktipalooza

Your chemist is dead wrong. Malaria is endemic to all of India with the exception of higher elevations (6500+ feet according to CDC).

Best advice is to make an appointment with a travel clinic. They will also be able to administer the recommended jabs for India.

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cyberhippie

It seems Shakti that things have changed in the UK and some medical advice is saying this.

Shaktipalooza

Yes it seems there's been a growing trend of not taking malaria prophylaxis while on holiday.

BBC: Deaths 'show malaria drug need'


Deaths 'show malaria drug need'

Britons travelling to exotic locations are being warned of the risks of contracting potentially fatal malaria by health experts.

The number of travellers to malarial areas has soared by around 150% over the last decade.

But people are not taking anti-malaria tablets, putting themselves at risk, the Health Protection Agency said.

Last year, three people died after 26 travellers to The Gambia contracted the most serious type of the condition.

The HPA is warning that nine out of 10 Britons who contract malaria are carrying this form of the disease - plasmodium falciparum.

Latest figures show that of the 1,722 Britons with malaria in 2003, 1,339 had plasmodium falciparum - 78% of cases, up from 17% if cases in 1977.

That year saw 16 people die from malaria, up from nine the year before.

With the number of people being killed, it is so important to remember to take the treatment prescribed by the doctors
HPA spokeswoman

The increasing trend of taking a break in a far-flung destination or heading of for a last-minute holiday is leading to people not thinking about malaria tablets, or forgetting to complete the whole course, the HPA said.

Travel to India has more than doubled over the last decade, and more holidaymakers are heading for destinations such as Cambodia, Thailand, the Middle East and Vietnam, according to the Association of British Travel Agents.

An HPA spokeswoman said: "It's not so much complacency, it's people thinking they won't need malaria tablets for what they see as a normal holiday.

"The indication is that, the number of cases is decreasing but the fatality rate is increasing.

"The message would be that, with the number of people being killed, it is so important to remember to take the treatment prescribed by the doctors."

She added: "A lot of people forget once they come back that they need to continue to go through the whole dose.

"In addition, people visiting friends and family who may originate from an area where malaria is present may wrongly think they are immune."

Travellers visiting malarial areas are being advised to visit their doctor or travel clinic before they go abroad to get advice on the best anti-malarial measures.

Once abroad they should use insect repellent, keep arms feet and legs covered and sleep under mosquito netting if outside.

Early signs of malarial infection include fever, a flu-like illness, shaking, muscle ache and tiredness.

Merchant

You don't "need" to take anti-malarials to visit India--it's just your choice, following the advice of a medical professional. Some people take them, some don't. Risk is affected by where and when you go. If you visit most parts of India between now and June, it will be bone dry with very few mosquitoes (they breed in standing water). If you go in July-August, everything will be wet after the monsoon, and you'll be at increased risk.

Despite having written the last paragraph, you really shouldn't get medical advice off the internet. You will get widely divergent opinions here, which may or may not be helpful. It's your decision--take the advice of someone qualified.

Nick-H

How I wish that was true here!

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abfab

I don't think this article is referring to travellers to India!

They quote the HPA in the article, however, the HPAs own very latest advice for travellers to India, specifically recommends NOT taking anti-malarials for large parts of India for most people (updated Jan 2007).

There are a few areas and cases where they do recommend some anti-malarial drugs, but most of North and South India are now concidered to be Low risk.

abfab

Your chemist seems to be echoing the latest advice being given to British tourists to parts of India at the moment.

I was given the same advice by Trailfinders Travel Clinic only a few days ago.

There are some parts of India where anti-malarials are still recommended, mainly Assam, and a band of states across the centre of India.

The Health Protection Agency has issued a booklet with the very latest detailed advice for travellers to India at:

http://www.hpa.org.uk/publications/P...ica tionID=87

The important thing to remember is that even in the low malaria risk areas of India, it is extemely important at all times to avoid being bitten by mosquitos. There is still a small risk of malaria, and there are some other very nasty diseases you can catch from mosquitos!

The HPA booklet above also has guidence on avoiding being bitten.

Have you talked to your GP, or a Travel clinic about your trip by the way? There are several very highly recommended vaccinations which you should concider before you travel.

beklemmung

One small thing - Shakti mentioned jabs in post #2, but as far as I know there's no such thing. You just have your choice of a variety of pills.

/edit - he was probably speaking about vaccinations in general... anyway, I'll leave this here.

Shaktipalooza

Read the article. It does mention India. If you do a little research you will also find reports of europeans on holiday in Goa contracting malaria.

India Malaria Stats

If you look at the stats there is some info about Karnataka, one of the OPs destinations. 2005 is the latest year data is available and indicates over 80,000 cases for the year. Also note that cases mapped out month by month show malaria reported for every single month of the year. The numbers do vary but not nearly as much as would be inferred by the previous comment about the next few months being 'bone dry with very few mosquitoes'. At nearly 9,000 cases for March it falls in the middle of average.

The HPA website does have a brochure Indicating low,medium, high risk areas including parts of South and North India.

abfab

The HPA does recommend anti-malarials for some parts of India, and this cluster in Northern Goa is very well documented.

There were a total of 9 cases reported for the whole of Europe, and they occurred over a period of a few weeks in December and January, in one area of northern Goa.

Only One case was from the UK, and he reported that he used no mosquito net or mosquito repellent. The patient reported that he had been bitten extensively during his second week in Goa.

All 9 patients recovered.

The HPA made the following statement:

"In recent years, the number of malaria cases reported in travellers returning from India has been low and decreasing, so that most advisors, including the Advisory Committee for Malaria Prevention in UK Travellers (ACMP), stopped recommending chemoprophylaxis for visitors to low-risk regions such as southern states of Kerala, Tamil Nadu, Karnataka, Goa, and southern Andhra Pradesh (including Hyderabad and the city of Mumbai [Bombay]).

Low to no risk regions are Rajasthan, Uttar Pradesh, Haryana, Punjab, Delhi, Uttaranchal, Himachal Pradesh, Jammu, and Kashmir. For full chemoprophylaxis recommendations for India and the rest of the Indian sub-continent please see table 9 on page 44 of the malaria prevention guidelines.

This recent cluster of cases, which has coincided with increased rainfall in the affected region, lead to the recommendation that
travel advisors should highlight the risk of malaria, instruct on the use of mosquito bite avoidance measures, and recommend malaria chemoprophylaxis to those travellers who will be visiting Goa, particularly areas north of Panaji, who will be remote from medical care."


I'm not entirely sure what point you are trying to make in your arguements here.

Are you claiming that the advice being given to the UK Government and to travellers to India by the HPA is wrong?

You do realise that the HPA is an eminent and major organisation whose data and conclusions are peer reviewed by top scientists and doctors throughout the world?

It is perfectly reasonable for you to draw your own conclusions as to the risks to foreigners in India, but I don't think it is reasonable for you to expect other readers to place your opinions (or that of a sensationalist article from the BBC) on a level with the HPA.

Shaktipalooza

abfab - I don't intend to argue, just stating an opinion. Yes HPA is a legitimate organization but is not the only source of information. Their numbers do clash a bit with historical trends, which do not typically nose dive from medium risk to no risk at all.

Anyway, this is getting old. I hope the OP takes the time to research multiple sources of information before making a decision. A visit to the travel clinic is a must.

julesa

i've been on Doxycycline for about 7 weeks and haven't noticed any side effects. my doctor showed a map of india which said it was all a malaria risk so i just took them, no probs to report.

cyberhippie

abfab

I'm also questioning how the HPA arrived at these conclusions independant of other sources who disagree??

Nick-H

Am I right in thinking that malaria is now considered more treatable than it was even a few years ago? I think this is one of the considerations, along with which strain exists in an area, is a factor in determining the advisability of taking prophylactics.

It may be that, in the future, Chickungunya and Dengue will be considered the big-risk mossie-born diseases associated with India. the former is, very disabling for a period of weeks or more; the later can be fatal, with increased danger of fatality on a second infection.

Shakti, thanks for the link to the HPA booklet. I think I had the previous edition, but this one looks bang up to date