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Travel Forums General Talk Help Isadora!

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1. Posted by george1979 (Full Member 101 posts) 9y

Hi Isadora,

Sorry to bother you but as you are quite knowledgable on this subject, and have travelled a fair bit, i thought you would be the best person to ask (that's not to say anybody else wouldn't be helpful) . I have asked my doctor (who is useless on a good day ) about anti malarials for South America but they keep asking me exactly where am i going to be and for how long etc. As this is my 1st backpacking trip i really only have a general idea where i will be, other than which country i will be in. I can't seem to get a straight answer from my doctor or chemist as to which malarials to take .
They have suggested Lariam and something other pills in combination but i have heard bad things about Lariam so would rather not use these.
The other was Doxycycline but i'm not sure if this is OK for the areas i am visiting. Malarone was mentioned but the price prohibits this.
I was hoping if i give you my trip details you could help?

I am leaving in 2 weeks to go on a RTW trip. my itinerary is:
madrid 2 weeks
Lima 3 days then fly to Cusco. Will be in and around Cusco for about 2 weeks or so. From there nothing is set in stone but was planning to travel overland to Lake Titicaca then on to La Paz and taking in the uyuni salt flats if possible.
Would then want to travel down to Argentina, then on to Chile but i understand i don't really need anti-malarials for this area.
The only other area i will be visiting that has a malaria risk is South East Asia which will be at the end of my trip in about 10 months.
This is really getting on my nerves now so any help you all can give would be very much appreciated.

2. Posted by Mel. (Travel Guru 4567 posts) 9y

Hello George

I am not Isadora, but since u posted on the public forum, I will give my 2 cents.;)

Go to the website of the World Health Organisation(WHO) and u can find out about the malaria medication which is suitable for each place. Then u will be able to just tell the pharmacist which u want. There might even be one, which covers all the places u might visit.

Mel

3. Posted by Isadora (Travel Guru 13926 posts) 9y

Hi George!

Sounds like a great trip - mind if I tag along??? (Not sure Beerman will be enthusiastic about being left behind to work and due chores though...)

Personally, I think you are being wise in not wanting to be prescribed Larium. Though males are less likely to experience the more severe adverse reactions (strange dreams, hallucinations, etc.), your destinations do not really make it worth the risk. As for the Malarone, it tends to be out of most traveler's financial range. Plus, as I have commented in other threads, the long-term information about this combo drug is very limited. (Both compounds, individually, have bee around for quite some time with long-term info - but not much there for the combo.)

Looking through your itinerary, you should be fine with using Doxycycline as your anti-malarial throughout your trip. It can be taken continuously for up to 2 years. It is also available as an OTC in South American countries and in Southeast Asia. (In Peru it will be "Doxiciclina".) I would get an initial prescription from your chemist just to get started. The Doxy will be more available in cities (ie: La Paz) than in smaller towns so keep that in mind.

Argentina and Chile are classically Chloroquine countries, but only because they do not have many areas with Chloroquine-resistant malaria. If Chloroquine is effective then Doxycycline will be also. At this time, there is no Doxy-resistant malaria. Most of Southeast Asia is Chloroquine-resistant, still making Doxy the drug of choice.

Many of the TP members who have travelled to the areas in S. America where you plan to visit haven't bothered taking any anti-malarials. That will have to be a choice you make for yourself based on your final plans. If, like me, you tend to forget to use the insect repellent, then taking the prophylactics is a very good idea. Again, that is up to you. I would definitely recommend them for SEA.

Doxycycline is also well tolerated by most people. Take it with adequate amounts of water and food, when possible. The side effects may include GI tract disruptions and nausea. The nausea can be quelled by taking them with lots of water or non-alcoholic beverages. Avoid taking them right befoe bedtime as they have a tendency to cause hearturn. Also increase the amount of SPF in your sunscreeen and apply it often. Doxy's other major side effect is a greater sensitivity to the sun (ie: you'll sunburn more quickly and more severely).

Hope this helps! If you have any other questions, please feel free to contact me.

Additional sources:

CDC - Tropical S. America
CDC - Temporate S. America
CDC - Southeast Asia
WHO Country List - Travel & Health

4. Posted by Hien (Moderator 3906 posts) 9y

When I first read the title, for a moment I wondered why Isadora needed help.

5. Posted by george1979 (Full Member 101 posts) 9y

Thanks guys (especially isadora ;))...
I will go the the Doxy - now i just have to deal with this halfwit of a doctor .
Anyway at least that's one less thing to worry about...
P.S. of course you can come along, just tell Beerman i'm gay .

George x

6. Posted by Isadora (Travel Guru 13926 posts) 9y

Quoting george1979

Thanks guys (especially isadora ;))...
I will go the the Doxy - now i just have to deal with this halfwit of a doctor .
Anyway at least that's one less thing to worry about...

You don't really have to "deal" with the halfwit doctor. As I say quite often, everyone is in charge of their own health so being pro-active is not a bad thing. Most people make the mistake of "asking" their doc for this thing or that. If you have confidence in your own research and your own decisions, then stating what you want avoids certain arguements. Okay, so it doesn't always work, but the chances are good that it may. When you are sick and don't know why, that's one thing - but travel-related vaccinations and prophylactics are another ballgame. You know where you are going - they are covering all the bases.

P.S. of course you can come along, just tell Beerman i'm gay .

George x

I don't think that will be the problem. It's not getting to come along that will be the sticking point. (We're rather inseperable but he makes a great luggage bearer!)

Glad I could be of help! Enjoy your adventures!! ;)

7. Posted by tway (Travel Guru 7273 posts) 9y

Quoting Hien

When I first read the title, for a moment I wondered why Isadora needed help.

Hey - that sounds like it should be my line!

8. Posted by james (Travel Guru 4136 posts) 9y

Quoting Hien

When I first read the title, for a moment I wondered why Isadora needed help.

It's because of her sex addiction

9. Posted by Hien (Moderator 3906 posts) 9y

Quoting james

Quoting Hien

When I first read the title, for a moment I wondered why Isadora needed help.

It's because of her sex addiction

I thought we were not supposed to make that public.

10. Posted by george1979 (Full Member 101 posts) 9y

Well that's that - spoke to the doctor and, after much discussion and wrangling, he prescribed me with a 3month supply of 50mg Doxy tablets. So that everything done b4 i leave (i hope ;))
Slightly concerned about this sensitvity to sunlight thing as it says on the box to avoid direct sunlight ! Kinda defeats the purpose of getting away from Scotland! Don't normally burn easily but i have got factor 25 sunscreen just to be safe. Icing on the cake was that, as i have quit my job to go travelling, the chemist said i did not have to pay for the tablets - result!

Happy travels...