Pilots and Malaria
 

M A L A R I A ..

We had a great thread running last year or the year before ... can we start another with tips and tricks how to combat this dreaded disease ?

Nearly lost another friend last month of cerebral malaria. :sad:

I have a few tricks up my sleave if enough interest is raised.

Cheers,

Gunnsss

GT
 

Hey Guns, I've clearly managed to avoid this disease by staying drunk! Many years ago when we all had to take the pills, I sucked on a lot of G & T. So far it's worked. I guess it's because the mozzies don't like Gin...?

:}

Ive heard alot of guys talk about drinking G&T's but then alot say it doesnt work. Ive been doing just fine by drinking lots of tonic which must mean that the G&T's dont work if you have too much gin which is usually the case on contract. Must admit straight tonic is not that fun:(

As a kid in East Africa, moved in & out of 'malaria' zones - didn't always take the tablets (paludrin???), but survived OK

In mid '70's did a year in East Kalimantan - took the tablets (daraprim???) religiously but had two goes of Malaria

Recently have done 3 years in Sudan - started on combined daily & weekly stuff, but my UK Doc (with an interest in Travel/Tropical Medicine - did a year as Team Doc for Ford Rally Team etc) persuaded me to take Larium - on the basis that Larium may send you crazy, BUT Malaria kills you!!! - so far no problems;

BUT I think I now have the answer - MARMITE, according to recent reserach, those who eat MARMITE give off an 'odour' that deters MOSSIES

In East Africa, I ate Marmite every day and again in Sudan - but in East Kalimantan the only 'yeast extract' available was that inferior product from the penal settlements - VEGEMITE

MARMITE - LOVE IT OR HATE IT

:) :D :) :cool:

PZULBA - Out of Africa

I'll be damned!!

My old mate marmite!!

Thanks for the info.

Best advice is....prevention.......use nets and reppellents, long sleeves and trousers after sunset. First sign of symtoms, flu like..usually 10-14 days after being bitten, get medical attention..ASAP...don`t think it will go away...it won`t.
Pills do not prevent malaria....Larium is not approved for pilots...

Been there, done that, got the T-shirt :ugh:

Mozzies.........
 

Avoid black clothes, Mosquitos like to fly on holding pattern above it.
And they have ATCs given radar vectors to hit you.
For information, only mozzie's female sucks blood.
...again females....
When mosquito's female ear the sound of the male, they run away.

Drink Tonic,....if you feel a kind of neck ache, get Lariam pills....

Or you can try to wisle like a male mosquito!
Not easy but... never know!

Speedbreak

Malaria, very funny! You'll die laughing...
 

Dear Pruners,

This is just well-meant advice. Go see a doctor with first-hand knowledge of your specific region.

Assuming the original request was serious, the advice I got for West Africa is as follows:

The only effective prophylaxis is either Doxycycline (some kind of broad-spectrum antibiotic if my understanding is correct) or some new, rather expensive stuff I cannot remember the name of. It begins with 'M' I think...

Doxycycline makes some people's skin sensitive to sunlight. I just paid 130 quid for a six months' supply at Boots, Heathrow. A prescription is required.

The new stuff costs about one quid per day but it's supposed to be free of side-effects.

Halfan, in a blister pack of three tablets, is something one should have ready to hand in case of falling ill when medical attention is not readily available. It is not to be taken as a prophylactic, since it has some wicked side-effects.

I tried Lariam and found myself getting wobbly and depressive. My local doctor was horrified to find it had been prescribed me. Go figure....

Resochin, Paludrine, etc, are all ineffective against the disease in West Africa.

Gin tonics, mosquito nets, repellent, turning up the air con... everyone I know, including myself, has gone down with malaria after some time in West Africa. We had one guy who became ill after two weeks in country and I had my first case after more than 20 years. It's not much of a joke when you are alternately freezing and burning up, shaking like a leaf and not knowing which end to present first to the porcelain receptacle. And that is one of the milder forms. There's another one where they just find you out cold in your bed.

Very important, when travelling in regions without malaria, is making it known that you may have this disease rather than typhus, influenza, Montezuma's revenge or whatever. I know of several people who have died because of delayed recognition that they were suffering from malaria. In some cases they went unconscious, leaving the doctors guessing what the problem might be. It just takes three days to die of cerebral malaria, and if you don't die you may end up lacking some of your facilities.

Mosquitoes may be small but they do demand consideration!

Good luck!

chuks

malaria
 

anyone ever tried malariaquin always worked for me everytime I went to see ma gran... central Kenya..... and all I had to do is have them a day or immediately I got there and it was supposed to boost your immune system...and the old repelant is always a treat not only to repel mossies but other bugs till you get acustomed to them...:}




:ok: hope this is of help

Malarone

Good (perfect, in fact) if you stay less than two weeks. Start 2 days before your stay, 1 a day, finish several days after. Little to no side effects. Expensive.

Tonic:
seriously - with the average amount of quinine in tonic water you´d have to drink over 100 bottles of Schweppes a day.
also seriously - there is nothing better than G+T after a long hot day...

My Tips
 

quote:
"ARTESUNATE".

Made in China bru ... but works like a bomb .. ask me I just came out of a heavy bout

I was also given Artesunate a few yrs ago in Gabon and now i keep a spare packet with me. I stay away from pills even though we were supposed to sign that we had taken Doxycycline. The guys always felt a bit crook after taking them.

Its interesting to hear about marmite. Im always taking vegimite on contracts and that must be another reason that i havnt had it in yrs, touch wood. If it is about the odour that repels mozzies them i would take marmite, definately smells and tastes worse than vegimite.

Ok, maybe another "old wives tale", but, I heard somewhere way back that the mozzies home in on the carbon-dioxide that you breath out..

Not the aftershave or the b.o. that attracts them, and they can't recognise dinner when it lies down.. (not like some people here...:E)

So, I have always used a normal standing fan when I go slumming it at my mates game farm, or anywhere else in darkest Africa - as long as there is electricity, that is, and even in winter, makes the duvet and the human heater alongside sooo much better..

Even with a net, the blasted bzzzzzzzzz keeps me awake and swatting at 'em, no such hassles with the fan. It supposedly blows all the carbon-dioxide away and the b@stards cannot get a lock-on on dinner... also, apparently they cannot land in the breeze, no, really, I'm serious... :suspect:

Yeah, I know.. outside at the braai is still a problem, use Tabard..

Oh, and Flyhard - MARMITE is MUCH better...!!! :p

Cheers

R

Call me a coward but I'll always take something when in a zone. Larium is supposedly effective but only for short term use, after a few months it really f**ks with the system.

I've heard that the artesun or whatever its called works wonders.

I keep a kit with me, two lab slides and a prick, if you get symptoms, take a thin and thick sample on the slides, THEN take fansidar or whatever works in your region. Apparentely, diagnosis is much harder if the blood sample is taken after treatment.

Touch wood (forehead) no dose yet.

:ok:

it can and does kill
 

Whew!
Missed a couple days of prophylasis meds and took a real bad dose of Cerebral Malaria. Put me in a coma, damn near killed me...six days in the hospital...most of it in ICU.
Falciparum Malaria is insidious, yet extremely fast moving. From the initial onset of symptoms to death can be in as little as 48hrs.
Its those symptoms that you must recognise. I swore I had a flu as i had been around others with flu. While home alone, it progressed , annihilating my energy and destroying my ability to make a clear decision . I was found in bed, diapheretic, semi-conscience and rushed to a local hospital where, due to lack of knowledge about Malaria, I worsened until airlifted to a larger city hospital where I subsequently recovered...minus 20 lbs!
It's so important that at the slightest malaise, to get tested and treated ASAP.
After recovering, I discussed at length, future protection and treatment with several specialists in tropical deseases.
I now use Doxycycline. It has very low incidence of side effects, is not used with the most serious of bacterialogical infections so immunity isn't a factor and, taken with food, won't upset most stomachs. I also carry a treatment pack of Malarone, so that should I encounter symptoms...4 tabs /day for 3days straight.
I chose not to use malarone as a prophylasis as this use prevents it from being used as treatment.
I've worked with people who also don't take any prophylasis, but on the onset of symptoms, scarf down the malarone.
There's lots of info out there and lots of other opinions on prevention, treatment etc....chose your own weapon....but make sure your armed.

rb

If I understand well, humans have to swallow those awfull pills ?
Until now I was trying to force mosquitoes (female only) to swallow them...not easy and very tedious, believe me !
Should have better read the notice before.
Personnally I have given up a preventive treatment, and I rather stick to a curative one with "Alfan" but it said that "obscure" side effects might be expected ???? I'm still waiting !

The silent killer
 

Greetings,
Hi there Gunns, sorry to hear it got you swaer.
Doxyciline, Vibramicine, Cyclidox and all other broadbased anti biotics, has some funny side effects, apart from light sensitivity, that you will normally wont hear about. Your swimmers all die!
Was using it for nearnly four years when my joints started freezing up. It was the funnyest sight for my crew to see me crab to the crapper in the morning because I cant seem to straighten my arms and legs. Doc advised against using it any longer. He said to stop right away. Said if I ever got any lower tracht infection he wont be able to sve me as my body would built up a resistence against antibiotics.Needless to say, I got malaria 7 days later. Nearly died. I was negotiating my way through a couple of amber nectars on the 6th day and woke up with a hangover(incidently the same feeling the morning after we visited you Gunns) The hanover stayed and got worse. I wished at some stage that I would die.
The company now issues us with a couple of testing kits and two courses of Coartem(this is not an advertisment). I cant remember the term from Chemistry 1B, but its a chemical mirror image of the Arthemeter drug they used in the seventies. Think the chemical name is Alpha-arthemeter.
You take a small blood sample when you really feel bad, because then there is lots of parasites in the blood. Late after noon usually does it. insert it in the test plate and wait for the confimational red line.
When the red line shows you drink 4 pills then 2 every 4 hours. If you start in the afternoon you will be over it in the morning.
Oh yes, after a scientific experiment we conducted somewhere in the Congo, Peaceful Sleep was more efective than Tabbard.
From personal experience I'll say Dark Rum and Coke while snacking on Garlic works better than Gin and tonic.

Marmite will be accompaning me from now
Thanks guys!
:)

Just remebered something else.
GARLIC BOMBS.
For those of you who dont know about it read carefully.

Wrap a whole clove of garlic in cheese (for the swiss and french folk who are fussy about heir cheese, gouda or chedder is fine) and grated usually works best because you can wrap the cheese a bit better. A few drops of tobasco and then just dump the whole bomb in your mouth and enjoy:ok:

Keeps the mozzies and night fighters away

New malaria drug cheap, but 'not ideal'
 

From todays Cape Times:

New malaria drug cheap, but 'not ideal'
April 26, 2004

By Jo-Anne Smetherham

A new malaria drug, expected to cost under one US dollar for a course of treatment, could be available to African governments in two years.

The artemisinin-combination drug might offer fresh hope to the many African countries with rising malaria death tolls.

The World Health Organisation (Who), non-profit foundation Medicines for Malaria Venture and GlaxoSmithKline have announced a joint effort to develop the drug, which will contain chlorproguanil, dapsone and artesunate (CDA).

"The flavour of the decade is artemisinin-combination therapy," said medical director of the Netcare Travel Clinic, Stephen Toovey. It is intended for "resource-poor settings. It is not going to be an ideal drug, but we don't have the ideal".

Malaria is reported to have killed more people than all the wars in history. Every day almost 3 000 people, most of them children, die of the disease.


Who estimates there are at least 300 million malaria cases in the world every year, 90% of them in Africa.

CDA will cost around one-third of artemether-lumefantrine, a drug much-hailed for its high cure rates in SA.

Artemisinin alone kills malaria parasites more quickly than other drugs but must be taken for seven days, so many patients don't finish the course. Artemisinin-combination drugs must be taken for about three days. Other more expensive artemisinin combinations are available but "nobody knows which is best", said Toovey who said that the disadvantage of the new drug is that it causes anaemia in children.

Malaria Feedback
 

:ugh: Gents- just came out of 10 day malaria ... and I tell you this one was bad .. (no I did not loose anyweight PP and Vis ;) )

I took Artesanate and had the fever for only about 3 days in which I was stuffed.

Luckily I had a lady looking after me - as I was alone in a room and on "leave". Hot tea and water was my survival and I did not dihidrate.

The worst was after the fever was the headaches .. it went on for about a week. I would be 100% the one moment and the next after typing a bit or so I would start seeing double and woep - I knew I had to go and lie down.

Artesanate worked (again) but then my blood pressure went through the roof. (OK we are having a bit of serious sh!t and stress here) but that just aggrevated the headaches.

Only a blood pressure pill sorted me out and I feel great now.

Thanks for a great thread.

Nellis has the malaria now - so we can await his feedback ;)

Cheers,

Gunsss

"also, apparently they cannot land in the breeze, no, really, I'm serious... "

heh heh...the crosswinds beyond limits, eh?

I recently bought a little machine from Singapore which works on a small 9v battery (not included) and emits noises which scare off the mosquitoes. It stated eloquently on the packet that you are only bitten by pregant female mosquitoes "who are forced to suck the blood of man or beast in order to nurture their eggs".

On Setting I it makes the sound of a male mosquito which apparently scares away the pregnant females who have obviously had enough of the old mozzy jiggy-jiggy anyway and on Setting II it makes the combined sound of male mosquitoes and also a dragonfly, the mosquito's main predator, so they think they're going to be chowed. It also recommends that you switch between Setting I and Setting II every few hours. This probably makes other mossies think that the male mossie actually defeated the dragonfly, though, so I keep the dragonfly on. Works like a bomb but sounds like having your own pet insect farm next to the bed...

Otherwise its the Tabard cream and the long rods and the aircon on max if available. Mozzie nets are lovely at least you know they can't get you even if you can hear them (my revenge!) but when you take one on contract, they already have them and when you don't take one, they don't have them and you spend 1/2 the night hunting down mozzies which mysteriously dissapear just after flying out of the white background.

Local business opportunity!! Instead of the watches, locals can start selling their blood for a few sifas so we can put a saucer on the floor next to the bed for the mozzies:E

Top thread guys !

Some years back I live & worked in SA, from where spent a fair amount of time working in Zim and in which ( Zim ) just about all the okes I worked with contracted Malaria - and this includes a lady friend of my wife’s who came to stay with us for a holiday and contracted it within a week of arriving ( sh!t happens huh ?! )

Personally I didn't bother with the pills and instead stuck to vast amounts of G&T - purely for medicinal purpose of course.... ;)

That said the ultimate answer is to NOT get bitten and anything which helps to prevent that must be a good thing.

So, to that end, perhaps some of the following might be of use – especially to an airline crew member who’s just passing through, e.g. maybe on an infrequent / ‘minimum rest’ trip - and of which I’d appreciate any views:

• Mosquito nets such as Mosinet
• Insect repellents containing such things as DEET / Pyrethrins / Pyrethroids / etc ( see: Insect Repellent Guide ). Nb. I’d be particularly keen to know of side-effects from using these ( esp at higher concentrations, e.g. Repel 100 )
• Electronic repellents such as that wristwatch thingee which apparently emits a sound that’s similar to a male mosquito’s wing beat and ergo supposedly scares away the females mosies.

Thanks.

Tony

Pilot & Malaria-Paludism
 

Hi,

was wondering how many expat pilots in Africa are concerned with Malaria-Paludism, what are the risks, how to prevent it, etc...

Cheers.

Am very concerned with Malaria. Just finished a 10 day stint in Lagos and did not spend much time out at night for this reason.

Know of a pilot in this same area who stayed longer (3 months) and got Malaria. Had to go home for a couple of months as he could no longer fly and is still effected by it at times.

Its worth keeping an eye on IHMO.

CD

I definitely agree... You have to watch out for it. Make sure you always have medication with you to treat you once you have it but out of personal experience I would say DON'T take the preventative medication.

Apart from the fact that you're not allowed to take most of them when you're flying, if you're going to get malaria, you will get it and the "preventative" medications tend to suppress the symptoms. Rather get it and know you have it so it can be treated.

Just get the basics like a mosquito net to sleep under and some insect repelant like tabard or peacefull sleep... :ok:

Deffinetly agree with staying off preventative medication. Be smart and use your net and cover up at night, African mosquitos are most active after sunset.

One story is that they do not like the smell of Garlic so eat plenty of that. They also don't like the smell of alchohol so that is the best excuse ever to go for a few beers. :E

Also recomend getting the meds for after you get it and also if you can get hold of a few self test kits and read up any info you can find on Malaria, especially when out in the middle of no where.

Remeber meds are very sensetive to heat so store them right, there is no guarantee that local available products might even work after been transported to the back of beyond or stored inproperly.

It seems inevetable to get it so good luck :ok:

Malaria.

I got malaria in the lowveld way back in 1965...they said there was no malaria in the area but I can assure you there was. I have had about six or seven re-ocurrances and it is quite debilitating. In the service we were given paludrine and one was expected to take it...it had little to no effect since people still managed to contract the disease.

I have lived in Somalia and in Nigeria and I have to say that malaria never once visited me in these particular areas. As some of the contributors have suggested...get a good grade net and sleep in that. The mosquitos tend to inhabit the dark areas of a house or room so it is useful to spray under the beds, cupboards, wardrobes and anywhere where you think they might be lurking. Wear lond sleeved shirts at night and expose only the minimum. A repellent helps at night...just before going to bed another spray of the room in all thne areas mentioned would be useful.

Places my maleria recurred...UK (twice), France (once) ME (four times).

Hope this is of use!

NC43

As Phenomenon said do not take the preventitive medicine. It does mask the symptoms and will not show up on a blood test if your positive for malaria. This ofcourse can lead to cerebral malaria :uhoh: uhoh: Use common sense and you should be fine.........:hmm: :hmm:

Some companies issue malaria prophylactics and insist on their use. Woe betide a crewmember found to have malaria while on tour without traces of the prophylactic in their system. This could be sidestepped by taking a dose or two if one felt ill so the stuff could be seen during an examination.

You must remember aswell that a mozi has to bite someone else with malaria first, and then bite you within seven days of having biten the malaria person, in order for you to get malaria. The mozi is not born with malaria, its just the carrier.

So find out if other people in the area have malaria as well, that will give you a good idea of your chances of getting it. The higher the density of the population where you will operate, the higher your risk, as there are more people for the mozi to bite within the seven days. After seven days, the malaria dies in the mozi.

If you do get biten, start looking for symptons after about a week to 14 days. There after you should be cool.

A very effective preventitive measure is a fan in your room directly over your bed.
The mozi is attracted to your cabon dioxide breath as you exhale to zone in on you so this disperses that trail. They are also fair weather flyers and cant land in cross winds so it keeps them of you as well.

Hope it helps and just keep your immune system boosted as this is still your last defence.

Adios amigo!:ok:

late night party
 

Spoke to a doc from the WHO in Kinshasa some time ago. The research show that the malaria moz in that area only becom activ late at night(9-10) and stop early in the morning.
Now that tells us to be indoors at that time. Sorry for those who like to sit outside in resturants etc till late night. Put the braai up early

The best preventative is to cover yourself in anti moz spray. Do not just spray the exposed parts of the skin but also where clothing stretch tight cos the boz can bite through the clothing.

Be careful of vehicles. The mozzies hide inside in the dark areas and zop your legs while driving If its your vehicle, spray the vehicle regularly with a long lasting bugspray. If its a taxi spray the driver and the car. Jokes aside, before leaving in the morning spray your lega, socks etc just for this reason.

The best cure for malaria is not to get bitten Use common sence and a lot of spray.

Keep it safe

I have lived on and off in West/Central Africa on contract for over 5 years. And surprisingly have not got malaria yet, touch wood.

You can use Prophylactics, such as Daramal/Paludrine or Doxycyline (just an antibiotic). Larium is one of the ones that is illegal for pilots. So many people say it masks the symptoms-rubbish and they say the long term (more than a month) effects of the medicine on your body is worse than malaria-rubbish, what’s worse than Cerebral Malaria. If you gonna take medicine for more than a year or two than it’s not worth taking them, just ridiculous. If less than a year I would recommend 2 months, Daramal/Paludrine and the 2 months Doxycycline and then keep rotating between the two medicines so the body does not get used to the medicine. Often though these do have side effects of skin being sensitive to sun-so take them at night before sleeping for them to get through your system.I stopped using the stuff though about 3 years ago, and rather cover up.

In medical tests Tabard has proven good, while Peaceful Sleep failed the tests despite having the same ingredient, Diethyltoluamide (look for this if you buying a local anti mossie spray).

Malaria test kits are good but be aware that it can only pick up the parasite in your blood once you have a fever, so if you feeling funny-it wont pick it up if you test.

If you do get malaria, try use a local medicine only found in West/Africa called Arinate (in a yellow box). It is a four day pill programme, that is better they say than checking into a hospital, can get Arinate for about 5 dollars. Even if you think you might be getting malaria, or any sort of flu symptoms (weak joints/sore neck/dark urine/drowsiness)-take the stuff at the first opportunity. It could save you. I have had a few occasions where I thought I was getting malaria and started the four day course, only to find out it was not malaria. For 5 dollars, worth the cash, prevent rather than cure.Have had a few friends who used it and it worked. Obviously if you have Cerebral than the hospital is calling....and the grim reaper at times.

Other than that like said above by everyone else, cover up, they do eat through socks so still put Tabard on under. The female mossie (malaria carrying one) feeds at dusk and dawn, and be aware of the mossie with striped legs, often is a carrier. As for the statement that they are attracted to the CO2 of your breath....haha don't think so,but the fan does help them not to hover over you. Crank that aircon and immobilize the mossie squadron.

Hope this is help, Why did Noah let that mossie on the ark?....or did the little basterd smuggle himself and his bloodsucking wife on board...?
:ok:

Airforce1, do the research before knocking the info:mad:

Menikos,
Here's a little something I posted earlier on the Medical forum:
I have been working in malarial areas of west Africa now for 28 years and presently take nothing; I just carry Malarone tablets with me for self-treatment if I happen to develop malarial symptoms and am unable to get to visit a doctor for any reason. I also carry a letter in my wallet saying that I work in West Africa and in case of unconsciousness malaria may be suspected as a cause.
I used to work on a contract where the client (Exxon/Mobil) insisted on anti-malarial prophylaxis. I tried Malarone, but gave it up because it gave me mouth ulcers, excess stomach acid and faint feelings of nausea. After that I took Doxycycline daily. That also had side-effects as I am very fair skinned and it made me much more susceptible to sunburn, but that was preferable to the Malarone. I have friends who have caught malaria here and have been treated with co-Artemether, which also seems to be very effective, but I don't think it's recommended as a prophylactic.
As others have said, the most important thing is totry and avoid being bitten. Make sure that the rooms you sleep in have effective insect screens on the windows, or get a mosquito net to put over your bed. Make sure that bedrooms are sprayed twice a day with a good insecticide. Try to avoid sitting outside just around dusk as that's when you're most likely to get bitten. If you do have to sit out at that time try to wear a long-sleeved shirt, long trousers and socks and spray exposed skin, especially around the neck, wrists and ankles with a repellent containing DEET.
So far, I've been lucky and have never caught malaria (maybe because my regular tipple - Pastis and tonic - repels mosquitos and most other things ), but having once had to spend some time in the London Hospital for Tropical Diseases being treated for another illness, and seen many people being brought in comatose with malaria, it's not something I'd ever treat lightly. I have one friend who lives in Scotland, arrived home for leave to find that his wife was sick with flu. Within 48 hours he had also developed flu-like symptoms and went to visit his doctor. Luckily his doctor knew that he worked in Nigeria and instead of just assuming that he had caught flu sent him for testing for malaria. He had a severe infection and is fortunate that his wise GP decided not to just take his flu symptoms at face value.

I also found the following article which may amuse you, as long as you don't have very smelly feet:

Researchers in Amsterdam found that sweaty feet and smelly Dutch cheese whet the appetites of malaria mosquitos. In a test involving people with washed and unwashed feet, malaria mosquitos showed a clear preference for the scent found on human feet. Furthermore, the Dutch entymologists discovered that these mosquitos were equally attracted to a piece of strongly-scented, ripe Dutch Limburger cheese. According to the scientists this makes sense because Limburger - a pungent, white, soft cheese - smells a lot like the 'toe cheese' found between human toes.

Unfortunately, no matter how much you wash your feet, you'll never be able to completely get rid of the smell because its simply a basic human smell. Hence, washing feet more often is probably not a plausible defense against malaria.

So, what does this study have to do with you? Well, researchers hope that one day they can reproduce the odor artifically and use them in making better mosquito traps.

So till then, keep those feet clean and lay off on the cheese.

There's also quite a useful WHO site emphasising all these points:

http://www.who.int/malaria/docs/heal...lthworkers.htm

menikos,

If you’re from Paris, I’m sure you’ll be able to find the French national institute of tropical studies, whatever its precise name may be. Ask them for their medical department or (if it still exists) the specialized tropical diseases hospital. Then tell those experts precisely where you’re going, what you’ll be doing and for how long, and they will give you the most current and up-to-date recommendations. I cannot emphasize the importance of the latest info enough: the parasites constantly evolve and misuse of malaria drugs (mostly: not taking the complete course) leads to drug-resistant strains developing in an amazingly short time. The info which was completely correct for one of the posters here even 6 months ago may be worse than useless to you now.

Malaria is a killer. Some strains can kill you within a day of the first symptoms showing.

In general, as with most bad things, prevention is better than cure. Firstly, avoid getting bitten. Sleep under a mosquito net, avoid going out at or after dusk, wear long sleeves and trousers at and after dusk, use mosquito repellant (and yes, the garlic eating helps).

Secondly, your body will to some extent fight the intrusion by the parasites by itself. Help your body by remaining healthy: regular light exercise (fitness freaks tend to be more susceptible to infections than normally healthy people), a balanced diet, avoid chronic alcohol abuse - that’s the hard one!

Drugs that can be taken as prophylactics (prevention), have many drawbacks. Their efficacy is most limited against falciparum malaria – the most dangerous form. Some have side effects that preclude flying while you’re taking them, others have side effects after long-term use. Once again, discuss with the experts in tropical medicine – not with pilots – whether or not prophylaxis will be right for you. Do mention you’re a pilot though, it will be an important factor in their recommendation.

Lastly, realize that none of these defenses are perfect. If you start feeling woozy, take your temperature. If you are running a fever, get a blood test done – NOW! Forget the idea of self-test kits, a blood test for malaria involves taking one drop of blood, concentrating it in a centrifuge, and looking at it through a microscope to identify the parasites. Takes about 10 minutes, but it requires equipment found only in a doctor’s office. If you cannot get a blood test done right away (within one hour), start taking the prescribed drugs for a malaria attack, and still get the blood test done as soon as possible. If the blood test turns out to be negative for malaria, no harm will have been done by taking the drugs. To follow this last advice you should carry a complete course of malaria treatment with you.

As an aside, I’ve noticed some people take such pride in their relative immunity to malaria that they go into denial about having the disease and refuse treatment or even testing. Sound crazy? It is! They all wound up in intensive care and one guy’s kidneys had started breaking down by the time we got him on an ambulance Lear to Geneva.

After returning to Europe, don’t think you are out of the woods yet. People have gone down with malaria 6 months after leaving Africa. Actually, a very few have contracted it years after their departure but their numbers are small enough to ignore. I would advice to always carry a card stating you have just returned from a malaria area and that if you collapse, a check for malaria should be run. One problem people returning to Europe or North America have encountered is a reluctance bordering on obstinacy on the part of some doctors to consider the possibility of malaria; they see it so seldom that they aren’t familiar with tests or current drug regimes and seem to have a hard time acknowledging the fact. I would suggest instructing your family and/or co-workers that if you have a bad fever and are unable to fend for yourself they should ask the doctor if he tested you for malaria, and if the answer is along the lines of “Oh, it’s a flu, no need for that” to take you, by kidnapping if necessary, to a hospital specializing in tropical diseases. I personally know three people who are alive today only because their colleagues kidnapped them from a hospital and took them to a Navy clinic.

Hello,

really thank you all for the precious information given, by using a common sense you can just help yourself.

Cheers

It worked for us !
 

Starting one month before moving into a malarial area, take 2 Paludrine tablets every day at breakfast time. Make this a religious obligation. Do not fail ! Ensure your staff put the Paludrine on the table first thing every morning. If Sunday is a day off, have them put it out on Saturday night. Especially important for bachelors, who are notorious for forgetting - especially when p******d. Keep a backup supply in the meds cupboard.
2 tablets for adults, one tablet for children. Every day, without fail, even when on leave, and continue for at least two months after final departure from the area.
Close bedroom windows and doors at about 4.00 pm, spray rooms and landings/corridors. Erect mosquito nets and spray INSIDE the nets. If you have airconditioning, turn it on as early as you can.
Work out an "air-lock" system, or screening to keep mosquitos out of the treated areas.
Out of doors, especially in the evenings, mosquitos will zero in on any bare flesh, and below knee height they just love drilling through socks and stockings. No longer fashionable, but there was a good rationale for mosquito boots. Spray vulnerable areas with "Off", or similar repellant. The good stuff is harmless to skin or fabrics.
Avoid the weekly prophylactics ( SundaySundayMedicine as it was known). Miss one dose and you have lost a week's protection. Miss one dose of Paludrine and you have only lost a day. But if you do decide to go weekly, NOT Sunday ! Too easy to forget after a good Saturday night.

Whatever happens, you are going to get bitten, and malaria is going to get into your bloodstream. Paludrine will keep the parasites suppressed and help prevent the development of full blown malaria - which at best is very unpleasant and at worst fatal.
In most cases, after leaving the area ( and maintaining prophylaxis for a while), the parasites will die off. However, it might be a good idea to carry a card in the wallet to say you have lived in a malarial area, should you be found in distress.

My wife and I plus three small children lived in tropical Africa for 12 years, and the above regime kept us perfectly protected.

p.s. Keep a tube of Anthisan handy - the bites itch like hell !