Anti malaria Prophylaxis

[Hoveronly]

Any idea which malaria prophylaxis is safe to take on a protracted basis and still fly?

Malarone ok?

[gingernut]

Apologies if I'm teaching you to suck eggs, but your choice of drug should depend on your itenary and level of risk. I'd suggest taking expert advice from a travel clinic, as some drugs may be contra-indicated in pilots.

Here's what my (dated) text books suggest- you can ring the manufacturers to clarify.

Chloroquine- up to 5ys
Proguanil- indefinitely
Mefloquine- licensed in th uk for 3m, but can be used for up to 1 yr
Doxycycline- 3m, long term effects unknown
Malarone- don't have the info. (mefloquine is proguanil+atovaquone).

The evidence surrounding these is pretty scant, so you may find expert opinion differs, although if you could be more specific, I'm sure that you may be able to elicit more expert opinion. :-)

[slim_slag]

Your best bet is to talk to locals and see what they do. I doubt you will get many on here who truly know much about malaria. It gets taught in Western medical schools because it's reasonably well understood, demonstrates an interesting life cycle of the disease itself, and an interesting disease interaction between species. After your final pathology exam it gets relegated to the 'interesting but useless' part of the brain.

From what I've heard from such locals the best prevention is barrier, not pharmaceutical. Only people who should be taking prophylactic medicines are visitors.

[gingernut]

I doubt you will get many on here who truly know much about malaria.

Probably guilty- I rarely go further than Cornwall myself, and most of my training has had some links to drug companies. Bite prevention is certainly your best friend.

Its worth remembering though that the humble mossy is the worlds biggest killer, and malaria kills about 4-5 returning travellers to the uk each year.

[Killer Loop]

I live and fly in PNG where malaria is extremely rampant. I was on Chloroquine last year and actually contracted the disease which almost killed me. After a quick visit to the UK to get the all clear the doctors at the Tropical Disease Centre told me that Chloroquine was pretty useless in my particular area and that I should take Doxy instead. I guess time will tell.

[flyboy2]

Guys
Your advisors need to be 'genned' up on latest malaria treatments-per area.

In Central & Southern Africa "Coartem" is often used with great success on aircrew with malaria. This contains the Chinese Root extract-Artesimin- but has another item included.
Once diagnosed as having the Falciparim parasite in the bloodstream, the victim can recover within a week-but not necessarily when infected with Cerebral Malaria !

Taking prophylactics on a long-term basis is NOT healthy for pilot's , so prevention is better than cure. All have side-effects, some are very serious-so beware & be warned !

Use sprays, creams,long-sleeves, long-trousers,mosquito nets,sleep under a fan[mossies cannot aviate in a downdraught]. Read al you can about malaria before going to Malaria areas.

[Dan Air 87]

I have also used some of the medication listed on the forum. I have used Malarone a few times but found that if I am using it for longer than 2 weeks I really get sick with dreadful stomach problems.

So, after extensive research, I now always stick to doxy and have done so for the last three years. The only other tip I would add here is that if possible include some natural yoghurt in your diet. I appreciate that you can't get the stuff everywhere where we are travelling but it helps to replace some of the bacteria that have been killed off by the doxy!

Take care now!
DA87

[soggyboxers]

Over 28 years flying in West Africa now and I've been lucky enough never to have had malaria as yet. When I first came out here I took the old chloroquine and nivaquine, which are now almost completely useless. I took no prophylaxis for many years, but always kept whatever the latest treatment was in case of emergency for self-treatment (from quinine sulphate to Halfan to Malarone as newer treatments were found). When I was working in Cameroun our client oil company insisted that we take anti-malaria prophylaxis and i took Malarone for a few months, but then gave it up when it gave me problems with stomach acid, mouth ulcers, headaches and eyesight problems. I took doxy for about 6 months with no problems except being more prone to sunburn.
I'm now back in Nigeria and I take nothing, but as some people here have said already, I take precautions to try and avoid getting bitten, For my emergency treatment I carry Coartem (artemether and lumefantrin) which is currently the drug of choice in this part of Africa. Artemether, combined with other anti-malarials currently seems to be the most effective treatment (though that will doubtless change).
Most doctors in Africa will know what the best drug is for their part of the continent (provided it's available to them) and many of the better hospitals and clinics can get a blood test result in a very short time to determine whether you do have malarial parasites in your blood and which strain you have.

[Killer Loop]

Woke up this morning feeling like a bag of sh@t. Had a test done. I have malaria. Obviously please take very little notice of my reply above as I clearly have little or no idea of what I'm talking about. So it's straight onto the Artemether and Fanzidar. Oh what a joyous 4 days or so I have to come!:yuk:

[Pangur_ban]

The London School of Tropical Medicine have a very helpful information department and are more useful than, say, travel clinics when it comes to advice regarding long-term usage and risks of anti-malarials. I'd imagine that their links with the military will mean that they have dealt with pilots many times.

As for the duration of use for the medicines, this info is being updated on a regular basis as more gets known about the newer drugs. Mefloquine (Larium) for example used to be limited to something like 3months but can now be taken for much longer as it has been around long enough to gather more data. Having said that, pilots are not supposed to use it.

Without teaching folks to suck eggs.....Best advice is to check what the local drug resistance is (from a reputable source). Find a non-resistant drug and check with Aviation Med specialist that is ok to take when flying. If you have a specific drug in mind I can probably find out how long you can take it for (email the drug name to me) - but I can't comment on suitability for flying.

And cover up!
PB

[Farmer 1]

A simple, straight answer to your supplementary question, Boboutofkenya: yes. We were issued with Malarone, and required to take it, and I never heard of any bad effects from anyone. However, I am aware that they can and do exist.

Whatever you decide to do, I would give you two pieces of advice: don't listen to any old wives, and there are many; and when you return to a part of the world where malaria is not prevalent, U.K. for instance, carry with you a letter explaining that you have visited a malaria-prevalent area, and include an emergency telephone number. So, if you suddenly keel over, the medics can do a quick diagnostic test, rather than thinking you might have flu/vertigo/be drunk etc.