malaria

what is the best way to avoid malaria? meds? Plan to travel around Loei/Nan/ nong khai. Any other necessary immunizations needed? Thanks for any information

Keep your body covered in mozzie repellant and wear long sleeve shirts and long trousers, shoes and socks at night. Prevention better than cure.

Both Loei and Nong Khave had flooding so I imagine there will be a lot of standing water.

john

Contary to belief Thailand is not known for malaris outside jungle type conditions,
However as previously stated, long sleeves and mossy repellent,
I was told malaprone.available in the UK AND ELESEWHERE I beleive was the best on the market, take two to three days before entering a malaria area and same after leaving, will give you a measured immunity.

I have never taken any meds to prevent it in 6 years hee and traveled to many places including the jungle.
If you are susceptible to catching infections be very careful.

I also have not taken any meds to avoid contracting malaria.
I prefer to wear shorts in the evening and the only precaution I take is to spray ankle and legs with mozzie repelant and then only when I remember, maybe 50% of the time. Taking a risk, maybe, been lucky, maybe. Up to individual.

well, i'm a mozzie buffet, no precautions and so far, lucky................but take the precautions mentioned, prevention is better than meds. especially if you get a dose of malaria while on meds, as it may mask the symtoms and real treatment is delay, which will cause more of a problem. dengue fever is more of a concern, but same applies. dawn and dusk, munching hours, try to stay covered.

is there a good brand of repellant available there? Long sleeves and long pants all the time there? Sounds awfully hot. Would shorts and tshirts be risky?

Koy Yo 15 (sp.?) is always good small plastic bottle cheap as chips, or one called 'OFF' white and orange plastic bottle,Roll on's too expensive in Boots, just pop in a chemists/7-11...and Galee, Shorts ..!! in Udon..in the Evening... tsk tsk tsk. lol.

Canuck, Malaria doesn't occur in the places you mentioned, nor in most parts of Thailand. The only places you might need to be a little wary would be in remote jungled areas, near borders such as Burma.

Dengue Fever is more likely to be an issue, for which you should take the precautions mentioned above - use a mosquito repellent, be more wary around and shortly after dusk, stay away from still or stagnant water, maybe wear long trousers and socks (though they can get you through socks!). Mossies usually "hang out" around trees and shrubs and shaded areas, and under bar and restaurant tables!!

Hi,
Had what i thought was malara the other month, went to the hospital and had a full check up. Doc. said he has not seen any cases of malara caught in the Udon area and i did not have it. Caught another bug instead but it worried me for a few days. Asked in the doc's in the U.K. the other week and he said there was no need for it in Thailand.
Cheers Doug.
Still wearing shorts and open sandals all day and night, no socks, to warm in summer for anything else, and sleep in the buff. it's more comffy,

Thailand
Summary of recommendations Medications Immunizations
Recent outbreaks Other infections Food and water precautions
Insect protection Air pollution General advice
Ambulance Medical facilities Traveling with children
Travel and pregnancy Registration/Embassy location Safety information



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Summary of recommendations:

All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.

Malaria: For rural areas bordering Cambodia and Myanmar, prophylaxis with Malarone or doxycycline is recommended. For rural areas bordering Laos, either Malarone, doxycycline, or Lariam should be taken.
Vaccinations: Hepatitis A
Recommended for all travelers

Typhoid
For travelers who may eat or drink outside major restaurants and hotels

Yellow fever
Required for all travelers greater than one year of age arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.

Japanese encephalitis
For long-term (>1 month) travelers to rural areas or travelers who may engage in extensive unprotected outdoor activities in rural areas, especially after dusk

Hepatitis B
For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months

Rabies
For travelers who may have direct contact with animals and may not have access to medical care

Measles, mumps, rubella (MMR)
Two doses recommended for all travelers born after 1956, if not previously given

Tetanus-diphtheria
Revaccination recommended every 10 years




Medications

Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A recent study indicated that, due to the frequency of quinolone-resistant Campylobacter in Thailand, the most effective antibiotic is azithromycin (Zithromax), given either as a single dose of 1 g or a three-day course of 500 mg/day (Clinical Infectious Diseases 2007; 44:338-46). Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or a quinolone antibiotic: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) (PDF) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as diphenoxylate (Lomotil) (PDF) or loperamide (Imodium) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.

Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.

If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.

Malaria in Thailand: prophylaxis is recommended for rural areas bordering Cambodia, Laos, and Myanmar, including Mae Hong Son. The malaria risk in Phang Nga and Phuket is very limited; therefore, prophylaxis is not recommended for these two areas. There is no malaria risk in Bangkok, Chiang Mai, Chiang Rai, Pattaya, Ko Samui, and Ko Phangan.

For the areas near Cambodia and Laos, either atovaquone/proguanil (Malarone)(PDF) or doxycycline may be given. Atovaquone/proguanil (Malarone) is a recently approved combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics. The recommended dosage is 100 mg daily, starting one-to-two days before arrival and continuing for four weeks after departure from the malarious area.

For travel to rural areas near the border with Myanmar (but not Cambodia or Laos), either Malarone, doxycycline, or mefloquine (Lariam) may be given. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine. Those taking mefloquine (Lariam) should read the Lariam Medication Guide (PDF).

Insect protection measures are essential.

Long-term travelers who will be visiting malarious areas and may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours. See malaria for details. Symptoms of malaria sometimes do not occur for months or even years after exposure.

Cases of malaria are sometimes reported from the southern part of the country (see "Recent outbreaks"). Because the risk appears to be extremely low, malaria prophylaxis is not generally recommended for travel to the south. However, travelers should be aware that the risk, though small, does exist, and should immediately seek medical attention if they develop fever or other malaria symptoms.

For further information concerning malaria in Thailand, go to the World Health Organization - South-East Asia Region.

Lots of good information on the website from the renowned Hospital for Tropical Diseases in London.
For all forumites based in the UK the Hospital Shop is a great place to buy travel kit, the Ultrathon Insect repellent is the best I've used.

http://www.thehtd.org/Default.aspx

Get yourself to Tesco or Big C and buy some good lemon body wash, wash your body especially your feet everyday with it. The mozzies dont like citrus. Wear long sleeves as others have said, long pants and socks. If you do get bitten dont scratch the bite get some Siang pure oil (About 110 baht a bottle) and apply to the bite.

The other half had an older sister many years ago she died of Malaria, it is around, but you would be very unfortunate if you caught it.