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URGENT Vaccines - GregW, Wocca, SamIam, anyone.....help!!

Travel Forums Central/South America & The Caribbean URGENT Vaccines - GregW, Wocca, SamIam, anyone.....help!!

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11. Posted by Kingwindle (Respected Member 301 posts) 11y

why is malarone that more expensive then? is it just because it is the newest drug out that mosquito's have not been able to become resistant to yet? I'm guessing this is the reason it is so expensive, so much more than chloaquinnine by the sound of it.
I am annoyed that the private travel clinic were so useless, its flippin private and you think they would be giving better advice than they did to me. Thanks again for the ongoing help.
Tarik

12. Posted by travelover (Respected Member 494 posts) 11y

This might be a tad repetitive, but is it really necessary to get Malaria pills for Costa Rica? I went to the travel clinic yesterday and the nurse said that we didn't need any shots, so long as we don't go into the higher risk zones (which are the Guanacaste, and northeastern regions of the country), and we don't eat the local food. So I figured I'd scrap my ideas of Monteverde and Arenal, and leave them to a second trip, one that I will have enough time to get the proper medication (I'm leaving in 10 days), but my friend wants to go to the thermal springs in Arenal (which is in the "high risk" region), and she figures we can make it without the malaria pills. Call me a scaredy cat, but I don't want to take the chance, PARTICULARLY with malaria! Has anyone (who doesn't live in Costa Rica of course) been to the Arenal/Monteverde regions without the malaria pills? Any advice?

13. Posted by el.moe (Full Member 111 posts) 11y

it is really up to each of us to take malaria prophylaxe pills!
but from my experience i can tell that i went always well without taking it. i have been to manaus a couple of months before which is considered to be one of the most risky areas. ok this is maybe some luck that i didnt get it.
but the point is, if taking the prophylaxe there are some side effects like sickness or even psychological illness. the same will occur if you didnt take malaria pills in advance, then getting infected and taking the pills afterwards. yes, this is possible too, but you have to be sure to have the pills with you and then you should go to a doctor.
second point is, you have no 100% security to avoid being affected by taking the prophylaxe before.
it is really up to you how you decide and i strongly recommend to talk to a medecine before because we are all no proffesionals !!!

on hep a/b i agree, good to have at any time.
yellowfever is a must in the amazon bassin as i know. Or at least you have to show it when entering a country coming from an affected area.

have a good trip, not too much worries =)

-moritz

14. Posted by Kingwindle (Respected Member 301 posts) 11y

travelover, i'm sure you can get at least some pills from the local chemist to go with surely?? Are you able to just go back to an area that easily in the future?? I mean will you find it easy enough with commitments you have to return? I'm only saying that because it sounds like you could miss out if you do not do it this time around. I'm not sure how risky it is going into an area that is malaria infested area, but there is still going to be the risk. There are man y people that have not taken them and been ok, but if it happens to you then thats well annoying and the potential to be very ill. I'm not an expert but cant you get some from somewhere?

15. Posted by Isadora (Travel Guru 13926 posts) 11y

After reviewing the profiles of all the other respondents, I may just be the closest thing to a professional regarding drug treatments. My background is that of Pharmacologist, spending 20+ years working for 2 major pharmaceutical companies (researching new drup therapies) and Director of Research for Univ. of Illinois - Chicago, Dept. of Pediatrics/Neo-Natology. Medical graphic design work was my side job before leaving the city for a new adventure. Now, freelance graphic design is my primary endevour. I am also not a big proponent of the pharmaceutical industry's practices, but do understand drug therapies and their need.

The following countries are ones with high-risk malarial areas where Malarone is the drug of choice (due to the Chloroquine resistant strains):

Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Suriname, and Venezuela

Doxycycline (Vibramcin), mefloquine (Larium), or Primaquine (in special circumstances) can also be taken but there are additional (possible) side effects besides the the standards (nausea, diarrhea, headaches) listed for all of the quinine derived meds:

Doxycycline (Vibramycin) - hyper-sensitivity to sunlight, acute sunburn. and possible yellowing of the skin and teeth (Doxycycline is one of the tetracycline series)
Mefloquine (Larium) - psycotic episodes, seizures, depression, hallucinations
Primaquine - anemia, elevated white blood cell count

Mexico, Belize, Guatemala, El Salvador, Nicaragua, Honduras, Costa Rica, and the Bocas Del Toro Province of Panama (located west of the canal zone) are areas where Chlorquine is an effective prophalactic. In the San Blas and Darien provinces of Panama (east of the canal zone), Malarone is the drug of choice.

Considering your travels are taking you through mixed areas, Malarone will still be the most effective preventative. Yes, it does carry a higher price tag, but your medical safety should rank as high as your personal safety does in this matter. My opinion - let someone else be the test subject.

Keep in mind, taking any of the antimalarial drugs preventively is not a 100% guarantee against contracting the disease. But, no prophalaxis does increase your chances of infection. I'd prefer not to spend my travels in a third world hospital - not because of their level of care - many are excellent. I'd rather being seeing the country from outside rather than through a window. But, that's me...

Side note: Malarone is more expensive because it is a two-compound combo drug, there are no other competitive drug equivalents currently on the market to help lower prices, and it hasn't been on the market long enough to have a generic version availabe - that happens once all the patents have expired. Until then, the manufacturer is in control of the pricing. Sucks - I know!!!!!!!!!

Are you completely confused and frustrated now? Don't be!

isadora

16. Posted by travelover (Respected Member 494 posts) 11y

In response to Kingwindle's post #14, I actually know for a fact that I will be going back to Costa Rica next year with my sister. So postponing my Monteverde and Arenal trips doesn't worry me too much. Plus, Costa Rica is pretty close to Canada (in any case, it's closer than most other places I want to go to!) so it won't break the bank. I do not know where I can get Malaria pills and/or shots other than the travel clinic, and at 7 days before departure, I'd just rather not go to the risky regions. I think I'd rather go the safe route when dealing with my health. I'll save the risk taking for my activities!

17. Posted by Isadora (Travel Guru 13926 posts) 11y

I failed to mention in the previous post - there has been major flooding around the Costa Rican - Panamanian border (Jan. 12, 2005). Though you have not mentioned when your trip is to begin, and it sounds as though the Costa Rica to Mexico portion will be later in your travels, there are likely to be some ramifications from this natural disaster that should be taken into consideration.

Though work is being conducted to clean up after the flooding, areas that are normally not at high risk may have a bloom in their mosquito population. Most of the damage is located in the southeastern portion of the country and the Bocas del Toro (mainland, not island) section of Panama. The rainy season has been extended for this year by both country's weather services.

http://news.bbc.co.uk/1/hi/world/americas/4166675.stm

http://insidecostarica.com/dailynews/2005/january/24/nac0.htm

isadora

18. Posted by Kingwindle (Respected Member 301 posts) 11y

Wow! Isadora that's sound advice form you. That just what i need to know. I expect then to get malarone for the south american part of my trip and then after that chloroquine for central and mexico.. I'll take your advice thanks, you just cannot imagine how bad this travel clinic was!

I'm definately going to take all this adivce and spend what i must on malaria tabs, I wish I had budgeted for it at the beginning.

Travelover, you lucky thing you can just nip back to Costa R!!

Thanks for ALL the help.

Tarik

19. Posted by Isadora (Travel Guru 13926 posts) 11y

You are very welcome for the info and glad you have found it useful. It's too bad your travel clinic convinced you to take the yellow fever, typhoid and cholera vaccinations. But, with the large number of countries you will visit - cholera could cross your path. Becoming a Typhoid Tarik - not likey even without the vaccination. Most clinics will check that country's version of our CDC (Center for Disease Control) and push everything mentioned. Rarely do they delve deeper than the top page of recommendations.

I had to make several calls, a personal visit and argue vehemently to get our own personal physician to get past the yellow fever/cholera thing. It wasn't pretty, but we received just the vaccinations and prophylactics we felt were necessary. We're only visiting Panama from Panama City west to the Costa Rican border.

With all the vodka tonics I've drunk, I should be covered for malaria anywhere in the world! (Tonic water = quinine water. You Brits invented it in India and used gin to cover the taste.)

isadora

20. Posted by Kingwindle (Respected Member 301 posts) 11y

so true isadora, they seemed to reccommend everything that came up on the screen, and i reckon they were taking a huge chunk of money from every injection they could give. She evn tried to sell us the flu injection at the end for 20 GBP, ($38)!!!!!

I thought typhoid because it seemed to be reccommended everywhere, and yellow fever because I may if I feel like it go to an infected area in the jungle. Cholera i thought I could bump into along the way.

Cheers again, Tarik

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