Malaria outbreak in Goa

Noodle · Jul 16th, 2007, 00:03

Quote:

Originally Posted by machadinha

Recently looking up something on malaria there I found the entire article was a direct copy from some other site (apparently reputable in this case). It stated the source in the small print, but still dubious practice to me, I wonder if permission was ever sought or given.

With many of their articles or parts thereof you'll find them all over the web and the origins of who started quoting who will be unclear, let alone their trustworthiness. It's an inherent issue with the open-source make-your-own-encyclopedia concept I guess. They seem pretty good and quick on defacement efforts, but the system seems to naturally break down on subjects where they lack the experts to keep it in check, so there's a whole lotta blatant nonsense to be found as well.

You're right

Mickey S · Jul 16th, 2007, 00:18

Quote:

Originally Posted by blackbird

I think we have an overexaggerated fear of malaria in the west, it has a sensationalised reputation. That isn't to say it's not dangerous... but two people I've known who lived in sub-Saharan Africa (where the risk is higher than anywhere in India) told me not to take the prophylaxis, because to people in those countries malaria is viewed more like a bout of flu: you will probably get it from time to time, just make sure you get diagnosis and treatment promptly and you'll be fine. One of them had had it once, and the other twice, but their attitude to it was much more relaxed than mine.

Why not just take the tablets? I have never understood the attitude of travellers who decide not to take anti-malarials; it's only a one-a-day (or, in the case of Larium, one-a-week) tablet, after all. Why risk it?

Nick-H · Jul 16th, 2007, 00:41

Blackbird, yes, malaria is still one of the world's big killers, but I suspect you are right about who it kills.

I remember a story about ten years ago about a young member of a wealthy Indian family visiting UK. He had an encounter with a general medical practitioner similar to my fictional example above, and was dead within days.

The discovery that quinine was effective against malaria was a great economic breakthrough. Previously, the disease had ravaged and decimated and workforce trying to construct the Panama Canal. Quinine made it possible.

India has far worse and even more dreaded diseases such as polio and diptheria --- but we do not consider these, having being imunised against them in our youth.

Mickey --- there is more to it than just taking the tablet. Thinking has moved on and that is not necessarily the current advice. It is a decision for each person. Personally I would not touch Larium, ever, at all, never. Each to their own

Noodle · Jul 16th, 2007, 00:43

Quote:

Originally Posted by Mickey S

Why not just take the tablets? I have never understood the attitude of travellers who decide not to take anti-malarials; it's only a one-a-day (or, in the case of Larium, one-a-week) tablet, after all. Why risk it?

Side effects, both short and long-term. Already present other diseases, so weakened body ... (liver and kidney especially to watch out for)

machadinha · Jul 16th, 2007, 00:45

<cross-posting>

Quote:

Originally Posted by Mickey S

Why not just take the tablets? I have never understood the attitude of travellers who decide not to take anti-malarials; it's only a one-a-day (or, in the case of Larium, one-a-week) tablet, after all. Why risk it?

Personally, because I don't like the associated possible side effects, esp. with extended use, some of which exacerbate conditions I'm prone to anyway; and because as noted their use is of limited use anyway.

I can't stress enough these are personal decisions though; factors to help your decision should include where and when are you going, what is the current advice on it, how long are you going for (on a short trip the benefits may well outweigh any ill effects), what is your personal medical history, what are your general predilections, do you think you can take the necessary precautions, etc. None of us can answer this I believe.

And remember, no matter what your decision, it is a potentially fatal disease, and can turn out so surprisingly quickly. And if you don't care, maybe those you leave behind will.

Nick-H · Jul 16th, 2007, 00:59

It is well worth considering that the area of India you are visiting may not have resistant strains requiring the newest super drug.

70s-80s overlander · Jul 16th, 2007, 03:15

Comment #1: my memory is that the recent outbreak of malaria in Goa was of a variety not viewed as common in that area.

Comment #2: in terms of the advice above that one should just go get a lab test if one has a fever, via Google I found two Indian medical articles noting the cost [2001 said 80 rupees for the 2 tests; 2005 said 60 rupees for the 2 tests]. Having a smear of your blood looked at by a physician or a well-trained lab tech is recommended as the primary intervention, but the focus of these articles was on what to do in rural areas lacking medical personnel. Each of the blood tests alone had its problems, but having the two blood tests done together was considered to provide sufficient accuracy in the hands of even untrained personnel. While 60 rupees probably is a lot of money for some rural Indians, it sounds like there would be no excuse for an Indiamiker not at least to get some blood drawn.

federica · Jul 16th, 2007, 03:29

Quote:

Originally Posted by blackbird

I think we have an overexaggerated fear of malaria in the west, it has a sensationalised reputation. That isn't to say it's not dangerous... but two people I've known who lived in sub-Saharan Africa (where the risk is higher than anywhere in India) told me not to take the prophylaxis, because to people in those countries malaria is viewed more like a bout of flu: you will probably get it from time to time, just make sure you get diagnosis and treatment promptly and you'll be fine. One of them had had it once, and the other twice, but their attitude to it was much more relaxed than mine.

You have to add that growing up in a Malaria region can give you partly immunity against it (not full!!!) It means a foreigner from a non-Malaria area is more prone to catch it than a local! I am sorry, I can't quote the sources anymore, and i can't explain the reasons here (too complex, and I am not from the medical field)

But malaria falciparum is really no fun, nothing like "just having a flu".... for some tough people it might be, but not for all. The cousin of a friend lost her life, leaving behind her baby. I have to add that it was not in India, but still...

machadinha · Jul 16th, 2007, 03:31

My understanding is even this immunity idea is a fluke. Locals may catch it once and die, or not; or they may catch it over and over again -- and die, or not.

blackbird · Jul 16th, 2007, 03:43

Quote:

Originally Posted by Mickey S

Why not just take the tablets? I have never understood the attitude of travellers who decide not to take anti-malarials; it's only a one-a-day (or, in the case of Larium, one-a-week) tablet, after all. Why risk it?

Firstly, I'd just like to say that I never told anyone not to take the tablets. If anyone asked me outright, I'd say take them. Why? Because if someone takes my advice not to take them, and then get malaria, the finger could be pointed at me.

On the website for my infant travel business I say "You must follow your government’s advice on malaria protection." That's not just about covering myself -- the first time I went to India I didn't know if I'd ever be able to afford to go again, so it was a holiday of a lifetime for me. So in that situation, taking the drugs for 8 weeks for a 3 week holiday made sense, as it reduced the chances of my once in a lifetime holiday being ruined by malaria. But I didn't like the side effects so when I went for 2 months I decided I didn't want to take them for 3 months. I balanced the risk in my mind and decided not to, based partly on the advice of people I mentioned earlier who had actually had the disease.

Everyone has to make their own decision, and I decided to go against the official advice from my country, but I'm not going to advise anyone else what they should do -- I'm not a doctor. If you decide not to take the drugs you have to take responsibility for that decision, and not blame anyone else.

So Mickey if you believe that it's always better to take the prophylactics, I'm not going to argue with you. It's your decision, and maybe you are right and I am wrong. If I ever get malaria I will accept that not taking the drugs could be the reason. Although as they don't totally protect you against it, you never know.

Quote:

Originally Posted by federica

You have to add that growing up in a Malaria region can give you partly immunity against it (not full!!!) It means a foreigner from a non-Malaria area is more prone to catch it than a local! I am sorry, I can't quote the sources anymore, and i can't explain the reasons here (too complex, and I am not from the medical field)

But malaria falciparum is really no fun, nothing like "just having a flu".... for some tough people it might be, but not for all. The cousin of a friend lost her life, leaving behind her baby. I have to add that it was not in India, but still...

The people I'm talking about are English but lived in Africa for several years, so there was no question of immunity.

I appreciate the tragedy of your friend's cousin, but to me that doesn't affect the overall picture. I understand that malaria falciparum is more deadly, but that most malaria cases are not this strain. We probably all know people who have died in road accidents but we still travel by car.

It's great to be able to share information about malaria, I have learnt a lot from this thread, but we won't all come to the same conclusion on the issue.

federica · Jul 16th, 2007, 03:56

Quote:

Originally Posted by machadinha

My understanding is even this immunity idea is a fluke. Locals may catch it once and die, or not; or they may catch it over and over again -- and die, or not.

You can read about it here:
http://www.cdc.gov/malaria/biology/humanhost/index.htm

There are several more scientific sources if you google "malaria+immunity", but they are not understandable for people with an average knowledge of medical terminology.

TDK · Jul 16th, 2007, 21:29

Quote:

Originally Posted by federica

You can read about it here:
http://www.cdc.gov/malaria/biology/humanhost/index.htm

There are several more scientific sources if you google "malaria+immunity", but they are not understandable for people with an average knowledge of medical terminology.

Hi All, just thought you might find the following links useful:

http://www.thehtd.org/travel/destination.asp?DocID=86

http://www.masta-travel-health.com/

http://www.ktl.fi/portal/english/ktl/news/?id=1119

http://www.channel4.com/health/micro...l_malaria.html

I had all the classic symptoms of malaria about ten years ago about a week or 2 after being badly bitten by mosquitos in A.P. i was bed ridden/didn't eat for a week and my American neighbour upstairs was carried out dead at the same time! However, like, Nick H i still wouldn't take Larium due to the possible neuropsychiatric side effects. I also gave up on taking other alopathic prophylaxis as i don't like to take medications long term, but everyone has to decide for them selves ofcourse, and best to get a blood test asap at 1st symptoms.I've found the MASTA approved Mosi Guard spray very good and natural also so good for kids too.

All the Best TDK

federica · Jul 17th, 2007, 01:24

Quote:

Originally Posted by blackbird

I understand that malaria falciparum is more deadly, but that most malaria cases are not this strain. We probably all know people who have died in road accidents but we still travel by car.

Even I would still go to India

I would just increase the precautions... compared with the road accidents were I normally use a seatbelt/crash helmet, don't drive drunk or with drunken people, don't drive when I am too tired etc.

For some people it might be prophylaxis, for others repellents work better. It's a highly individual and personal decision. I think it is important to be informed about the disease (as good as possible), about the prevention and what to do in case you get it. And to update this info regularly...

Sama · Jul 17th, 2007, 06:12

sorry,

Quote:

Originally Posted by Nick-H

India has far worse and even more dreaded diseases such as polio and diptheria --- but we do not consider these, having being imunised against them in our youth.

The US Center for Disease Control advises travelers to India to get a polio booster because the shots we got as kids are no longer effective. and yes, I did get a polio booster before my first trip.....

edwardseco · Jul 17th, 2007, 06:47

A worthwhile note Yogagal. Somewhere I read that the pill/shot have a recommended time period for effectiveness..

Jul 16th, 2007, 00:41	#33
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 26,875	Blackbird, yes, malaria is still one of the world's big killers, but I suspect you are right about who it kills. I remember a story about ten years ago about a young member of a wealthy Indian family visiting UK. He had an encounter with a general medical practitioner similar to my fictional example above, and was dead within days. The discovery that quinine was effective against malaria was a great economic breakthrough. Previously, the disease had ravaged and decimated and workforce trying to construct the Panama Canal. Quinine made it possible. India has far worse and even more dreaded diseases such as polio and diptheria --- but we do not consider these, having being imunised against them in our youth. Mickey --- there is more to it than just taking the tablet. Thinking has moved on and that is not necessarily the current advice. It is a decision for each person. Personally I would not touch Larium, ever, at all, never. Each to their own __________________ . Just one member of the IndiaMike Mod Team

Jul 16th, 2007, 03:15	#37
70s-80s overlander 70s-80s overlander Join Date: Sep 2005 Location: chicago,il,usa Posts: 152	60 rupees for both malaria blood tests (april '05 price) Comment #1: my memory is that the recent outbreak of malaria in Goa was of a variety not viewed as common in that area. Comment #2: in terms of the advice above that one should just go get a lab test if one has a fever, via Google I found two Indian medical articles noting the cost [2001 said 80 rupees for the 2 tests; 2005 said 60 rupees for the 2 tests]. Having a smear of your blood looked at by a physician or a well-trained lab tech is recommended as the primary intervention, but the focus of these articles was on what to do in rural areas lacking medical personnel. Each of the blood tests alone had its problems, but having the two blood tests done together was considered to provide sufficient accuracy in the hands of even untrained personnel. While 60 rupees probably is a lot of money for some rural Indians, it sounds like there would be no excuse for an Indiamiker not at least to get some blood drawn.

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Jul 16th, 2007, 00:59	#36
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 26,875	It is well worth considering that the area of India you are visiting may not have resistant strains requiring the newest super drug.

Jul 16th, 2007, 03:31	#39
machadinha Not Your Guru Member Join Date: Jan 2005 Location: yörp Posts: 10,574	My understanding is even this immunity idea is a fluke. Locals may catch it once and die, or not; or they may catch it over and over again -- and die, or not.

Jul 17th, 2007, 06:47	#45
edwardseco Maha Guru Member Join Date: Sep 2001 Location: Land that shakes and bakes. Posts: 3,932	A worthwhile note Yogagal. Somewhere I read that the pill/shot have a recommended time period for effectiveness..

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