Flying helicopters in africa, anti malarials

[helimutt]

Do any of the Rotorheads fly in africa for long periods of time, and do they use any anti-malarial meds, ie Malarone, and if so, any side effects?
I guess some of the long haul fixed wing guys only fly in and out but heli pilots probably find themselves there for extended periods.

Cheers

[gwelo shamwari]

Not sure about those flying over there, but growing up there gin and tonic was the staple anti malarial counter measure. :-)

[helimutt]

Noted :ok: :)

[Tango123]

Well, some eat them (malarone), and some don't, but even those who eat them gets malaria and those who don't gets away without having malaria. I don't due to the side effect dehydration headache and so on. The treatment if you get malaria is really good down here in Nigeria and will leave you grounded for a few days (3-5 approx). wouldn't recommend any other medicine like Lariam cause the side effects can be even harder. make sure that the company you work for has a medical centre that you can attend 24/7.

T

[helimutt]

Appreciate the input, thanks. Off to Tanzania so know it to be a Malaria risk area, and would rather not catch it if possible. :ok:

[unstable load]

It's a rather emotional subject in many ways. Doctors at home will swear that you MUST take anti malarials, then the ones in the countries will tell you "under no circumstances".
There are theories of the prophylactics "masking" early symptoms and making treatment harder due to delayed diagnosis, aside from the health issues from long term use of the drugs.

Some companies insist on use on pain of being fired if you get malaria and don't have the stuff in your system.

If you do get malaria, the treatment where you got it will be the most effective and skilled.

Personally, I have the pills with me at all times and I decide when I get there whether I will use them or not, dependant on season and number of known cases of malaria in the area. I also have a self-test kit in case of emergency.

[helimutt]

Self test kit? Tell me more? :confused: can i buy it in uk ?

[Senior Pilot]

helimutt, I'm sure that you checked the Search facility and saw this thread? Can Exxon deprive me of my human rights? (http://www.pprune.org/rotorheads/132514-can-exxon-deprive-me-my-human-rights.html) is an old thread, but deals with anti malarials and their effects.

[ec155mech]

being here as an engineer. I would say

1. dont use Malarone, as it has proved to be basically useless. and can delay dianogstics
2. you cant use Lariam as flight crew ( lord knows why, and yes I know about all the surveys that say you go bonkers from it. ) but if you have no side effect I dont see the problem.
3. get the things for your room, those vaporizer things you plug into the socket. and use plenty of anti mosq. products

[birrddog]

My suggestion (if you want medical advice go to a doctor), based on experience in Africa..

Don't take anything; where long clothes from dusk to dawn (long trousers, long sleeve shirts), sleep under a net, and use an anti-mosquito cream, like tabbard (better than the sprays and you can get more even coverage).

Keep plenty Artemisinin handy - make sure you get it from a reliable source e.g. before you go in country (there is a lot of fake on the market in Africa - even from the ER in hospitals who were duped!).

The moment you feel poorly take the Artemisinin. (headaches, fly like symptoms, tiredness)

If you use it as a prophylactic it will make you used to it and reduce or remove its effectiveness.

[Flyting]

Prostitutes are rife in DAR and AIDS is rampant there.....so rubber up if you dare to touch anything....:eek:

As unstable load says...it's an on going debate...

I was always advised not to take anything as it would mask the symptoms, but instead, take a self test kit with and the anti-venom pills in case...
I got it in DRC while working there. We had a full time medic with us at all times, so no real worries.... Started showing the symptoms, spoke to him about it, he did a self test which turned up negative (I have now learned that a neg does not necessarily mean you don't have it...!) but because of the symptoms, he suggested taking the drugs and having a few days off.... After about 3 days resting up, sweating it out, I was A OK and back up for work...:ok:

So, my advice, don't waste your money on the pre-meds, get a self test kit, know the symptoms, and if they start showing, take the few days off and pop the good pills...

Get down to a travel clinic and speak to them about what drugs are best for Tanzania.....

Tanzania is a great country with lots of good people who are not as bribe orientated as their brothers on the west coast...

[delta3]

It probably depends how long you stay

If long, then you can do as the "Africans" say (ie no pil), but I noticed that most of them do get occasional fever attacks. Apparently suffices to forget socks/sleeves in the evening when having a drink at the bar while having mosquitoes around.

My stays tend to be less than 3 weeks (was in Tanzania a few months back, will be in Rwanda next month) So I take Malarone, even if it creates discomfort (headache..).

m2c
d3

[helimutt]

6 week tours, might just take the malarone with me, and make sure i'm not far from a decent medical facility.

Senior Pilot, yes looked through that thread which is informative and goes back a long way.

Cheers all.

[rotorboy]

know the symptoms. Carry COARTEM, its cheap, and effective.

Start taking it at the onset of symptoms. It breaks the fever fast and has few if any side effects.

Make sure you have it handy fro 2 weeks after you leave Africa, as some one I know :* came down with Malaria 10 days after an afternnon in the the Luanda airport!

[Hawkeye0001]

Hey Helimutt!

I'm flying in Tanzania at the moment and although it is generally considered a high-risk area for Malaria it much depends on where you're going to be stationed (I suppose Everett in DAR?). If you're going to be in the Arusha / Kilimanjaro / Mount Meru area or elsewhere in the highlands don't worry at all, pretty much no Anopheles mosquitoes around in these areas as it's simply too high. If you stay in the lower inland parts, around Lake Victoria or Dar Es Salaam have some medication at hand to take it when you get sick. As one of the previous posters mentioned use Coartem instead of Malorone. You can get it here for 12.000 Shilling (~8 USD) and it works faster, better and with a fraction of the side effects of Malorone. You can get Malaria Quick Tests in every pharmacy, too (careful with false negatives though!). I would not take prophylaxis if staying longer than the average tourist, your liver will not be thankful.

The best way to go about Malaria is prevention anyway: after ~5pm use Mosquito repellent, cover unprotected skin, sleep under a fan, use a mosquito net (check for holes!) and spray your room about an hour or two before you go to bed. A good advice my AME (frequent Tanzania traveller) gave me: bring your own net, bring a bit of rope and bring a wall hook or nail. This way you can fix a mosquito net anywhere.

Have fun and if you need any help give me a shout! Oh, and good luck with TCAA:yuk: :mad:

[hval]

Helimutt,

Worked Africa and Asia for many years. Took different anti malarials for over two years. By this time the whole lot of us were well and truly screwed up. Blood shot eyes, yellow skin and suffering, delicate stomachs (which I still suffer from many years later). We all gave up taking the tablets.

If taking Artemisinin, don't take it alone. Take it with the relevant anti malarial. The Plasmodium organisms are starting to become resistant to Artemisinin. Taking the anti malarials helps to prevent this.

[soggyboxers]

This link will give you some factual information specifically about Tanzania and the most common diseases found there:

International Association for Medical Aid for Travellers - Tanzania (http://www.iamat.org/country_profile.cfm?id=97)

This link exposes some of the common malaria myths:

Dispelling the Myths - Malaria (https://www.malariahotspots.co.uk/facts-myths.html)

This is what the Center for Disease Control has to say:

CDC Destinations - Tanzania (http://wwwnc.cdc.gov/travel/destinations/tanzania.htm)

In my 30+ years I've been lucky to have had malaria only 3 times and not very badly and I've treated it with Coartem (Artemether/lumefantrine). I've usually used doxycycline as my chemo-prophylaxis although as I am fair-skinned this may have contibuted to a few small rodent ulcers which I've had to have treated with cryotherapy. I always carry Coartem when I go on leave and I've printed up and laminated a small card saying that I work in West Africa and if I'm found unconscious suspect falciparum malaria.

[hihover]

Flying in Sierra Leone last year, was advised by the local doc just to take sensible precautions with bug spray, mosie nets etc. Malarone won't stop you contracting Malaria, and upon any symptoms, his first action would be to give me Malarone anyway. Had no problems at all.

I have to add that, the year before, I was in Mali with wife. We started Malarone prior to going and after about 3 days in country I came down with terminal screaming ab-dabs. That night as wife gave me my Malarone, I noted that they no longer had "Malarone" inscribed..........yep, she was giving me the wrong pills ffs! I did note that she was not affected by taking the laxatives she was feeding us???? or at least, feeding me!

Tam

[rjsquirrel]

If all else fails, ask the Centers for Disease Control:

CDC - Malaria - Travelers - Malaria Information and Prophylaxis, by Country (http://www.cdc.gov/malaria/travelers/country_table/a.html)

one note at the bottom of the table might be the understatement of the year:

This risk estimate is based largely on cases occurring in US military personnel who travel for extended periods of time with unique itineraries that likely do not reflect the risk for the average US traveler.

[Pandalet]

What you need is some of this!

https://failblog.files.wordpress.com/2011/08/epic-fail-photos-insect-repellent-fail.jpg

[helimutt]

Ok, here's a very interesting update. It may prove useful to those of you who ever find yourself out this way!

I came out here about 10 or so days ago, totally prepared to take on the might of the mozzie. I thought I had far superior thinking processes. I believed I could outwit the little monsters. I brought a mosquito net. I brought the plug in room vaporiser. I brought 50% deet skin spray and some 100% deet skin spray, just for good measure. I never went out without long sleeves or long trousers, and plenty of spray on exposed areas.
Oh, and just to make sure, I decided I was going to take Malarone until I got here and see how it all worked out. Better to be safe than sorry eh?
How many bites have I had in 10 days? Well I thought it was only one, on my stomach where one had managed to get through the gap in my shirt when i'd been out at night for a meal.

Now, 2 days ago I felt as if i'd strained my neck (fat chance) and then I had stomach upsets, loose bowels etc, (I know, I know, too much info) but it's relevant, and yesterday got up feeling dreadful. Off to the local clinic said my base manager. So I dutifully went, and with a stomach so painful I thought I was going to pass out, I had a full blood test.

(NB Here in this country it's possible to walk into the clinic, without an appointment, and have a blood test with instant results. Try that in good old Blighty eh? Just shows how backward the UK is as I had to wait a week for blood test results back there recently)

Anyway, turns out I have Malaria! Already! Doctor said I had to have been bitten about 5-7 days earlier. Parasites present. Started on a 3 day course of Duo-Cotecxin, and some Dividol, and some Perinorm, and just for good measure, some Panadol. Today, was started on some Zinnat (cefuroxime axetil) and apart from a low white blood cell count and borderline kidney function, I feel much better, if not a little tired still, but the doctor says if I hadn't have taken the Malarone I could have been a lot worse. Also, they did another test to check exactly which type of parasite I had, in case it had been from previous travels, but no, it was a local type, falciparum, which hadn't been living in my liver for a couple of years. The doctor recommends not going out at night! Everyone to use mosquito nets, always use skin protection deet 50% stuff, and to cover up as much as possible if going out. Also, if you do go out, make sure you try to go somewhere there is a breeze blowing.

So, the moral of the story is I guess that no matter what you do, the mosquito will find a way, even if they are just a carrier for the parasite.

At the first sign of any illness, go have a malaria test. They tell you there and then and can start treating you. Taking Malarone didnt make any difference to the test result. It won't stop you getting malaria.

[MyTarget]

Sorry to hear that and get well soon; what part of Africa are you in?

[Flyting]

At least that answers your original question.... pity you had to find out so soon after arrival... :ugh:

[soggyboxers]

Old (possibly African) proverb:

‘If you think you’re too small to make a difference, try sleeping in a closed room with a mosquito’.

[212man]

It's an interesting topic! Of the 4 strains of Malaria, Falciparum is the most dangerous and the one that kills the most people - often colloquially known as Cerebal Malaria. It doesn't recurr - it kills you or you kill it! The two that can recur are Ovale and Vivax and these tend to give fairly mild flu-like symptoms. Sadly, I know of two engineers who had these for several years and became used to the regular recurrences. The only problem was they ignored them and failed to spot a new infection that turned out to be Falciparum and by the time the severity was realised, it was too late!

I had Falciparum in 1997 and it wasn't an experience I'd wish to repeat. Interestingly, after 7 days on a drip in a semi delerious state it appeared to have been cured. A couple of weeks later on my treturn to the UK the symptoms re-appeared and I took myself down to the local A&E to report I had malaria. Of course, they had to run various blood tests to check it wasn't something else, which led to quite an uncomfortable delay. It turned out that not all the parasites had been killed.

A certain General Manager for BHL in Lagos once sent out a memo that stated the incidence of sickness due to Malaria was unacceptable and amounted to personal negligence. He was in Lagos for 7 years and never contracted it once. A couple of years later he came out on a visit in his new role, from the UK, for 2 weeks. On his return he became ill, lapsed into a coma, was on a life support machine and was read his last rites. He eventually recovered. I think the moral of the story is that at the end of the day, Malaria is like Russina roulette - whether you get it or not is all down to the luck of the draw!

[BlenderPilot]

When I worked in West Africa I took Savarine for a little bit, until I woke up one day with my lips swollen like crazy, so I quit it, never got Malaria, I used to out in the field by myself so I was told to take HALFAN with me and if I felt sick just pop the pills and ride it out.

I saw a few of the Peace Corps guys go a little crazy with Mefloquine BTW. Not recommended.

[helimutt]

I'm in Tanzania by the way.
Well I didn't quite realise that Falciparum was the most dangerous. Maybe i'd read it and not realised. maybe I was treated quickly enough that my parasite count was low when I started treatment. I wonder at what point you lapse into coma, not that I wish to experiment or anything. Probably if you dont realise you have it, and leave it, discounting it as something else for a couple of weeks?

Anyway, the medicine they give you for treatment isnt pleasant, makes you feel kind of spaced out, dizzy, but, all things going well, I can return to work tomorrow. So glad I had the test quickly and was taking Malarone already.

Lets see what the next few weeks brings. Wonder if I can go for the record number of Malaria infections in one tour? :hmm:

212man, just out of interest, how long do you reckon you may have had it before being tested/started treatment?

[batboy1970]

I have been in Africa for some years and am a Health and Safety Manager in the oil industry. Im dealing with the same questions and concerns day in day out. In my expierience, most of the short term ex pats will take a prophpylaxis but we have on occassion had them still getting malaria. Our longer term expats both resident and rotators tend not to take them, reasons given being, some complain of side effects and others dont take as malarone is known to be very hard on the liver long term.
Larium is avoided s it appears to be the modern day 'bluey' and sends you nuts and many take Doxycycline but thats more of a general neutrelizer.
Fact is if your going to get malaria the best place to get it diagnosed is Africa, Drs there recognise it as we do the cold in uk, yes they will confirm it with a blood test but most of these Docs know by looking at you, UK is hopeless at diagnosing it, this is where the self test kit comes in, if you have reputable or company approved medical providers in Africa, dont even bother self testing, just go and see them, carry your self test home with you, your still vulnerable for up to a month out of the malarial area.
Know the sympthoms, flu like, aches and pains in joints, stomach pain, sweats, Malaria is a progressive illness unlike the flu where you feel better after a few days this will just polax you, treat as early as you can. Carry an anti malarial with you when you go home.
Stick to some basic rules and minmise bites , youll never eliminate totally, regards repellant, believe it or not the best you can use is not custom made but is Boots skin so soft spray, your most at risk from dusk till dawn, wear long sleeves if poss, use mozzie nets over beds, keep A/C as low as possible , mozzies go dormant below 18oC, keep windows and screens closed and avoid areas of still or stagnent water, malaria is a killer alas we have expierienced it so get to know the sympyhoms and dont try and beat it as you would a cold or flu......you wont

[Nubian]

Helimutt,

You seem to have been most unlucky!
Been working in Africa, the Caribbean and South America for over 5 years. Never had Malaria, so I can't tell you much about how long the recovery will take but from former colleauges, they have told me that profylactics are ok to use if you're only going to stay for a short while in ''infected'' areas.
They told me that, the use of profylactics will ''mask'' the symptoms and delay the diagnosis which in turn will let the parasites get a better grip and the recovery will eventually take longer. These resident africans, a couple of them has it reguarly, have had malaria both ON and OFF profylactics and ''prefer'':p getting it without.(due to the earlier diagnosis, symptoms)
Falciparum consitute about 80% of the deaths from Malaria, and is the most aggressive of the 4, and if let alone for long enough it gets to your brain (hence celebral malaria) and if that is the case, you'll be lucky to survive.
As said above, most important is to prevent the bites in the first place.
We used to spray our rooms an hour or so before going to bed, when not using nets, and cover exposed skin during night with repellent (ie. ears,neck,arms, feet)
Good personal hygiene is important to limit the amount of bites as well, think espesially about your ancles/feet. I allways use repellent on my socks and lower pants when going out after sunset.
I night have been lucky, but these things have worked for me.

The good thing with malaria, is that it has diffrent drugs you can use to be treated with, it is very diffrent with for instance Dengue-fever which is a virus and don't have any medical treatment for it, so you have to ride it off... trust me, you don't what to get that either (personal experience 41C fever+lots of pain) and the mosqito is active during the day...

On a sidenote, the normal reaction of health-workers in northern Europe to Malaria, is that is close to signing your death-sertificate, and you just shouldn't even go to places like Africa if you can avoid it......which has to do with the limited knowledge of the average practitioner as they are very seldom exosed to these problems.

Hope it helps, and good luck in the future!