The decision of whether or not to take anti-malarial medications when traveling can be a controversial one. Some people take them weather they are necessary or not. They do what the travel clinics or their doctor tells them. Many travel clinics just visit the CDC web site and prescribe one of four different medications based on the country they will visit and the medication that is the most effective per CDC guidelines. All very well and good. But there is more to the story, and this knowledge can be helpful if your doctor is not as informed as you are about the trip, or you cannot take the anti-malarial medication. Even the least offensive medications of them all, Malarone, can have side effects which can spoil your trip. Following are things to consider when planning a trip to a malarial zone in addition to consulting your physician:
1. What time of year will you be travelling? Mosquitoes requite heat. If it is winter where you will be going, there is a strong likelihood that bite prevention measure are all you need.This includes careful use of DEET, as well as spraying your clothes with Permerthrin. You can also purchase clothes that have been treated with Permerthrin, but it is less expensive to purchase it yourself and treat your clothing.
2. What part of the country will you be going to? The country may indeed have malaria, but maybe not where you will be going. Higher elevations are cool and are less likely to attract mosquitoes, if at all. Mosquitoes also require water, so dry areas are usually not an issue. Refer to one of two malaria maps which can be found online to determine your risk per the part of the country you will be visiting. One is by the CDC, and one is by the UK organization Fit for Travel. In South Africa for instance, it may be malarial, but many of the safaris are advertised as malaria-free. Thanks to spraying efforts, many countries such as Botswana and Swaziland are now considered low risk. Namibia is so dry, most of the country is malaria free.
3. Where will your be sleeping? Even if the area is endemic for malaria, your tour may not use lodging in a malaria zone. Malarial mosquitoes only come out from dawn to dusk, so if you are not sleeping in a malarial zone, your risk is once again greatly reduced. Bite prevention measures may be all you need for when you are outdoors. In order to find out if your accommodations are malaria free, Google the name of the accommodation along with the word malaria. If it is in malaria free zone that is usually mentioned on the web site.
4. How much contact will you have with locals? In order for malarial mosquitoes to transmit the disease, they need to bite an infected person first. Then they need to come over and bite you. The life of a mosquito is not that long after they bite somebody, so the chances of you getting bitten and subsequently infected is greatly reduced the less you are with the local population at night. Somebody with malaria would have to be in your group for you to get it.
Malaria is still a deadly disease, and certain strains in particular are deadlier than others. But it is wise to consider the real risk involved so as not to spoil your vacation due to a bad vaccine reaction or unnecessary medication. But when in doubt at all, change your travel plans as this author recently had to do. Once you get further educated about the destination and possible malaria risks, make your travel plans accordingly.
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