I'm heading to Belize in 8 days. The Cayes, Placenta,
hiking in the south. Did you travel to these places? Do I
need to take Malaria pills.
*
The doctor recommended Mefloquine which here in Boston, USA
are US$8/pill. This is going to be very expensive based on
a 1+year trip. Do you know where I can get cheaper pills?
In CA??
Any information is appreciated.
Thanks!
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You must take pills. Malaria is serious. It can kill you or
make you very ill for a long time. I would get a second
opinion on the pills. Mefloquine is usually prescribed for
South America which has a chlorine resistant strain of
malaria. In Central America Chloroquine is the usual pill.
Many doctors up here don't have much experience in malaria so
it could be a simple mistake.
you definitely do not want to get Malaria. Ask your doctor
about taking a daily dose of doxycycline, an antibiotic
instead. This is quite often covered my medical plans, since
they don't know its for Malaria. only disadvantgae is it
makes you a bit more sun sensitive. You also have to remeber
to take a pill a day unlike Mefloquine (Larium) which is
once a week.
Jessica,
Malaria prophylaxis is recommended but I was surprised to
find out that your doctor advised mefloquine. For travel
west of the Panama canal, chloroquine is generally
recommended (and definitely much cheaper.) If you are
going to be in malarious regions for several months,
terminal prophylaxis with primaquine might also be a good
idea. Check out the CDC site www.cdc.gov/travel/index.htm
and ask your doctor why he didn't prescribe chloroquine.
Although you should start chloroquine prior to leaving the
US, it can be purchased cheaply in central america as well.
I would definitely agree with the above posts that
chloroquine (Aralen) is the best option when travelling in
Central America. The standard dosage is a 500mg oral tablet
per week beginning one week prior to travel, every week
during travel, and for 4 weeks after returning home.
Furthermore, it can be used safely in women who are
pregnant or at risk of becomming pregnant. Side affects may
include mild nausea and headache, but hey, that beats
malaria any day. Mefloquine is currently being prescribed
in areas where chloroquine-resistant strains of Plasmodium
falciparum have surfaced (South America, Asia, Africa,
India, and Oceania...but NOT Central America). It is
interesting to note, however, that 82% of imported malaria
cases to the US in 96-97 were contracted in Africa and the
likelihood that you will contract malaria in urban areas of
Central America is really quite low. However, an ounce of
prevention is always worth a pound of cure.
-Justin US Medical Student
If you are only going to Belize, you do not, I repeat, DO
NOT need malaria prophylaxis. This is from a world reknown
entomologist. His name is George Bevelier (sp?). He and
his wife have owned and operated the Rum Point Inn in
Placentia Point since the 70's.
Check out their website at www.rumpoint.com and ask them
for yourself, I was just down there in March.
As a side note; if you ever do take a malaria pill,
definitely take Mefloquine (Larium). The reason why you
won't find it all over the world freely is because it is a
base for a cure if you get it. Thus, "they" don't want
everybody taking it 'cause then more and more strain of
malaria will become resistant to it. You will also hear
all the bullshit about weird dreams and other sideffects of
Larium; ignore them, it's bullshit and some kind of
travelore.
I've had the wierd dreams and mild flu like symtoms while
taking Larium but of course that could have been nothing
more than a bad case of travelers lore.On the other hand I
agree that Belize and Placentia in particular didn't offer
much of a threat.Have Fun!! Try Mikes bar in Placentia or
the over the water both are good fun.
I don't think there is much of a malaria prob in belize.
last jan I returned from a 6 mos trip traveling mexico,
guatemala, and belize. I started taking chloroquine and
stopped taking it because there really was no malaria prob
and it was a hassle remembering everyday. there is more
hype about getting malaria than there really is. Just make
sure you get shots for hepatitis and take the anti-typhoid
pills before you go. The biggest worries are gettign
stomach problems from unclean water and conditions. If you
are worried about mosquitoes, wear repelent. Antimalarial
pills in the US are horribly expensive, buy them down there
where they are cheaper, although belize is an expensive
country compared to the rest of central america with the
exchange rate being fixed at 2 belize dollars to 1 US
dollar.
take a water taxi from belize city to caye caulker, the
most laid back island very reminiscent of jamaica. Go
snorkling with big fish little fish, they give a good
tour. Stay at hotel 1798 (i think it is) it's by "the
split" cheap rooms, clean, hot showers, modern, and cable!
It's a real find and the owner is american and I talked the
price down, too. also don't miss I&I bar, a cool bar built
to be like a treehouse with reggae music and swings instead
of stools at the bar.
have fun in belize!
I agree with most of the posts above that you should
definitely NOT take Lariam in Belize. The WHO advises
either Chloroquine 300 mg per week (not 500 mg) OR no
prophylaxis but simply general measures like covering up,
DEET etc...
I strongly disagree with Wayfarer saying Lariam has no side
effects and that you should always use this. That's simply
not true. It is well known that 20 % of people have minor
side effects, 5% have to stop the drug due to side effects
and 1/15.000 have severe psychiatric side effects. Mind
you, I am not advising against the use of Lariam in certain
areas where there's resistance against chloroquine, I just
say don't be blind like Wayfarer saying side effects are
nono existant. (BTW, tell me 1 single drug without side
effects!).
I also disagree with Paul advising for Doxy. Some people
really think Doxy is better then Lariam, but this is not
true, and certainly not usefull for Belize since
Chloroquine is the preferred drug.
Have a look at my "medical matters" site on
www.1000traveltips.org
including info on Lariam and where to take which profylaxis
for every country in the world.
If we're going to get nit-picky, please quote me where I
said Larium had NO side effects. Of course every drug has
a side effect, even if infinitesimal.
I made an assumption; it is quite common knowledge (or so I
thought) in travel circles that there is this rumor
surrounding Larium and its side effects. Specifically I'm
talking about the development of psychosis while taking
it. And actually I think that IS one of the side effects,
but it has been so overblown. Kind of this travelore
thing. Completely unfounded in the magnitude it is being
presented.
I don't know, take Larium when traveling in a heavily
infested malaria area and compare notes with those other
travelers not taking Larium. You will undoubtedly starting
getting, "You're taking Larium, well I heard that..." or
"You know, well, 'they' say...blah, blah, blah."
You've made your point clearer now and it is true you did
not state Lariam has no side effects. Sorry.
Still, there are other things in your posts I don't agree
with:
"if you ever do take a malaria pill, definitely take
mefloquine (Larium)"
Are you aware of the fact that the WHO has guidelines for
each territory? In that case, you will know that ONLY in
the C areas (i.e. Africa, South America and some parts of
Asia), Lariam is recommended, in A and B areas you
shouldn't take it as prophylaxis.
"The reason why you won't find it (Lariam) all over the
world freely is because it is a base for a cure if you get
it. Thus, "they" don't want everybody taking it 'cause then
more and more strain of malaria will become resistant to
it".
I also don't agree with that. The reason you can't get it
freely in the US or Europe is simply because it's a drug
like any other, so just like any other drug (f.i.
Chloroquine and doxy) you need a prescription because only
a doctor can decide whether it's good for you. However, in
other countries like Thialand where these rules are not so
strict, you can get it freely, and even at a fraction of
the US price.
Koen, my point was that you CAN get it easier in places
like N. America, but NOT in SE Asia. At least that was the
case when in Thailand the first time in '92. We were just
about floored when told it was going to be USD$7 per pill
here in the States. So we thought, no worries, we'll just
wait till we get into Bangkok and get it at a fraction of
the cost. But you know what? It wasn't available in
Thailand. Yeah, just wander up to a chemist's counter and
get a load of valium for the trip and host of other stuff
you can't get over-the-counter in the States, but we could
not get mefloquine. After looking into then taking chlor
or dox, we thought the side effects and hassles of taking
it daily were too much trouble and just said, fuck it. I
had no problems in three months of travels there. Again,
it is my understanding that you take high doses of Larium
as a cure for malaria once "in country" if you are already
on chlor or dox or nothing and contract malaria. However,
I don't think you can take Lariam as a cure if you are
already on Lariam as a prophylaxis. That's why they don't
want Lariam available all over SE Asia.
I then was in India a couple years later and inquired about
mefloquine there. Yep, it could be bought. I didn't take
anything there for malaria prevention and would be highly
suspect of taking mefloquine produced in India.
Regarding your thoughts about where and what to take. I do
understand that chlor and dox are not fit for all areas of
the world, but am not aware that Lariam is restricted
because of resistant strains of malaria, yet. That's why
Lariam is so great because it is the new-kid-on-the-block
and malaria hasn't become so resistant to this
prophylaxis. So I still stand by my statement earlier, but
will research your comments further.
Okay, I admit I did not have the patience to read through
the entire conversation above (though what I did read was
interesting). Just a short message on mefloquine: I don't
think the above made it clear how STRONG it is. People I
know have had heart problems from it, some have had nerve
jitters. I myself have experienced the freaky dreams and
nausea. I'd say: research the appropriate drug to take for
the region you are going to; but please do keep in mind
that mef is very very very potent (to the point where our
US military refuses to issue it to units in malarial
areas). I'd take the alternative, if there is one.
I'm sorry to disappoint you, but I did find mefloquine in a
pharmacy in Chiang Mai, freely available and only at 5
cents a pill.
Secondly, it is not really necessary to take prophylaxis in
Thailand as long as you cover up well, use DEET, stick to
the tourist trail especially during dry season. Have a look
at my site for detailed info on that
(www.1000traveltips.org under Thailand/general
info2/medical matters).
Thirdly, you shouldn't think there's no cure left when
having malaria while taking Lariam. This is very rare, but
if it happens, stick to the usual treatment: Quinine 3 x
600 mg/day and Doxy 100 mg/dag from the second day onwards;
Fourthly, you're missing the point regarding "Lariam is the
new kid on the block, so take it everywhere". Firstly, why
would you take this drug in areas where other drugs are
equally effective, especially if these other drugs are 1)
cheaper 2) have less psyhiatric side effects. 3) Above all,
you will this way jeopardize the policy of the World health
organisation who tries to stop spreading of resistance
against drugs. Of course there(s no resistance against
Lariam yet, but there will be soon if everyone starts
taking Lariam like you advocate.
1) Well, things have changed in Thailand from a
pharmaceutical standpoint then, fair enough.
2) If "you cover up well, use DEET, stick to
the tourist trail especially during dry (to you mean wet
season?) season", then you don't need to take malaria
prophylaxis anywhere in the world.
3) The jury's out on that...
4a) That's precisely why you (I) would take Larium, 'cause
it IS the most effective (nothing is for free, you pay for
what you get) even if more costly. Yeah, you're right; I
shouldn't be advocating the most effective malaria
prophylaxis. No, don't let the word out, let's keep it all
to ourselves...I mean shit, wouldn't want anyone else to
get their hands on the good stuff.
4b) "less psyhiatric side effects". As Ronald Reagan would
say, "There you go again." All malaria prophylaxis' have
side effects. If for the sake of argument we say that
Larium has the potential for a higher chance of
"psyhiatirc" (sic) side effects, other prophylaxis' have
higher chances of other side effects than Lariam. You just
weigh the potential side effects with each prophylaxis'
efficacy. I sound like a broken record, but again, the
side effects of Lariam are overblown and with the best
efficacy, stick with Lariam if given or making the choice.
After travelling through C.A. for 4 months including Belize
and now living in Bocas del Toro, Panama I havn't seen a
need for antimalaria pills. I didn't take any and to take
them for a year doesn't sound too healthy. Have a good trip
and adapt to what you find.
jak
1) We agree about that.
2) You are absolutely wrong about that. I can give you
plenty of countries where you do need to take prophylaxis
EVEN when you cover up, use DEET etc... Itrian Jaya and
Subsaharan Africa are 1 example. Did you know f;i. that if
you stay 3 months in Irian Jaya, chances of getting malaria
without prophylaxis are 80%, while with prophylaxis they
are close to 0%? (Annals of internal Medecine 1997- trial
with 260 Indonesia soldiers). The same goes for Africa.
Chances of getting malaria in Eastern africa without
prophylaxis are 2,4% per month. So please, use Lariam in
these areas!!
3) Let me know what the jury thinks...
4a) You clearly don't understand that there are different
strains of malaria. In Central America, you don't have the
dangerous Plasmodium Falciparum strain, so there's no need
for Lariam, contrary to other places in the world.
4b) Lariam DOES have more psychiatric side effects then
Chloroquine. There was a French trial comparing the 2
products, and it turned out the incidence was 11% with
Lariam versus only 2% for Chloroquine.
In conclusion, I can only say, read the info on malaria on
my site again, because everything I'm telling here is
written there also. There are also links to the articles
I'm referring to, so you can check out yourself. All these
articles can be found on the web for free. But apparently
you don't bother...
One more thing. Dox may work but I prefer to save it for
other things. With all the antibiotics being pumped into us
and our food it seems to me that its a good idea to avoid
using an antibiotic for any purpose that something else will
fill. As more and more bacteria become resistant to more and
more antibiotics you don't know when you are going to need
that last effective med in a life threatening situation.
You've definately gotta get Malaria medicine. I'm going to
BElize for a month and it's a must my doc was telling
stories of Doctor friends she has who went down to
volunteer in Central America and didn't bring any and they
got fuct.
However, I don't think it's a big rush if you stay in the
cities (since it's transmitted by mosquitos).
My doctor prescribed me Novo-Chloroquin. I take 2 tablets
every week starting 1 week before I leave and 4 weeks after
I get back.
Unfortunately I can't tell you how much they cost (I'm from
Canada) but she stands by these as being the best (few to
no side-effects ... maybe a little nausea tho ...)
Make sure you take anti-histimines (like Alledryl/Allegra)
cause you'll get tons of bites .....
Have a good time ...
- Later.