Malaria Risk In Kerala

Ahh...

Some bad advice roams the streets of Kerala.

1) Forget what any one person tells you about their experience. Statistics are not about the individual. They are about the collective. Some clown tells you in these posts, "Heck, I didn't take that nasty medication and I didn't die" He is the individual. Collectively there is malaria in Kerala. And just wait 10 days after the start of the rains there will be more - watch those Aedes aegypti breed!

2) I doesn't matter if you are fit in your 40's eat organic bat skat on bread made from the wheat you ground yourself. If you are not in an endemic malaria area normally, doesn't matter how fit you are... when you get it, it will make you very, very sick. Sicker than the people raised and who live in an endemic area.

3) Malaria is bad enough but it is plasmodium falciparum that will give you lots of regrets for not taking your prophylaxmeds. Vivax is bad, falciparum makes that a picnic. And it is in Kerala.

4) If the meds bother you, change them. There are lots of choices. If you are there a few weeks, it is a minor problem, and the benefit outweighs the problems.

5) Peace Corps have their heads up in a dark place. I was one in Central America and saw one of ours lose 40 lbs in two weeks due to malaria. PCVs like to believe that they are made of the same stuff as the local population. But, we are not. We don't have the exposure so we are really vulnerable.

Take the damn meds. If you start to have problems, call your doc for a change in them. It will be a great trip, and you will come home safely.

Good first post there.

Welcome to IM.

Hey everybody!
Liznola pretty much said what had to be said here. Good Job!!!

I will add some more info. Malaria is present all over India, rural areas and cities except on altitudes over 2000 meters (Himachal Pradesh, etc). 40% is P.Vivax, 20-40% P.Falciparum and the rest is P.Ovale and P.Malariae.

There is evidence that the most dangerous parasite (P.Falciparum) is more spread in the post monsoon period, and P.Vivax infections are more common during the monsoon period.

Some individuals (preferably black africans and black americans) who doesn't express the blood group Duffy on their red cells are immune to infections with P.Vivax but not infections with P.Falciparum.

There are other genetic differences in populations that also can regulate the susceptibility to be infected with malaria, mainly within the HLA-system. If you are a native in an area where malaria is endemic, you are more protected than the visitor.

Clinical trials of a vaccine for malaria has been encouraging. A recent study in africa (2011) showed that it prevented 50% of the cases of malaria including the worst cases. This could save houndreds of thousends of lifes. In 2009 800 000 people died of malaria (90% infants in africa)

Infections with P.Vivax can be deadly in some cases or you get really sick. So be well informed when you shall take the decision: profylaxis or no profylaxis. Use a net and repellants and if you are going to use profylaxis, bring the meds from your country (beware of low class meds that has been found in third world countries).
I brought meds from home and started to take them in september and took them for ten weeks during my last trip to Goa. But thats me

Phew! That was a lot of scientific jibberish, I hope it makes sense to you all. Be careful out there!

Bolenath (yes I am a doctor)

Malaria is present in the whole of India below a certain altitude as stated.

However, how much of it is around and the level of risk varies widely. The British National Health Service map is good.
As per that map, Goa is not a "low" risk area, and antimalarials are advised.