vaccines and malaria?

qwertyjjj

Do you need any vaccines for India?
I'm pretty sure my yellow fever and normal polio, tetanus, etc are up to date.
What about anti malaria tablets? I'm pretty sure when I was in Delhi a few years back, I didn't need to take AMs but some sites I see say it is necessary all over India.

machadinha

As in required, no. (Unless you're coming from a yellow fever area, in which case indeed a yellow fever vaccination and proof of it is mandatory.)

For the rest, my normal advice would be to look up your local travel health clinic/doctor specializing in the same. There are of course vaccinations that are highly recommended, and then malaria prevention itself is an endless debate. Discuss it all with them. Depending on where you ask, the modern approach towards malaria prevention indeed tends to veer towards regionalized measures, and I believe it is so in the UK, too; so their advice will likely depend on your planned itinerary, not a blanket advice for all of India, with the emphasis being on just bite prevention in no little (but far from all) of the country. It is so in the Netherlands where I live.

Don't forget many vaccinations need some time to kick in, or they may come in the form of a repeated course; I think though am never sure where I live, it is advised to start looking into it a month before travel.

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qwertyjjj

IME, they look it up on a map, if it is a malaria area, they prescribe AMs regardless. The problem is you only need 1 bite, it just depends on how concentrated malaria is in the region.

Nick-H

What else do you expect them to do?

At least your UK agency rates different parts of India as having different levels of risk. You can see the map here and get the full lowdown here

Klompen

It's a hugely complex issue with no right answer fits all...

Gosh that feels like such a cop out after years of researching the subject.

But at every stage and over the years, the rules have changed country by country and there has been a sadly consistent conflict of international opinion on the ins and outs of protecting yourself against Malaria within India's shores.

So sadly in my opinion (can't we have some international conformity on this?)

You will have a hard time evaluating the risks and acting appropriately, it's a quagmire of ambiguous information.

But side effects aside (another HUGE subject)....Doxycycline, Paludrine & Chloroquinine, Lariam and Malarone are all effective, read that closely effective because this word is largely replaced with recommended in health literature ....There's world of difference but for many people in mom and pop Doc practices it's often confused with suitable/not suitable..

Unfortunately for the traveler they sometimes miss prescribe due to this?

Or deny requests for a particular anti malarial.

The question of the risk division across India is equally blurred....

Just ask your doc, and take it from there which is the only responsible (albeit shortened) advice I can give you.

It's down to your personal comfort zone in the end............SHAME! Health authorities!

qwertyjjj

That's interesting, why the surge in Goa compared to surrounding areas which are low risk?
Also, I heard some people sya it was cheaper to buy the AMs in India? Can't I just drink lots of G and T

Nick-H

I'm not sure that tonic water still contains quinine, and I'm not sure that it would still be an effective antimalarial. Either way, I'm afraid the gin would just add to your problems, helping you to become dehydrated in the heat!

You can get some antimalarials in India, but please note the requirement to start taking before entering the malarial zone, and to continue afterwards.

I have no idea on the why-goa question. a wild guess would be migrant workers. It's a very wild guess: I've never even been there.

Just to answer my own question... I'd expect them also to consider which strains of malaria are present in a particular area, including considering what resistance there is, and the what different strains are likely to be present. No malaria is fun, falciparam [I think?] can get to your brain and kill you quite quickly.

machadinha

That is of course what they do (or again they do where I live at least), and so now different types of antimalarials will be prescribed, or rather recommended -- no one will force you to take them --, for different areas (and then for some areas indeed they won't be at all, but rather to concentrate on bite or should we say technically rather sting prevention). They'll now ideally take into account any adverse side effects that may be contra-indicated in your situation; if not, you should stress that they should. (Liver conditions as well as, with some antimalarials, psychological issues would immediately spring to mind. A good practitioner should enquire about these.)

I know again at least where I live (not because I in fact "know" that, but one gets that clear impression) they'll try and gauge as well if you know your way around in the tropics and specifically in your destination a little, and so have some idea of how to take some simple preventative measures, and generally look after your health there. That is to say I'm sure they won't let their advice depend on that, but they'd no doubt get a little more adamant about it if they sense you don't. I've been directly asked about my travel history, and good for them, and with about each visit to them, and then they'll soon notice if you know where you're going or not and what your general approach to it is, these people aren't daft. Rather, they are of course seeing prospective travelers all the time, and my feeling with no few of them here is many of them know such destinations first-hand. As well as then their clients, and their various categories of care and carelessness.

Then again I do find such procedures and advice much more reasonable and helpful here, and open to indeed mutual discussion, than what one hears of some other countries, just as costs here don't tend to run up to what apparently it may elsewhere (in fact much of it is insured here under our national health package). Little to do about it; between ambiguous advice and different approaches among medical practitioners, worldwide or even within the same country, or ditto among any random group of lay travelers, I still know what I'd prefer. If it costs some, yes, so that should be reckoned as falling under your general travel expenses. Not being able to afford it shouldn't be a reason not to (rather than having made a rational and considered decision to that effect), but maybe consider rather that if it's prohibitive, you can't afford your trip.

Your health is really not something to economize on.

Yep, and you'd be essentially self-medicating. To each their own, but it's not what I would do. This isn't a cold you're looking at.

To take malaria prophylaxes or not is another debate altogether (I sometimes have, sometimes haven't, based on various considerations, and indeed including with good feedback with such docs), and lord knows it's been done to death here and elsewhere on the web and beyond; but if you do at all, I'd personally seek to do it properly, and so under proper guidance. Else, what's the point, one might wonder.

machadinha

... But so anyway, a quick further glance would of course affirm that Qwertyjjj is looking to go there on a spur of the moment and very soon, and so presumably mostly wants to hear affirmation that nothing is necessary.

Qwertyjjj, you can do the maths yourself, and it's otherwise asking for the obvious as we say where I live. You'll have to make up your own mind. All the reasonable advice you've been given above, and could have thought of yourself; anything beyond that really is up to you.

Don't ask anyone else to confirm that's not necessary; it certainly wouldn't be the responsible advice to give on a board like this.

If the only concern is it's short notice, then of course start what you feel is necessary rather today than tomorrow, and then finish (or indeed if absolutely necessary: start, though this wouldn't be recommended if you can avoid it, for all the reasons mentioned) whatever is needed once there.

Nick-H

Not if you asked a doctor, you wouldn't!

Last time I looked, which is over a decade ago, some of the prophylactics were available in British pharmacies over-the-counter (Chloroquine, proguinol, can't spell either!) so a certain amount of self-prescription might be fine. To self-medicate in case of suspicion of the disease itself might be suicidal.