Should I take the antimalarial pills while (or before) travelling around Argentina, Uruguay, Paraguay, Chile? Do I have to take them at all? Is there any other disease I should be protected against (Hepatitis A, Yellow fever)?
Any tip would be really helpful!
Search the forums for 'malaria', and several useful threads will appear. Malaria risk in Argentina, Uruguay and Chile is minimal, and depends on region in Paraguay (note: Paraguay is one of the few countries where Chloroquine is the specifically recommended antimalarial drug). Yellow fever inoculation is not an official entry requirement for any country mentioned, but if you could get one cheap, it wouldn't hurt. And vaccination for hepatitis (preferably also B) is always a good idea if you ask me.
check cdc.gov/travel for more information
[ Edit: Edited at Sep 26, 2006 3:46 AM by bentivogli ]
tnx niels! website is really helpful but still i'm not convinced to take this strong antimalarial pills for such a long time (3 months).. and you, you took them?
otherwise i'll skip the yellow fever inoculation (it's rather expensive) but not hepatitis B, just in case.
forget the malaria prophylaxes. No need for it in South America. The chance of malaria is too little, but you are sure when taking the prophylaxes that it does some damage to yourself
In the 20 years I am in South america (all around. also Amazone) I have never encountered malaria and seen too few cases to make it worthwhile. Just cover up at dusk, and have a good repellent and be gentle with the use of alcohol(zero is best ofcourse..) in malaria areas is in my humble opinion a lot better prophylaxe
be careful with the kind of advice that Marcel's dispersing. Although I'm sure he never got malaria, that's no proof of anything, and in some regions, the risk is really very high.
Malaria is a highly area-specific disease, since the mosquitoes only prosper under the right conditions. Consult a medic if you don't know what to do; do not rely on advice given here, no matter how well it's meant, or how experienced the people who give it. It's your health, you shouldn't take unnecessary risks.
Nice theory yes. And as health is so important to Niels (as should ofcourse)why advice in taking prophylaxes for an area where malaria no real risk and which will 100% sure do damage to body and soul and give no 100% cover anyway. In all my travels I have met too many travellers (not soth america btw, but eastcoast Africa and southeast Asia) who did get malaria and did take the pills.
Problem when taking the pilss is that you do not get the idea of having malaria but seems a normal flew. Till it is very late. And even sometimes too late.
When not taking pills you recognize malria straight away. Take the medicine which will have effect within 24 hours and than go to a doctor asap to check if there is need for more medication.
That has always been my philosophy but ofcourse evereyone should do what he feels like,
Well, I'd follow the national health organization advice first, and take anti malarial pills in the recommended areas.
Of course, you could not take any and not catch malaria, but is it really a risk you want to take ?
ofcourse if you ask a doctor he will advise you to take pills. Would I do too probably if I could be held responsible....If the guy does get malaria you have done what you could and cant be blamed (or taken to court...)
But still, I wonder why to prescripe something which has such bad side effects and is still far from 100 % to prevent you from getting malaria as the other option is to wait and see if you get it, take the medicine which will make you ok within 24 hrs and go and see a doctor to check if any other medication is necessary?
I have been on the road with many people (and as said this thread all started with South America and there I have never ever got a client who got malaria, not even met travellers who did let alone that someone will have cought the deadly version of malaria.
And in Africa strangely the people who did what i did never got malaria and in the same group there were some taking pills and got malaria. (must say that they did take beer, and did not bother using shorts after dusk because they were protected by the prophylaxes..)
Bookwisdom and life are not always the same
The choice to take anti-malarials will be up to you. Right now, two of the countries that you will be visiting are "No Risk" countries - they are Chile and Uruguay.
Argentina and Paraguay do carry some risk in the following areas:
Rural areas of Salta and Jujuy provinces (along the Bolivian border) and Misiones and Corrientes provinces (along the border of Paraguay).
Source - CDC
Risk in the departments of Alto Paraná, Caaguazú, and Canendiyú.
Source - CDC
If you travels will be taking you to these areas, then I highly recommend malarial prophylaxis treatment while in those areas. I would highly recommend using Chloriquine (and it is the only anti-malarial recommended for Argentina) because it is taken once a week, is well-tolerated by the body, and is quite inexpensive. (It is a derivative of "good old-fashioned" quinine. You take one tablet one week before entering areas of risk, continue weekly while in the area and 2 weeks after leaving. When taken with food or milk, Chloroquine's sid effects are almost non-existent. (I took mine on an empty stomach most of the time and had no problems.)
If you choose not take the prophylactic treatments, I recommend drinking cocktails that contain tonic water (ie: gin & tonic or vodka & tonic) as tonic water does contain quinine. (Yes, I'm serious.) You can take your chances, BUT, if you do contract the disease, you will be placed on much higher doses of the anti-malarials (possibly in combination - ie: more than one drug) for quite a long period of time. I don't mean to scare you - it's just reality.
My recommendations for your other vaccinations are:
Hep A: Hep A is transmitted though food, water and contaminated dinnerware. (Beware of street vendor foods.)
Hep B: Hep B is transmitted through bodily fluids (saliva, semen, blood and urine) and medical treatments.
Thyphoid: Thyphoid is transmitted through drinking water and food. Though the vaccine is 50-80% effective, it will boost your immunity and treatment, if you are infected, will be much shorter and the disease less severe. (One of our members received her vaccination and still contracted thyphoid from eating infected eggs. She was very happy she had taken the vaccinations before her trip.)
Yellow Fever is not required for any of the countries you have listed UNLESS you are entering the countries from an endemic zone (ie: SE Asia, Africa). Also, I'd skip the rabies unless you will be working with wild animals or spending most of your time in rural areas. Don't pet the monkeys or skunks and youu should be fine there.
Hope this helps...
When I wrote "you shouldn't take unnecessary risks", that clearly goes both ways. Don't take medication you don't need, but don't abstain from taking medication where required.
I want to stress again how important proper precautions are, and how impossible it is to generalise in this respect. No-one here will be able to tell you what is best in your situation, no matter how experienced they are; a good tropical docter (or a service like CDC) cán.
One more thing: Marcel's story about docters prescribing drugs by default is simply untrue; while that still might go for the US (but even there I think it pretty unlikely), it's absolute rubbish for Europe, where the medical community is much more hesitant to prescribe chemicals you don't need.
***Don't take risks; consult a professional***
[ Edit: Edited at Oct 9, 2006 5:48 AM by bentivogli ]