Anti malaria medication

[ventus2cxt]

MALARONE VS MEFLOQUINE

I have been flying in India since June 2009. My family doctor from Canada is is a Flight Surgeon and also a specialist in Pre Travel and immunization. He recommended the daily use of Malarone to prevent Malaria.

Now as you know we have to get a Class I with the Indian Air Force. My fourth attempt next week, lot of stupidity from the IAF and a long story. As a side story the IAF Doctor indicated that malarone was not approved and that I would have to use mefloquine.

When I mentionned that mefloquine was not recommended due to significant neuropsychiatric side effects and that few national bodies recommended the use of mefloquine for aircrew, the answer was we are in India and we know best.

In summary ICAO, Transport Canada, FAA, and Ernstings Aviation Medecine indicates that mefloquine is unacceptable for use by aviators.

So what are you using for anti-malaria

[piggybank]

The medication chosen will depend on the area you are working. What works in one area may be less effective for the malaria in another location.

Here in the southern part of PNG I am using doxycycline 100 mg per day. The camp medic (local man who really knows malaria) claims its the best all rounder for this region.

Going back 18 years for this area I took a variety of the anti malarial as prescribed, skin creams etc. All failed. I had three types of malaria, Vivax for three years on and off, Falciparum once, Ovale once.

Nowadays this location has been fogged with insect killers a lot which has cut the malaria down to the point very few people are infected, however I take the medication in case I have to relocate fast.

The main problem with doxycycline is it can make you more sensitive to the sun, you burn easier.

Medication is taken two days before coming to PNG and for ten days after leaving PNG.

Edited for typo ineffective to read effective

[galaxy flyer]

Us-based operator, we mostly use Malerone, isn't even an FAA medical issue. But, then again, you are in India.

GF

[ehwatezedoing]

To quote Galaxy flyer ;)

Canadian-base operator, we mostly use Malarone (when required) isn't even a Transports Canada medical issue. But, then again, you are in India.

[Alsacienne]

You must take advice from a real DOCTOR, preferably one specialising in Tropical Diseases because what you need to take depends on where you are going to be and how long you need to take it.

However, just for information, DS works for an NGO in sub-saharan malarial areas.

Mefloquine (Lariam) is only good for 1 month's cover and has nasty psychological side-effect.

Malarone is good for 2 months' cover.

Doxycycline is an antibiotic, (usually also the medication of choice to cure cholera!!) which also acts as an antimalarial. It can be taken for up to 6 months. Note that long term use can affect the liver in later years. It is also important to keep out of the sun when on Doxy because it makes your skin react to sunlight.

[Shack37]

Going back a few years now but to emphasise the previously mentioned importance of the right medication for the area you are based. In early 1979 I spent two months in Natuna (Indonesia) taking Nivoquine as prescribed by the then company doctor. This was followed by 6 months in China (Yellow Sea area) from where I returned to the UK in September 1979. During the Xmas New Year period 1979/1980 I became ill with what was eventually diagnosed as Malaria (Plasmodium Vivax). Doctors confirmed it was a result of my stay in Natuna a year earlier and that Nivoquine was not a suitable prophylactic for that region. Ironically they prescribed Nivoquine as a cure and I haven't had a recurrence since.

[HEATHROW DIRECTOR]

I believe the UK medics prohibit the use of Lariam for aircrew and air traffic controllers..

[piggybank]

Shack 37

We must have been at Natuna much the same time.

I was on the Pelita Pumas prior to the big airfield expansion and through to 1981.

I never took antimalarials in my time there, and did not catch it. (by luck it would seem)

18 years back in this swamp location I am now, when it was plagued with every known form of malaria, the pilots took no medication and did not catch malaria.

At that time we put it down to fitness, they made a real effort to stay fit.

[Typhoon Tripacer]

My experience with malaria is relevant to West Africa where the Chinese artisunate based drugs are considered most effective. Unfortunately I believe they are still not licensed in the UK and US, although they are produced by the major drug companies.

Daraprim is one example which is taken once a week and has no nasty side effects that I have heard of and it is also far cheaper than Malarone or Mefloquine. The same or similar should be just a few dollars if available in India for a couple of months supply.

The above notwithstanding is it essential for a pilot to take prophylactics for malaria. If you are aware of the symptoms you should be aware of onset for several hours before any serious effects and the continual taking of any drug is not a good idea for the body. Taking the prophylactic can also increase the risk of masking the illness and making treatment more difficult

[Shack37]

piggybank
We had a Racal navigation/survey transmitter for oil exploration work. Arrival was by DC3 from Singapore and then to the north by either boat or motorbike (if the bridges were intact). I don't know of any colleagues getting malaria there so I've always harboured a suspicion it may have been a Chinese mossie.

[gingernut]

The regime required depends on the area travelled to and other risk factors (accomodation etc).

Mefloquine is contra-indicated "in those who perform precision activities."

[Capt. Glenn Quagmire]

Mefloquine is a controversial drug, a lot of people swear by it and it IS effective in preventing and treating certain kinds of Malaria. However, it does have some horrific side effects which do not effect everyone the same hence the difficulty with this drug. Unfortunately for me I had all of the side effects and I can literally say I was poisoned:yuk: so my advice is that you try and avoid it if you can.
That being said, perhaps in your case the other options might be even worse for you...

[Final 3 Greens]

Mefloquine/Lariam is fine, so long as you don't suffer from depression, whereupon you might develop suicidal tendencies :mad:

For the avoidance of doubt, I am being semi serious.

Having said that, I have used this anti malarial successfully.

[gingernut]

Mefloquine/Lariam is fine, so long as you don't suffer from depression, whereupon you might develop suicidal tendencies

I'm not sure that this is true.

[Final 3 Greens]

Gingernut

I remember the screening questions when I was prescribed it for the first time and the medic probed quite heavily for any signs of depression, responding with 'some people have reported severe depression and there have been cases of suicide with Lariam users.' Whether you can attribute direct cause and effect, dunno.

Now I am not a medic, but a quick search of the internet produced the following links - read and make your mind up if they are overblown or reasonable.

Dangers of taking Lariam (http://prescriptiondesk.com/drugs/lariam/)

Lariam Official FDA information, side effects and uses. (http://www.drugs.com/pro/lariam.html)

Lariam (http://www.netdoctor.co.uk/medicines/100001462.html)

'It's not a benign drug - it has ruined my life' | Society | The Guardian (http://www.guardian.co.uk/society/2002/oct/24/health.lifeandhealth)

Anti-malaria drug: Risk of Suicide (http://www.ahrp.org/infomail/0802/29.php)

http://www.lariaminfo.org/pdfs/UPI/UPI20020521Lariam_and_Suicide_Main_UPI_Story.pdf

[Jumbo744]

i've been using those 2 for the last few years:

CoArinate (for adults)
Coartem

very efficient, not much side effects, and gets you back on feet really fast.

[flyboy2]

Hi
You all must realize that you're discussing the taking of prophylactics, which in non-medical language means a PREVENTATIVE.
All prophylactics have very serious side-effects, most of which cannot be taken by flying crew, as the previous posts state.

The Chinese root extract sold as Artisinum or Coartem is really a method of eliminating the malaria with minimal side-effects and therefore can be taken by flight-crew, when a blood-test proves the presence of the malaria.

Malaria tends to have area-specific problems, so consulting a doctor with proper experience is important. However it appears that some seem unaware of the benefits of using Artisinum-based medicine such as Coartem.
I'm NOT stating that this medicine is the be-all/ end-all of malaria cures.
Get good medical advice quickly or you will die, especially when contracting Cerebral Malaria!