We will be staying in cabarete for one month - July 06. We have been advised by three doctors to take, and give to our 2 and 5 year old children, chloroquine to prevent malaria. Is this necessary? There are side effects that we would prefer to avoid but we do not want to be irresponsible with our children's health. Please advise asap!!!
- Thread starter sandraodems
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Cabarete malaria risk?
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don't take my word for it...
"Children are especially sensitive to the effects of chloroquine. This may increase the chance of side effects during treatment. Overdose is especially dangerous in children. Taking as little as 1 tablet (300-mg strength) has resulted in the death of a small child. Children should avoid traveling to areas where there is a chance of getting malaria, unless they can take antimalarial medicines that are more effective than chloroquine."
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202133.html
"Children are especially sensitive to the effects of chloroquine. This may increase the chance of side effects during treatment. Overdose is especially dangerous in children. Taking as little as 1 tablet (300-mg strength) has resulted in the death of a small child. Children should avoid traveling to areas where there is a chance of getting malaria, unless they can take antimalarial medicines that are more effective than chloroquine."
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202133.html
There has yet ever to be a case reported of malaria from Cabarete. FYI, Dominican pediatricians do not recommend malaria prevention treatment to Dominican children, regardless of where they will be traveling in the DR.
See http://www.cdc.gov/travel/regionalmalaria/caribean.htm
See http://www.cdc.gov/travel/regionalmalaria/caribean.htm
Couple of points:
1) Given a choice between forum members and a doctor, I'll side with the doctor
2) You doctor is probably responding to the malaria scare of last year. The vast majority of reported malaria occurs near the Haitian border (malaria being much much more prevalent in Haiti than in the DR. Last year (or was it the year before?) there was a concurrence of events that let to malaria being present in Punta Cana. One was the hurricane / tropical storm that passed through, leaving a lot of water on teh ground which let to a significant increase in the mosquito population. The other is the construction boom in Punta Cana and the fact that Haitians are used for much of the manual labour in construction in this country. So, put together a population with a high per capita incidence of malaria with a truck load of mosquitos, and you end up with a higher than normal incidence of malaria.
Last I heard, about ten tourists were confirmed malaria-positive, which led to people thinking that this country was a hotbed for malaria. Bit of an exaggeration there...
Meanwhile, to the best of my knowledge, there have been no reports of malaria amongst the locals or tourists on the north coast, so you should be all good.
Cheers!
1) Given a choice between forum members and a doctor, I'll side with the doctor
2) You doctor is probably responding to the malaria scare of last year. The vast majority of reported malaria occurs near the Haitian border (malaria being much much more prevalent in Haiti than in the DR. Last year (or was it the year before?) there was a concurrence of events that let to malaria being present in Punta Cana. One was the hurricane / tropical storm that passed through, leaving a lot of water on teh ground which let to a significant increase in the mosquito population. The other is the construction boom in Punta Cana and the fact that Haitians are used for much of the manual labour in construction in this country. So, put together a population with a high per capita incidence of malaria with a truck load of mosquitos, and you end up with a higher than normal incidence of malaria.
Last I heard, about ten tourists were confirmed malaria-positive, which led to people thinking that this country was a hotbed for malaria. Bit of an exaggeration there...
Meanwhile, to the best of my knowledge, there have been no reports of malaria amongst the locals or tourists on the north coast, so you should be all good.
Cheers!
Just a coincidence, but today at another forum there was a report of a case of malaria this week of someone who visited Punta Cana 2 weeks ago. I think there have been isolated cases there before. The idea there was a link with Haitian construction workers (maybe working on the new Palace Punta Cana resort).
But apart from such isolated cases I have at most heard the advice to take some precautions when visiting the Haitian borderlands. Cabarete is not close to Haiti, and I would not worry about malaria.
But apart from such isolated cases I have at most heard the advice to take some precautions when visiting the Haitian borderlands. Cabarete is not close to Haiti, and I would not worry about malaria.
Malaria
I will chime in here and say one thing.
Take only the advice from your doctor
whether or not people think there is a chance of malaria or whether they feel it is or isnt good for you or your kids.
I will chime in here and say one thing.
Take only the advice from your doctor
whether or not people think there is a chance of malaria or whether they feel it is or isnt good for you or your kids.
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Hlywud,
Sorry to disagree with you. When it comes to malaria, many doctors in the US are misinformed or not up to date. That is why there are second opinions and why individual research available online can be discussed with one's doctor or can help one decide about the risks involved.
If you check the CDC link provided above (http://www.cdc.gov/travel/regionalmalaria/caribean.htm), you will see that the US Center for Disease Control that monitors malaria in the world, states that prophylaxis is only recommended in areas considered of risk in the DR -- La Altagracia province and Haiti border areas. Cabarete is not a risk area.
As pointed out, the remedy is much worse than the minimal risk it would prevent.
There are even studies that show that the prophylaxis is not 100% effective, and the side effects are a real thing. Better still is just to use insect repellent.
Sorry to disagree with you. When it comes to malaria, many doctors in the US are misinformed or not up to date. That is why there are second opinions and why individual research available online can be discussed with one's doctor or can help one decide about the risks involved.
If you check the CDC link provided above (http://www.cdc.gov/travel/regionalmalaria/caribean.htm), you will see that the US Center for Disease Control that monitors malaria in the world, states that prophylaxis is only recommended in areas considered of risk in the DR -- La Altagracia province and Haiti border areas. Cabarete is not a risk area.
As pointed out, the remedy is much worse than the minimal risk it would prevent.
There are even studies that show that the prophylaxis is not 100% effective, and the side effects are a real thing. Better still is just to use insect repellent.
In the almost two year's since Hurricane Jeanne there have been on-again, off-again malaria warnings and recommendations for La Altagracia province and for a few short weeks for Duarte province from both the Canadian PHAC and the US CDC.. In the preceding number of years there were none at all except for a general recommendation that as the proximity to Haiti increased, so did the concern about malaria.
There has, in all the time I have been travelling to the DR, never been a warning or recommendation of prophylaxis for the North Coast - NEVER. While I did take chloroquine while in Punta Cana last year; this year I passed and I have yet to take anything while travelling to the North Coast. Again in September I will not take anything unless conditions change dramatically before my week in Sosua.
I am surprised that as a US based poster that you are concerned as this is atypical of American posters - it is more often that UK based posters raise malaria issues as their travel medicine specialists seem to see it behind every tropical bush.
JMHO.
Gregg
There has, in all the time I have been travelling to the DR, never been a warning or recommendation of prophylaxis for the North Coast - NEVER. While I did take chloroquine while in Punta Cana last year; this year I passed and I have yet to take anything while travelling to the North Coast. Again in September I will not take anything unless conditions change dramatically before my week in Sosua.
I am surprised that as a US based poster that you are concerned as this is atypical of American posters - it is more often that UK based posters raise malaria issues as their travel medicine specialists seem to see it behind every tropical bush.
JMHO.
Gregg
sandraodems said:
Did you ask those doctors what they based their advice on? Certainly it wasn't based on personal experience, or even on research into the liklihood of getting malaria in Cabarete.
Do you live in Canada by any chance? Every so often the health department there puts out scare warnings about health dangers in the DR that are usuallu unfounded.
One thing you can be sure of is that those of us who live on the North Coast or have spent a lot of time there and are responding to your question don't want you or your children to get sick from malaria. And if we thought there was a reason for you to be concerned, be sure we would err on the side of caution and advice you to get the protection.
PS: Thanks, Rocky, for letting me know I made a major error when I left out a key word.
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Malaria is not really normal. I don't think it is common to have malaria. In 25 years of being a dominican from the states, none of my island frieds of family have had malaria. I have walked all hours of the clock in santiago and puerta plata and I never got malaria. I never use insect repellent.
In Sosua...
I have frequently been asked about Malaria, by tourists & newbies.
To appease their fears, I would call an employee over and ask them what Malaria was, and their reaction of not knowing or never having heard of it, was usually enough to alleviate their fears.
After many years of asking the same question, some of the employees now know that it is a disease, but have never heard of anyone who had it.
If that's not proof enough, nothing is.
I have frequently been asked about Malaria, by tourists & newbies.
To appease their fears, I would call an employee over and ask them what Malaria was, and their reaction of not knowing or never having heard of it, was usually enough to alleviate their fears.
After many years of asking the same question, some of the employees now know that it is a disease, but have never heard of anyone who had it.
If that's not proof enough, nothing is.
malaria risk Cabarete
Thanks to all of you who have taken the time to reply to my question regarding chloroquine. I am an american and apparantly the doctors here have jumped on the bandwagon with the British and Canadian doctors. I think the big reason is the scare in Punta Cana. Everyone feels that there is nothing (except prevention) to stop the same thing from happening elsewhere in the DR given the relative proximity to infected areas. I even telephoned the Clinica Dr. Bournigal in Puerta Plata yesterday and the man I spoke with gave me the same recommendation and the same reasoning - take chloroquine for prevention. He also mentioned that he had never seen a case of malaria himself. I do not know if this man was a doctor but he seemed somewhat informed. He also said the travel agents are giving the same recommendation - so this information is also coming directly from the DR.
I usually follow doctor's recommendations and am not one to act irresponsibly, especially concerning my children, but I do not know if we will take the drug. Chloroquine is not even recommended for children under the age of two and my son is only a few monthes beyond that. If the risk in Cabarete is so low, I would rather not give it to him. Unfortunately, I will worry. We were in Aruba last year when hurricane Emily came through and there were tons of mosquitos for about a week. We were not using repellent and he received many bites - many more than the rest of my family. We will use the repellents in the DR.
This is all so odd and disconcerting. We were in Cabarete four years ago with a 14 month old child for two weeks and we did nothing special other than watching what we ate and no one got sick (we did not see a travel doctor before we left). I look forward to getting beyond this stressful stuff. The doctors have also recommended Hep A, Hep B & Typhoid Fever vaccinations for all of us....... We have all received the Hep A, the children have recieved one dose of Hep B and I am not sure we will get the typhoid vaccination.
Thanks again for all of your comments - please feel free to chime in again if you like, as I will continue to check the postings. We are really looking forward to a wonderful trip to Cabarete - just like last time!!
Thanks to all of you who have taken the time to reply to my question regarding chloroquine. I am an american and apparantly the doctors here have jumped on the bandwagon with the British and Canadian doctors. I think the big reason is the scare in Punta Cana. Everyone feels that there is nothing (except prevention) to stop the same thing from happening elsewhere in the DR given the relative proximity to infected areas. I even telephoned the Clinica Dr. Bournigal in Puerta Plata yesterday and the man I spoke with gave me the same recommendation and the same reasoning - take chloroquine for prevention. He also mentioned that he had never seen a case of malaria himself. I do not know if this man was a doctor but he seemed somewhat informed. He also said the travel agents are giving the same recommendation - so this information is also coming directly from the DR.
I usually follow doctor's recommendations and am not one to act irresponsibly, especially concerning my children, but I do not know if we will take the drug. Chloroquine is not even recommended for children under the age of two and my son is only a few monthes beyond that. If the risk in Cabarete is so low, I would rather not give it to him. Unfortunately, I will worry. We were in Aruba last year when hurricane Emily came through and there were tons of mosquitos for about a week. We were not using repellent and he received many bites - many more than the rest of my family. We will use the repellents in the DR.
This is all so odd and disconcerting. We were in Cabarete four years ago with a 14 month old child for two weeks and we did nothing special other than watching what we ate and no one got sick (we did not see a travel doctor before we left). I look forward to getting beyond this stressful stuff. The doctors have also recommended Hep A, Hep B & Typhoid Fever vaccinations for all of us....... We have all received the Hep A, the children have recieved one dose of Hep B and I am not sure we will get the typhoid vaccination.
Thanks again for all of your comments - please feel free to chime in again if you like, as I will continue to check the postings. We are really looking forward to a wonderful trip to Cabarete - just like last time!!
malaria risk
Hello again,
Just to repsond to the thread regarding seeing a travel medicine specialist here in the states. Two of the three doctors we have talked to ARE travel medicine specialists. The third is our children's pediatrician - who I trust enormously and who has never pushed me to give my children vaccines that were not clearly safe and beneficial. Thus, this will be a very difficult decision for us.
Thanks again for your thoughts.
Sandra Odems
Hello again,
Just to repsond to the thread regarding seeing a travel medicine specialist here in the states. Two of the three doctors we have talked to ARE travel medicine specialists. The third is our children's pediatrician - who I trust enormously and who has never pushed me to give my children vaccines that were not clearly safe and beneficial. Thus, this will be a very difficult decision for us.
Thanks again for your thoughts.
Sandra Odems
I did massive research both before and after visits to the DR. I would have to agree with Rocky. Everything I read about cases of malaria were very old and from the Punta Cana area or Haiti. Also during my visits to the north coast I asked people what they do to protect themselves from malaria and mosquitos and they didnt seem to know what malaria was. As far the mosquitos if your truly concerned you could use bug repellent but I found myself when outdoors at night to just simply stay away from the lights and the night time bugs seemed to be non existent. I didnt even use any repellent and didnt get bit by even 1 mosquito my last 3 trips to Sosua/Peurta Plata.
I understand its hard to trust people you dont know and you definitely trust your doctor or you wouldnt see him, but you should at a minimum ask where he is basing his information from. Also possibly visit the CDC website and print out the information to show him as well as some of our comments.
I understand its hard to trust people you dont know and you definitely trust your doctor or you wouldnt see him, but you should at a minimum ask where he is basing his information from. Also possibly visit the CDC website and print out the information to show him as well as some of our comments.
malaria risk
The hard part about the CDC website is that they say you should use protection in all rural areas. The definition of rural and what areas apply to that is unclear. Should Cabarete not be considered rural? It seems like some of the areas directly adjacent to the beach strip can get pretty rural.
The hard part about the CDC website is that they say you should use protection in all rural areas. The definition of rural and what areas apply to that is unclear. Should Cabarete not be considered rural? It seems like some of the areas directly adjacent to the beach strip can get pretty rural.
Around here, Cabarete would not be considered a rural area.sandraodems said:
It is a hussling bussling town, alive with action.
The real bottom line is, that seeing as how there is not one single recorded case of Malaria in history in Cabarete, one should feel pretty darn safe.
It takes two to tango....
I gather there are no, or not many Haitians in Cabarete, or at least not many new arrivals from Haiti who may harbor the Plasmodium parasite in their blood. First, a mosquito has to bite the Haitian carrier, survive the ordeal ;-), and then bite a healthy person. Actually, the probabilities of contagion are quite low. So, avoiding mosquito bites (netting, repellants, etc), and of course, reducing the population of infected people (Trujillo, where are you? ;-), and folklore has it that high alcohol blood content makes you almost invulnerable to the Plasmodium parasite (at the expense of increasing your chances of liver disease ;-), will reduce your chances of getting malaria almost to nil...
..
I gather there are no, or not many Haitians in Cabarete, or at least not many new arrivals from Haiti who may harbor the Plasmodium parasite in their blood. First, a mosquito has to bite the Haitian carrier, survive the ordeal ;-), and then bite a healthy person. Actually, the probabilities of contagion are quite low. So, avoiding mosquito bites (netting, repellants, etc), and of course, reducing the population of infected people (Trujillo, where are you? ;-), and folklore has it that high alcohol blood content makes you almost invulnerable to the Plasmodium parasite (at the expense of increasing your chances of liver disease ;-), will reduce your chances of getting malaria almost to nil...
..
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