Malaria?

carcol said:

Hi, as the only dominican at my company in NYC, I've been asked how is the supposedly malaria outbreak doing, especially in the Casa De Campo area.
Should people be worried about that? What is going on? Is it controlled?
what should foreigners do before they get there and during.
Any insight would be appreciated!!! thanks.

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hi there, i'd also like some info on this. i'm coming in june from ireland and i reallydon't want to take malaria tablets but it looks like i'll have to.

your best bet is to consult your doctor or a travel clinic near where you live.they know best!!

carcol said:

I've been asked how is the supposedly malaria outbreak doing, especially in the Casa De Campo area.

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Casa de Campo is in La Romana province (AFAIK) and there has not been a Travel Advisory for this province during this outbreak. The advisories were for La Altagracia province and Duarte province (since rescinded). Both the CDC (USA) and PHAC (Canada) still recommend malaria prophalyxis, but only for La Altagracia province (including the Punta Cana and Bavaro tourist areas), not La Romana. As previously recommended however you should consult a trusted medical professional.

marylou22 said:

hi there, i'd also like some info on this. i'm coming in june from ireland and i reallydon't want to take malaria tablets but it looks like i'll have to.

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For those who have this irrational fear, don't have this fear - you take 500 mg Chloroquine once a week beginning the week before, then while you are there and a 4 week period after you leave. There are nearly no side effects and they cost dick. If you go to an endemic area, not including La Romana however not spending the $10 to get a hard to cure dangerous liver disease is pretty stupid and cheap behaviour.

I have been taking it weekly for the last 7 months since I travel to a malaria endemic area and by the time the 4 weeks ends I am leaving again, and it has no effect at all other than preventing malaria.

Don't get overworried about Malaria. Be really careful about taking preventative medicine. Although they have made huge improvements in the past years, prolonged prevention burdens your livier more than actually contracting the disease, and treating it on a timely basis.

I lived in malaria world headquarters (Nigeria) for over 3 years, and I only know one person who took the prevention, and she stopped after 2 months because of the side effects. All of the resident doctors (expat as well as locals) say to stay away from the profalactic (but always have a treatment at hand). If any of the symptoms pop up within two weeks of entering the area, get a quick blood test for Malaria, it takes 5 minutes.

I had it twice, so I speak from experience. Stay away from areas with a lot of moquitoes an hour either side of dusk, or wear long sleeved shirts and long pants and use autan. The pills are only an 80% protection anyway.

If you do however decide to take something, I've heard that Malarone is supposed to be mild as far as side effects are concerned (and there are some, anyone who tells you there aren't hasn't sat up all night trying to calm someone down who is hallucinating ....). Lariam and Resochin and the likes are supposed to be pretty bad, I'll have to consult my tropical medical kit, but I believe they are both Chloroquinine based.

Definately consult more than one medical source. I basically agree with canajungirl, but in this case the medical center "near you" (depends on where you live) may not know best. Don't count on European or American doctors to know a lot about Malaria. I came down with it once while I was in Germany, and they freaked because they werwnt used to treating this. They made me stay in the hospital for a week before releasing me. The next time I had it in Lagos, I just got a few pills and took 2 sick days at home.

duck said:

Don't get overworried about Malaria. Be really careful about taking preventative medicine. Although they have made huge improvements in the past years, prolonged prevention burdens your livier more than actually contracting the disease, and treating it on a timely basis.

If you do however decide to take something, I've heard that Malarone is supposed to be mild as far as side effects are concerned (and there are some, anyone who tells you there aren't hasn't sat up all night trying to calm someone down who is hallucinating ....). Lariam and Resochin and the likes are supposed to be pretty bad, I'll have to consult my tropical medical kit, but I believe they are both Chloroquinine based.

They made me stay in the hospital for a week before releasing me. The next time I had it in Lagos, I just got a few pills and took 2 sick days at home.

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I think it is really terrible advice to avoid two chlorquine a week for a short period to prevent it vs. taking huge amounts if you get it, particularly since diagnosis in non-endemic areas is hit and miss and mostly miss so you may contract it think it is the flu and not take the cure and then you want to talk about liver problems.

For an occasional trip, assuming it is in an endemic area ( and only a few in the DR are endemic) prevention is infinitely better than post-exposure treatment and this is a irresponsible thing to advise. Treatment is very large doses of cholorquine or qunine and can be quite harsh, and you wind up with a disease and large doses of what you are trying not to take in advance in small doses.

Since the strain in the DR is chlorquine sensitive that is all one needs to take - Lariam can cause and has caused psychotic episodes and malarone is chorloquine based anyway and is not needed unless you need the additional ingredient which you don't in the DR. Both also cost many times more.

For someone sensitive to chloroquine they can take doxycycline but you have to take it daily for the same multi-week exposure period, it costs more, and makes you photosensitive and may cause intestinal upset.

Note just because you can cure syphilis, chlamydia and gonhorrea doesn't mean you don't use a rubber, using your debatable logic.

ricktoronto said:

I think it is really terrible advice to avoid two chlorquine a week for a short period to prevent it vs. taking huge amounts if you get it, particularly since diagnosis in non-endemic areas is hit and miss and mostly miss so you may contract it think it is the flu and not take the cure and then you want to talk about liver problems.

For an occasional trip, assuming it is in an endemic area ( and only a few in the DR are endemic) prevention is infinitely better than post-exposure treatment and this is a irresponsible thing to advise. Treatment is very large doses of cholorquine or qunine and can be quite harsh, and you wind up with a disease and large doses of what you are trying not to take in advance in small doses.

Since the strain in the DR is chlorquine sensitive that is all one needs to take - Lariam can cause and has caused psychotic episodes and malarone is chorloquine based anyway and is not needed unless you need the additional ingredient which you don't in the DR. Both also cost many times more.

For someone sensitive to chloroquine they can take doxycycline but you have to take it daily for the same multi-week exposure period, it costs more, and makes you photosensitive and may cause intestinal upset.

Note just because you can cure syphilis, chlamydia and gonhorrea doesn't mean you don't use a rubber, using your debatable logic.

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Point taken, but I still think one should get advice from more than one medical expert, preferrably one with experience working in an area where malaria is prevalent.

Most prevention medicines also mask the symptoms should one get the disease, making it harder to diagnose.

As for me, I'll just keep some tablets in my travel case in case the symptoms show up.

me and my 6 mo old baby just got back from a 2 1/2 mo stay in La romana. the mosquitos were real bad, and we did go to a Dr. b4 the trip to get his advice. all he said was for me to wear bug spray and cover up the baby cause shes too young to spray. so i did the best i could. there are no warnings on cdc. anyways, they bit her real bad once we got there but since your body gives off chemicals once you get bit, they slowly disappeared...and luckily she never got sick......BUT....another member of the family who had a 5 mo old baby DID just recently get bit by a malaria carrying mosquito and i guess it was real bad. (it happened after we left) she had to bring her to the SD hospital but they caught it early and with the drugs shes fine now.....so yes, be careful and bring some industrial bug spray and re apply frequently. it only takes one bite remember...

Not again..

carcol said:

Hi, as the only dominican at my company in NYC, I've been asked how is the supposedly malaria outbreak doing, especially in the Casa De Campo area.
Should people be worried about that? What is going on? Is it controlled?
what should foreigners do before they get there and during.
Any insight would be appreciated!!! thanks.

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If there is truly another malaria scare the tourism industry is in for serious problems.......Is anybody paying attention..or once again looking at the small picture...without tourism this country will be really scary. LEONEL WHERE ARE YOU

ricktoronto, chill out...

i see all points of this argument but you have to remember rick, that sometimes prevention isn't the best bet..

where i come from malaria prevention is extortionately expensive and certainly not "a couple of bucks"
besides for that, side effects are a massive factor to consider. its what is turning me off getting the protection before i go. i will not spend my holidays hallucinating, nauseous etc... larium is what is prescribed here. there is very little else choice wise.. the dr.'s just don't prescribe anything else. believe me i've checked this out.
i strongly believe that if there is no malaria outbreak in your destination that you should just be extra vigilent at dusk etc adn use an extremely strong spray with deet. like autan...
please chill out, this is a friendly advice forum, you always seem slightly aggresive..

use deet

If you dont want to take the meds, then go to your nearest camping/outdoors sporting goods store, and buy yourself the Deet spray. they sell it with as low as 10 percent deet spray, up to 95% deet. it is safe, last for hours and will certainly keep the mosquitoes away! note- you cant find the high concentration level deet in a regular drug store, thats why you have to try the camping outdoor store.

marylou22 said:

i see all points of this argument but you have to remember rick, that sometimes prevention isn't the best bet..

where i come from malaria prevention is extortionately expensive and certainly not "a couple of bucks"
besides for that, side effects are a massive factor to consider. its what is turning me off getting the protection before i go. i will not spend my holidays hallucinating, nauseous etc... larium is what is prescribed here. there is very little else choice wise.. the dr.'s just don't prescribe anything else. believe me i've checked this out.
i strongly believe that if there is no malaria outbreak in your destination that you should just be extra vigilent at dusk etc adn use an extremely strong spray with deet. like autan...
please chill out, this is a friendly advice forum, you always seem slightly aggresive..

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Utter nonsense Marylou - you are in a developed country and cholroquine is one of the cheapest medicines on earth - it is generic and costs (here) 8 cents per 250 mg pill, or 16 cents a week - Lariam is neither required nor recommended where the malaria is succeptible to chloroquine. However you checked it out you didn't do a good job if you have an option of no medicine or the wrong medicine.

Lariam is "prescribed" there if you let a doctor prescribe it, ask for chloroquine and use it. You won't hallucinate or be nauseous.

An ounce of prevention - and keep in mind for ALL toruists to DR you do not need anything - only two a few select areas, regrettably one seems to be the Punta Cana area. Which is avoidable for other reasons anyway.

hand on a second..

ricktoronto said:

Utter nonsense Marylou - you are in a developed country and cholroquine is one of the cheapest medicines on earth - it is generic and costs (here) 8 cents per 250 mg pill, or 16 cents a week - Lariam is neither required nor recommended where the malaria is succeptible to chloroquine. However you checked it out you didn't do a good job if you have an option of no medicine or the wrong medicine.

Lariam is "prescribed" there if you let a doctor prescribe it, ask for chloroquine and use it. You won't hallucinate or be nauseous.

An ounce of prevention - and keep in mind for ALL toruists to DR you do not need anything - only two a few select areas, regrettably one seems to be the Punta Cana area. Which is avoidable for other reasons anyway.

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oh right ricktoronto, i'll go down and tell the doctor, 3 pharmacists, 1 pharmacy technician and 2 nurses that they are talking utter nonsense will i? i may live in a developed country but larium is what they prescribe here 95% of the time. please don't tell me i'm talking utter nonsense again. i got that advice of professionals in this "developed country" who studied for many years to become professionals.
where i come from the following are "essential" according to our national dept. of health adn all health boards.
Typhoid, tetanus, polio, diptheria,
Recommended:
Malaria, hep a adn hep b.
that is why i came to forum to ask advice (its purpose)as i would prefer not to get any vaccinations that are only recommended and not essential. there is a reason why they are not essential.
nonsense? nonsense is you telling people that the advice they got from professionals is "utter nonsense". And as for "letting" the dr. prescribe me medicine adn dictating what i should and shoudln't take, i wouldn't dream of questioning a professionals judgement adn thinking that i would know better than somebody who has studied this for donkeys years! i don't know many who do.
please lose the attitude. i'm going without.

thanks la flor

la flor, that's really handy to know. ta

marylou22 said:

i may live in a developed country but larium is what they prescribe here 95% of the time.

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Marylou.

In which country do you live?

I only ask because in Canada (PHAC) and the USA (CDC), the recommended prophalyxis for the malaria strain found in the DR is chloroquine; not lariam; and chloroquine is exceedingly inexpensive as far as a single course of treatment is concerned. Usually the pharmasist's dispensing fee is more than the cost of the meds.

If in your country they are prescribing lariam for a non-chloroquine resistant malaria strain then they are doing a diservice to their profession and their patients (excluding specific cases where chloroquine may be contra-indicated).

Gregg

They Cost Dick?

ricktoronto said:

For those who have this irrational fear, don't have this fear - you take 500 mg Chloroquine once a week beginning the week before, then while you are there and a 4 week period after you leave. There are nearly no side effects and they cost dick. If you go to an endemic area, not including La Romana however not spending the $10 to get a hard to cure dangerous liver disease is pretty stupid and cheap behaviour.

I have been taking it weekly for the last 7 months since I travel to a malaria endemic area and by the time the 4 weeks ends I am leaving again, and it has no effect at all other than preventing malaria.

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And what is the current exchange rate on "dick" these days? LOL

Regards

marylou22 said:

i see all points of this argument but you have to remember rick, that sometimes prevention isn't the best bet..

where i come from malaria prevention is extortionately expensive and certainly not "a couple of bucks"
besides for that, side effects are a massive factor to consider. its what is turning me off getting the protection before i go. i will not spend my holidays hallucinating, nauseous etc... larium is what is prescribed here. there is very little else choice wise.. the dr.'s just don't prescribe anything else. believe me i've checked this out.
i strongly believe that if there is no malaria outbreak in your destination that you should just be extra vigilent at dusk etc adn use an extremely strong spray with deet. like autan...
please chill out, this is a friendly advice forum, you always seem slightly aggresive..

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Thank you Marylou! My friendly advice came from years of experience living where millions of people every month get malaria (and you wouldn't read about "outbreaks"). Everyone should listen/read as much as they can, and then make their own judgement based on that. I personally prefer not to pump myself full of medicines (that definately have side effects) when I'm not sick. Covering up and using repellent are equally effective - especially when we are talking about a handful of incidents.

I also split my time when I'm on the island between the DR an Haiti which is also a risk area, and would never think about taking something beforehand - but that's my "debateable logic."

The condom analogy would fit more with covering up and using repellent, seeing as these are both applied externally as opposed to ingesting, and both are very good at preventing infection.

Rick's point however should be considered if someone is more confortable taking the prevention. Having the disease is definately a real bummer.

duck said:

Thank you Marylou! My friendly advice came from years of experience living where millions of people every month get malaria (and you wouldn't read about "outbreaks"). Everyone should listen/read as much as they can, and then make their own judgement based on that. I personally prefer not to pump myself full of medicines (that definately have side effects) when I'm not sick. Covering up and using repellent are equally effective - especially when we are talking about a handful of incidents.

I also split my time when I'm on the island between the DR an Haiti which is also a risk area, and would never think about taking something beforehand - but that's my "debateable logic."

The condom analogy would fit more with covering up and using repellent, seeing as these are both applied externally as opposed to ingesting, and both are very good at preventing infection.

Rick's point however should be considered if someone is more confortable taking the prevention. Having the disease is definately a real bummer.

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exactly duck, my body will be toxic enough from the copius amounts of presidente beer i'll be drowning it in

ah, i'm not worrying bout it anymore, i'm just going to be careful. sure if i get malaria i'll come back here and rick, you can have a nice gloat and tell me i told you so!!!