[Yashodhara]

We will be in India for roughly a month in January ( )  and are still unsure about how to go about malaria prevention. The doc prescribed Malarone stand-by, following the recommendations of the German Foreign Ministry. Hmm, I wonder if we might end up getting scared at every little symptom like a light headache or anything, I would not want to be running to a doc all the time to check. On the other hand we are not keen on taking malaria tablets all the time if this is not necessary. We don't consider ourselves being very paranoid about diseases, this is just about making the best choice for this trip. We will mostly stay in midrange places and will follow all the advice about covering oneself up properly and using repellent. Another question would be if Malarone is available in India too. I know doxy is, but how about Malarone or Lariam? In case we opt for the prophylaxis we would like to only buy here what we need before the trip and then stock up in India.

Tough decision, how do you experienced travelers handle this? Any comments are much appreciated. Thanks for your help.

[tstan]

Hi Yasho

The manufacturers of Malarone have kept a tight control on where it may be sold - I don't think it is available in India or Thailand but it is available in Singapore and other "Western" countries on prescription. If you are going to use it as a treatment (rather than a preventative) you are probably best to buy it before you leave for India.

It is wise to back up with good DEET based creams or sprays some of which can be bought in India, mosquito coils, electric plug-in deterrents (keep in mind that there are a lot of power cuts in India) and use Permethrin to soak your mosquito net, socks, shirts, trousers, pillow case and sleeping bag liner. The latter also repels bedbugs, cockroaches etc.

It is important to realise that other unpleasant diseases (like Dengue) are spread by mosquitoes and taking a lot of malarial medications might give you a false sense of security.

[iwanttogoback]

yash

i don't know much about malarone, it's not used much by australians - lariam seems to be the drug of choice here.

are you concerned about side effects?

after much research and thinking i decided that taking antibiotics for a month, and using a tropical strength deet cream, lots of sunscreen, a hat, and clothes that generally covered my legs and arms was, for me, the best choice. i really didn't like the sound of the possible side effects of lariam.

luckily, though, i'm not very attractive to mozzies.

[cyberhippie]

No malarone in India I'm afraid Yash, doxcycline is also a good choice and as cheap as chips in India.

However the balance of European opinion seems to now say apart from Goa and the Northeastern States, antimalarials are no longer considered neccesary.

[torryquine]

We're not too paranoid either, but we take Malerone as a preventive and have experienced no side effects.  Mossies love me, malaria is horrible.  I agree with everything said about repellants, but be carefull with anything containing DEET.  Take a good anti-histamine cream too if you're prone to being bitten, as it stops you scratching and opening the skin, and you get a better night's sleep.

Someone once gave me one Larium tablet.  Half an hour later I was on the floor of my Bangkok room, with severe heart palpitations and unable to move without falling over.  I had a series of panic attacks over the following months.  We avoid it now.

[iwanttogoback]

tq, although the incidence of side effects with lariam is reputedly low, that kind of thing is exactly what i am avoiding. i've had a panic attack or two and i'm not interested in drugs that might induce them.

yes, antihistamine cream and/or tablets are a good idea as well.

cy, opinion here is that mumbai, with its humid climate, can also be a malaria risk.

it sometimes seems a case of damned if you do, damned if you don't!

[Yashodhara]

Thanks a lot for all your comments, very helpful indeed. I am leaning towards the preventive option now, Malarone or doxy, but I will have to see what Mr Y thinks. Yes, we have heard about the possible side effects of Lariam, this is really scary. Then again I have spoken with some people who were very happy with Lariam (and it is just one pill a week), but I certainly would not want to experience anything TQ mentioned, brr that is too frightening.
Doxy sounds like a good choice to me, but taking antibiotics for such a long time? We would end up having to use it for two months then, right? I would really like to only depend on the treatment/stand-by option since this is what medical institutions recommend here, but I m just sooo unsure. Will think about this for a few more days and let you know how we decide.
Also thanks for the repellent and cream advice, we will take that to heart. Taking these precautions seems to be even more effective than the actual malaria drug I feel. Ah, reading guide books and making travel plans is much more fun than dealing with potential health risks.

[WonderWomanUSA]

On my last visit to India, I bought Doxycycline the day I arrived, and took it for a total of 90 days (10 days after returning home) -- the side effects are minimal with that one and it is often given for long periods of time to clear up teenage acne. Some women, however, says it gives them yeast infections ...  but it's still MY antimalarial of choice.

[iwanttogoback]

good to hear that wwusa too uses doxy. most of the folk i travelled with used doxy and there were no reported side effects from any of them - no nausea, yeast infections or sun sensitivity.

i know that there is a fairly vocal anti-antibiotic lobby and in my normal life at home i don't use them unless i have to, but in a situation where you need protection against a potentially fatal disease, and the alternative meds have some serious potential side effects then it's an easy choice for me.

[Yashodhara]

You have convinced us! We talked to the doc this morning and will now go for doxy. A friend of ours is going to Ghana for a month, his doc prescribed Lariam and our friend is willing to take that. I hope we have made the right decision, at least I feel a lot better now having ruled out some of the nasty side effects stuff.

Thanks again for your input, dear ones.

[iwanttogoback]

another victory for team doxy! , which you can also buy cheaply in india so maybe don't get too much at home if it's expensive?

are you excited yet?

[Bumblebee]

I`ve been in India since 4 months now. First 2 months I was in Delhi, Agra, Mc Leod Ganj, Manali and Ladakh and took Lariam (I had taken it before in egypt and had no side effects). I did the same first time I was in India (Pune 2 months). This time after some 2.5 months (and having reached Karnataka and Goa), I ran out of tablets (I had figured before I`d buy some in India), but I feel akward taking Lariam for months... So, I don`t take anything anymore since some 1.5 months. I never used mosquito nets (I had brought an impregnated on my first visit to India, but it was so much hassle hanging it up and not touching it when inside, that I didn`t use it..
I have DEET with me, but I only apply it once I feel mosquitos bite (sounds weird I know), but again I don`t want to apply this chemical on me every day for months, maybe a year...

I have been ill last week after my arrival from Karnataka to Delhi; headache all day and night, nausea, throat pain etc, but after 2 days I was recovered. Funny; but I never thought then I might have caught malaria..
Now I am again little bit ill, after visiting Varanasi for 3 days; I caught a cold, probably during our evening boat trip on the Ganges during the festivities.. malaria is not on my mind again.

I know I may not be cautious in malaria prevention, but I just don`t feel well by taking this strong medicine for a long time and apllying DEET every day for months. In Karnataka only I do apply it almost every night because I get bitten like hell there, but otherwise I don`t.
So; yes, I have been bitten by mosquitos a lot, just today in Delhi in the house of a friend where I stay, during the day!

But travelling for one months only; go for prevention!

helga
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Helga`s India blog