Malaria question

wasleys

I apologise for starting yet another thread on malaria but could do with some advice from people who have specific knowledge concerning the situation outlined below.

My wife and I are visiting India and Bhutan for a month from mid-October. In outline our itinerary is as follows.

Arrive Delhi from UK for two days.
Fly to Bhutan, spend three weeks on the road to Tashigang.
Day drive from Tashigang across border to Guwahati for overnight.
Train to Delhi.
Train to Mount Abu, few days drive via Narlai to Udaipur for train to Delhi.
Day in Delhi.
Fly home.

Having referred this trip to our practice nurse we have been told that we will need malaria protection for Bhutan but not for India with the exception of Assam. In Assam we will be exposed to a particular risk which will require a different type of medication.

Because of potential conflict between those medications, interaction with other medications I take (especially anti-coagulants) and because pharmacists have access to the latest travel advice we have been advised to seek the advice of a pharmacist. We will, of course, do that.

Looking at the NHS advice it appears to be at variance to some extent with WHO advice. The information I have been given about Bhutan seems questionable.

My own assessment of the situation regarding malaria follows.

In Bhutan from arrival at Paro to Tashigang there is no significant risk thanks to altitude.

On the day’s drive from Tashigang to Guwahati, the overnight in Guwahati (Hotel Dynasty) and trip to the station the following morning there is a potentially serious risk. However the chance of exposure during a daytime drive and night indoors is very low.

In Delhi and on the Mount Abu to Udaipur section there is a slight to moderate risk.

Comments on my assessment of the situation and suggestions for an appropriate approach to protection on this trip would be welcomed.

Michael

jolly72

There is nothing to worry about at all about Malaria. Just keep some mosquitto repellent with you.

However, try to avoid getting infected from Swine Flu anywhere during your trip. Its not that a major problem in India yet, but as you are travelling many countries...

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Nick-H

Well, yes, it is yet another malaria question, but we won;t rush to the rant given the specific questions

1. Do you know the NHS publication on malaria and travel? It is excellent. It is aimed at healthcare professionals, but is accessible to laymen too. You can download it from -->here You need to check out the FPA site for updates too. There is nothing like getting professional advice, but it is good to take a look at the source as well.

My personal opinion is to go with the Brit advice; it is more detailed in terms of areas. Unless the WHO site got updated since the last time I saw it.

2. The internet is an excellent source of information on drugs and drug dependencies and inter-reactions. The information may even be available on the manufacturer's own site.

I think Assam is not only high risk, but has the nasty form of malaria. I haven't a clue about Bhutan.

Never rely on mossies biting you at set times. Disturb them and they'll take a snack; any time. Of course, there are day-biters as well, that carry different diseases.

There's always someone around with downright bad advice. Nothing to worry about? Just a small matter of death...

edwardseco

I love a nurse but maybe not for detailed knowledge of tropical medicine. Glad to know there is no risk of malaria in India so I didn't get it after all..

Nick-H

In UK --- a nurse is all you'll probably get, and their primary source of information is probably the book I referred to above. What's more, unless you go to a specialist tropical diseases hospital, or a private travel clinic, they are probably just as qualified and informed as the doctors at a general practice. It was certainly the case at my local practice that the nurse ran the travel clinic and immunisations and gave the jabs.

Haylo

The UK advice given to short term visitors is NOT that there is no risk of contracting malaria in India, but that malaria protection (i.e. medication) is not recommended in many areas, and depends on length of stay and other factors - except for visitors to Assam which has a particularly nasty and resistant strain.

The view of the British medical establishment is that the risk of an average holidaymaker in India contracting malaria in many areas is low and does not warrant the use of malaria medication which often has harsh side effects.

The UK advice for short term visitors to most areas is to protect yourself by taking measures to avoid mosquito bites, rather than by taking drugs. This strategy has the additional benefit of also protecting people from dengue fever, as studies have shown that people who are taking malaria medication can be more careless about mosquito protection, as they have the perception that they are "safe"

They also consult the NHS "Fit For Travel" website, which has an excellent malaria map. Different parts of India have wildly varying climates and vary from being zero risk whatsoever to high risk.

Any website which gives precautions for "India" is to be treated with the healthy scepticism it deserves.

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shishu8

Dont worry about Malaria if you take some basic precautions you will never get it. Just a piece of advice , you can start taking some multi vitamins and doing some breathing exercise or Yoga to increase your immune system. When you are in India, eat lots of raw onion if you can, and also try eating some indian curries with turmric and other local spices in it. Turmeric has excellent healing properties and it inreases you immune system. This will give you quite a protection from local diseases. Also for any mosqito bites and itching you can rub onion juice on it and it will not give you any trouble. This is based on ancient Indian home remedies , so do it on your own risk (though there is negligible risk) or ask your local doctor before you use it.
Now a days swine flu is in news so take lots of preautions to avoid flu. Consult your local travel advisory office before you travel. All the best for your visit.

Shashank

Haylo

Are you suggesting that yoga, multivitamins and rubbing onion juice on a mosquito bite will prevent malaria - which is caused by a parasite?

If so, your advice is dangerous, and if I'm not mistaken, complete bollocks.

shishu8

I already said it is an ancient home remedy. Do it if you trust. There is lot of literatue avaible on internet about Malaria and how to avoid it and the treatment to seek.
My advice was not for Malaria but for many other local ailments that could effect the traveller. Again I said local home remedy and it has always worked for me , so try on your own risk.

Haylo

Garlic is an excellent tiger repellent. I have never once been attacked by a tiger after eating garlic. Go tiger hunting at your own risk...

edwardseco

Wow, that is quite a statement about the hidden rationing of health care but irrelevant to the topic here {files it away}..

The worst part of this topic is that so little actual research goes on over malaria considering how many it affects. Attention Gates Foundation..

camelgirl

My husband also takes anti-coagulants and he cannot take any of the regular malaria meds, however he does take doxycycline instead. Hope this helps, if you decide you do want some malaria protection. http://www.anytestkits.com/doxycycline.htm

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jolly72

all that matters is how much immune your body is about all such pitty deseases.. Yoga and multivitamin will actually increase your body's ability to fight.. once you are ready a simple bite from a poor less-than-a-gram mosquitto can not harm a-70kg-plus human being otherwise just drinking plain water in india may upset you

take care.

Nick-H

simple bites from less-than-gram mosquitoes kill millions every year.

I wish we could stop people posting such utter bullshit, but it is a free world.

You don't seem to know much about water either. Water-born diseases are hardly a simple matter.

jolly72

Without any offense, let me clarify. many of my friends from countries wheer the water is 'free of any desease', when come to india and drink unbottled water, they fell ill the very first day in India. Whereas, I have been drinking the same water from last 35 years without any problem. people from other countries who have been drinking not-so-clean water have no problem either in India.
same body immunity case is true with mosquito bites as well..

However, I completely understand and appreciate your concerns about your health during travel..

would suggest you to please also consider making arrangements for drinking water and high temperature apart from malaria during your india visit.

it was just my personal opinion which you may again find a bull shit, but please accomodate