Malaria in Thailand

[blue2]

Hi, My friend is going to Koh Chang, Thailand this coming January for two weeks and is adament that she and her boyfriend do not need to take malaria tablets. Will she be at HIGH risk if she decides not to take them? One of the main reasons she doesn't want to take them is that she will be trying for a baby while out there (it's a honeymoon) and has been told that she would have to wait 6 months after she gets back for the malaria tablets to be out of her system.

Thanks for your help with this!

[Buenchico]

Quote:
"Malaria risk exists throughout the year in rural, especially forested and hilly, areas of the whole country, mainly towards the international borders. There is no risk in cities and the main tourist resorts (e.g. Bangkok, Chiangmai, Pattaya, Phuket, Samui). However, there is risk in some other islands as well as resorts"
Source:
http://www.who.int/ith/countries/listt/en/inde x.html

As the island of Ko Chang isn't in the forested and hilly parts of the country, it's unlikely that the risk should be regarded as 'high' but, all the same, it's probably significant enough to be of some concern. (The WHO website refers to 'risk areas near Cambodia and Myanmar borders' ; Ko Chang is near to the border with Cambodia)

See also:
http://www.dh.gov.uk/PolicyAndGuidance/HealthA dviceForTravellers/EssentialInformationOnMajor Diseases/MajorDiseasesArticle/fs/en?CONTENT_ID =4114858&chk=6%2BUNyc

Chris

[dzug]

http://www.fitfortravel.scot.nhs.uk/ gives a map confirming the info given by Chris - in fact the dot that is Koh Chang looks dark red (high risk) to me though it's not entirely clear.

Bear in mind there is no cure for malaria - you've got it on and off for life if you catch it, even if it isn't always fatal.

[dzug]

In fact it contains this quote that I missed at first:

Prophylaxis: Since mefloquine resistance is now common, doxycycline or Malarone is usually advised for those visiting the borders with Cambodia (including the island of Ko Chang), Myanmar and Laos.

[Rock'n'Roll]

I would travel to such places on a "better safe than sorry" policy. She has a lot to lose and nothing to gain by refusing Malaria defence tablets. Will tablets affect her becoming pregnant? think a Doc. would be the person to ask.

[KARL]

I will yet again offer my thoughts on this issue. The parasite that causes the disease being transmitted by a particular genus of mosquito, it follows that ensuring you minimise risk of getting bitten is a very effective defense. The tablets (and even the medics will admit this if you ask them) are no guarantee against malaria, merely a reducer of risk - they are also the equivalent of dunking the body in a vat of chemicals. The WHO and other such bodies are working for a truly effective block to the disease, but meanwhile they have never suggested issuing the population of affected areas of the globe with these tablets nor do they even suggest those people should consider using them. The mosquitos are most active during weak light (dawn and dusk and dim artificial light, less in total darkness) and they have very predictable locations for lurking in. They are extremely susceptible to insecticides. Therefore, spray (Baygon original is the most effective but others work well also) your bedroom at least at three day intervals short bursts each: into all ceiling/wall corners, under all furniture, onto any curtains and around windows and doors - and keep windows and doors shut. Wear repellent (mosquito milk, tropical is very good) on all exposed skin including forhead, behind ears, under chin, down the neck, arms (two sides) legs, ankles and feet. A mosquito net (insecticide impregnated is best) over the bed is an added protection if available. I have spent probably over a decade total in malarial areas, gave up on the tablets after a few weeks and employing these measures neither I nor the three family members accompanying me some of the time have ever had malaria. In case of the unlucky event, if you suffer cold/flu-like symptoms within six weeks of returning hom then insist on a malaria test to eliminate that possibility.