This topic came up last night while a group of us were planning our trip to Morocco in Oct 2013. I thought I would write about it as I have had a fair bit of experience with malaria.
I have had malaria about 25 times now. When I worked in Sierra Leone for a year and a half I would get it usually about once a month. I had other cases working in Western Tanzania and once or twice since then. The first time was a bit of an experience as I didn't realize what I had until suddenly my vision went black & white and I keeled over walking across a compound...thought the world looked very strange sideways. Since then I have learned to recognize my symptoms early and carry medication that nips it in the bud quite effectively. Everyone has different symptoms but in general you feel exhausted, achy and find it hard to concentrate. You will also do the hot sweats and cold shivering thing if you let it go far enough.
I only took an anti-malarial medication once as a prophalaxis (sp?). That was in the military while deployed to Rwanda in 1994. We were given Mefloquine (trade name Lariam) as were our troops in Somalia. This was one of the first trials of the drug. Safe to say it was a disaster. Really steady guys began suffering from depression, strange behaviour, vivid dreams/nightmares and even psychotic reactions. We had several suicides and guys doing bizarre, dangerous things with fully loaded weapons. Now Lariam is available to the public but if you read the fine print up to one in five people will have a reaction to it including depression and psychosis (sp?).
Since then I do not take a prophylactic medication to prevent malaria. Over time the meds can be harder on the body than actually catching malaria, which if your careful, isn't much worse that a case of the flu or a very bad cold. I carry a full course of MALARONE with me everywhere. This is nine pills which are taken three times a day for three days. For the malaria strain of P. Falciparum (the most common strain) this will clear it up quickly with no side effects. If you think you have malaria and take the full course and were wrong, again, no side effects. I did managed to get two types of malaria once, P. Falciparum and P. Ovale in western Tanzania. The malarone took care of the first but didnt quite finish the second and had to get a specialist medication. But these other strains are quite rare, especially in Africa.
My recommendation, and that of my beautiful, talented wife who is a well travelled journalist, (she is watchiong me write this) is that if you are going on a short holiday, taking anti-malarials as a prophalaxis is okay. For anything long term it is just too hard on the body. And, prophalxis doesn't prevent malaria virus from getting into your bloodstream, only from reproducing. That means it may just sit there waiting to spread after your holiday.
So, my advice in a nutshell is:
- Don't take mefloquine (Lariam) ever!!!!!!!!!!!
- Don't take ant-malarials as a prevention method unless your trip is a short one.
- Carry Malarone or similar as a treatment if you feel you have the symptoms
- Research what malaria strains are common where you are going
- Sleep under a mozzie net and wear long sleeves/pants in the morning and evening.
- Don't let the fear of malaria ruin a trip...it really isn't a big deal for healthy, active adults.
This is especially important
"We've got a date with Destiny...and she's ordered the lobster!"