Medical & HealthNews and debate about medical and health issues as they relate to aircrews and aviation. Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME.
Quick Question. Will be sent to Congo for 24 hours then down to J,Burg for 24 more before returning home. next week. Is it worth getting some Malaria Tablets for such a short stop over in Congo. and what might be a recommended type.
Thanks in Advance.
The best remedy against malaria, like was said by Johe02:
"Don't get bitten."
Now, DEET and stuff like that will help, especially being in the open, I would say also as soon as it gets dark, when mosquitos are getting active, wear long sleeves and long trousers with socks, and avoid areas with lots of mosquitos.
Next to that I would never go anywhere without my mosquitonet for the night, small investment IMHO to prevent something that can still kill you, although in most cases it won't.
Make sure the mosquitonet is not too small and can be tugged in under the mattress, and still leaves room for you.
(otherwise mosquito's bite you THROUGH the net)
Hope this helps...
PS Will try out the Vegemite although I don't find it an attractive idea.... But maybe it explains that my daughter who really loves it never had malaria.....
Malarone is your second choice, however it does have a number of side effects as well and is not recommended for pilots.
I was recently prescribed Malarone for a 6 week stay in India. The Doctor (at a Tropical Medical Clinic) advised that it was a relatively new drug and as yet does not appear to have any significant side effects. Care to elaborate on the side effects and why its not recommended for pilots?
As it happens I didn't bother with the pills as I'm in a relatively low risk invironment. The Deet sure stinks!
Malarone is the only prophylaxis that my airline will allow us to take, so I reckon it is approved for pilots.
During some long discussions about Malaria with a WHO doctor who had been working with malaria for most of his life, I discovered the following:
1. He does not take malaria prophylaxis long term, only when there is an epidemic.
2. At all times between dusk and dawn, limit visits outside, wear light clothing with long sleeves and trousers and apply Deet. Don't forget around your socks and all areas of exposed skin.
3. Malarone is new and does not show as many side effects as other malaria medicines.
4. Malarone an be taken as a "curative dose". I keep some in my bag and if I were to get headaches and a fever I would take it on his advice to help prevent the disease developing more.
5. Drinking Gin and Tonic has no significant effect. Some will tell you it does. The amount of Quinnine in a glass of tonic is minute compared to the amount you would take as a drug.
My airline offers the following advice:
If you stay in an air conditioned room and take precautions as above, the risk of malaria is very small. If you go on safari or out of built up areas, you should take Malarone, especailly if staying the night away from the hotel.
Having said that, one of our Captains did get the serious form of Malaria and nearly died. He followed the advice.
My own feeling is that I follow the advice of the WHO doctor or I would be on tablets almost all the time. Even though Malarone is taken the day before and 7 days after, the long term effects would not be that great. For a trip of your length, I would spray and cover up unless you intend to adventure a bit. That however is my opinion and you take the risks you feel appropriate.
Don't forget when you go to Africa that you can still get Dengue fever from the mossies that fly during the day (I still wear repellant in daylight) and that things like Bilharzia (Liver fluke) are very nasty and can be caught from still water. Don't swim in lakes!
The problem with all chemoprophlaxsis against malaria has been side-effects.
Malarone is a new and potentially useful combination of two drugs Proquanil and Atovaquone.
These two drugs have been used in isolation previously and have shown to have side effects.
Primarily and most commonly this is Kidney Dysfunction, which is often compounded by the relative state of dehydration that is often found in people visiting Malarious areas. (Hint drink lots of fluids)
I am very cautious of new medications that tout little side effects, especially when they are simply reformulations of existing medications that have been shown previously to have them. A bit like mixing snot and sugar and calling it icecream.
I am currently practising in a malarious area and NONE of the pilots (HM Forces) who I tend to are taking Malarone! It may well be a safe and effective drug, however in the environment that I am in maybe is just not good enough.
Whatever you decide to take is up to you, just take something. A recent study in the Congo has shown that by taking nothing you are at 6% risk of contracting Malaria following a 2 week stay.
But as I said talk to your AME or GP who will put you on the right track.
I took doxycycline for 2 months when in Mozambique and broke a tooth on a piece of not very hard bread after 5 or 6 weeks so perhaps it's true that antibiotics are very bad for your teeth & bones......
If I ever go again I wouldn't take the tablets but would take the 'curative dose' of malarone.... and cover myself in deet... and invest in a top of the range mozzy net.
Is the 6% figure for people who take no precautions at all? How does DEET and permethrin nets etc affect the figures.
I was in Zambia recently and picked up a course of artesunate from the local pharmacy before heading into the bush (tend to think the locals know what the score and that's what they recommended). Never came across that before, looks effective from the insert, is it any good? Pharmacist said malarone was just too expensive and he didn't stock it, his price was higher than mine would be at Boots.
Talking with the locals who don't take prophylaxis or precautions, they expect to catch malaria about every 1-2 years. They quickly recognise it, start treatment and are back at work a couple of days after. That's what they claim, anyway......
They also claim that charring bone, grinding it up and rubbing it in cuts in your back gives you strength! Be careful of local folklore. Malaria is the worlds' second biggest killer, so what you will actually find is that most local remedies don't actually work.
My airline supplies Malarone as part of the package when we stay in Africa (Sierra Leone, Ghana, E Guinea). Seems to provide good protection and minimal side-effects..(delhi-belly at times) I also pack a can of insectiside for my room, and finally deet 50%....as well as following the advice to cover-up etc. Been visiting for 7 months..through the rainy season, I havent been bitten...touch wood!
Jetstream, tend to agree that there is some strange stuff practiced in some parts of the world (and the UK isn't exempt), but artesunate comes in a nice blister pack and is made in Belgium. Have taken the time to look it up, and it seems to be pretty good stuff, better than quinine according to The Lancet. An old Chinese herbal remedy from wormwood, so maybe we should add absinthe to our G&Ts. Of course if you listen to the pharmas it will be counterfeit
On who's recommendation has malarone been deemed unsuitable for pilot's?
And on what evidence do they make this recommendation?
Sorry to be picky, but it sounds like this is an important issue for commercial pilots, particularly as mefloquine (larium) is seen by some, as "being contra-indicated in those performing precision activities."