Important Disclaimer: NONE of these people are MDs, and all of them are talking about the affects of taking Larium (generic name Mefloquine) for months and months (unlike 8-10 weeks). So...your cases may be very different.
1. Re: prevention-of-malaria pills (Timothy Lubin)
2. Re: Re: prevention-of-malaria pills (Robert Zydenbos)
3. Re: prevention-of-malaria pills (Gac4233@aol.com)
4. Re: prevention-of-malaria pills (Steven Ramey)
5. RE: prevention-of-malaria pills (Whitney Kelting)
6. Re: prevention-of-malaria pills (Kathleen Erndl)
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Message: 1
Date: Wed, 28 Aug 2002 15:47:40 -0400
From: "Timothy Lubin" <LubinT@wlu.edu>
To: <risa-l@lists.sandiego.edu>
Subject: [RISA-L] Re: prevention-of-malaria pills
Reply-To: risa-l@lists.sandiego.edu
For what it is worth:
I am not an MD (surprise!), and I am sure the CDC would object to what
I am going to say, but...
I have been told by some doctors familiar with Asian medical risks that
it would be better if most otherwise healthy people did NOT take
prophylactic treatments against malaria because these low doses
inevitably lead to the emergence of drug-resistent strains of malaria,
as has happened in India. Moreover, as I understand it, the drug does
not prevent infection altogether, and once infected one is supposed to
treat with higher doses of a DIFFERENT drug. So it is perhaps better to
keep the widest-spectrum drug for this purpose.
And like Steve, during the couple years I have spent in India at
various times I have never taken any medicine against malaria, nor have
I gotten sick (knock on wood) ... yet. I do go to some lengths to avoid
exposure to mosquitos at dusk, etc.
I heard on NPR that a vaccine against malaria is going into the first
human trials, but a marketable form is still a decade off.
Tim
Timothy Lubin
Assistant Professor (Religions of South Asia)
23 Newcomb Hall
Washington and Lee University
Lexington, VA 24450 USA
office: 540.458.8146; fax: 540.458.8498
lubint@wlu.edu | http://home.wlu.edu/~lubint
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Message: 2
From: "Robert Zydenbos" <zydenbos@gmx.li>
To: risa-l@lists.sandiego.edu
Date: Thu, 29 Aug 2002 01:48:25 +0200
Subject: Re: [RISA-L] Re: prevention-of-malaria pills
Reply-To: risa-l@lists.sandiego.edu
At the beginning of my 17-year stay in South India I took a prophylactic
daily until, after about a month, it gave me stomach problems. Since
then I took no such thing, was stung at least three or four times by
mosquitoes every day but never fell ill. In my wide circle of
acquaintances I knew of only two people who contracted malaria. Much
depends on exactly where one is and perhaps on how resistant one is.
But of course not everyone wants to live dangerously, however small the
danger may be. I too would advise to use a mosquito repellent -- even if
a mosquito doesn't give you malaria, why suffer bites at all? Not all
repellents are equally effective, though. [Blatant advice follows:] My
favourite is Autan (stick or lotion) from the Bayer company, very
effective, economical and long-working (up to 7 or 8 hours, depending
on circumstances, of course). Another excellent one is Odomos, a
cream by the Indian company Balsara which comes in tubes of various
sizes and is available in just about every drug store, chemist's shop and
also in many general provision stores and supermarkets across India.
While it is not effective quite so long (perhaps 4 hours) as Autan, it is
available everywhere, and it has a pleasant citronella odour. :-)
Prof. Robert J. Zydenbos
Institut für Indologie und Iranistik
Universität München
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Message: 3
From: Gac4233@aol.com
Date: Wed, 28 Aug 2002 20:27:00 EDT
Subject: Re: [RISA-L] prevention-of-malaria pills
To: risa-l@lists.sandiego.edu
Reply-To: risa-l@lists.sandiego.edu
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To: RISA-L:
My
custom when I go to a malarial area is to fall back on
the old fashion chloroquine as a preventive plus a 15% Deet lotion on the
skin with 90% Deet on yr. cloths. The latter shld. not be used on yr. skin.
It will burn. I've found laying out my clothes I plan to wear on the nite
before gives plenty of time for the chemical to soak in. Putting it or
something similar on a tent or mosquito, as suggested, netting is probably
advisable, & I plan to do so the nxt. time I'm in such an environment --
also
having the proper antibiotics is important. And you shld. probably chk. w/ a
tropical doctor here. I know I was far away frm. medical aid when I came
down w/ an ear infection brought on the tropical environ, & I only had the
tetracycline for gastro-intestinal complaints. I didn't get better till I
got to a city, & cld. receive the correct antibiotic.
Peace,
Geoffrey Cook
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<HTML><FONT FACE=arial,helvetica><FONT SIZE=2 FAMILY="SANSSERIF"
FACE="Arial" LANG="0">To: RISA-L:<BR>
<BR>
<BR>
My custom when I go to a malarial area is to fall back on the old fashion
chloroquine as a preventive plus a 15% Deet lotion on the skin with 90% Deet on
yr. cloths. The latter shld. not be used on yr. skin. It
will burn. I've found laying out my clothes I plan to wear on the nite
before gives plenty of time for the chemical to soak in. Putting it or
something similar on a tent or mosquito, as suggested, netting is probably
advisable, & I plan to do so the nxt. time I'm in such an environment --
also having the proper antibiotics is important. And you shld.
probably chk. w/ a tropical doctor here. I know I was far away frm.
medical aid when I came down w/ an ear infection brought on the tropical
environ, & I only had the tetracycline for gastro-intestinal
complaints. I didn't get better till I got to a city, &!
; cld. receive the correct antibiotic.<BR>
<BR>
Peace,<BR>
Geoffrey Cook<BR>
<BR>
</FONT></HTML>
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Message: 4
Date: Wed, 28 Aug 2002 21:13:12 -0400 (EDT)
From: Steven Ramey <sramey@email.unc.edu>
To: risa-l@lists.sandiego.edu
Subject: Re: [RISA-L] prevention-of-malaria pills
Reply-To: risa-l@lists.sandiego.edu
To add another experience to the thread, my wife, 2 year old son, and I
spent the last academic year in India. Doctors here and in India were
insistent about anti-malarials, so my wife and I took Doxycycline, and my
son took Lariam. After a few weeks, my wife had stomach problems, so she
switched to Lariam. After 5 months on Lariam, my wife stopped being able
to sleep. She might sleep 15 minutes in 24 hours, and she had the typical
anxiety and nightmares that go with a Lariam reaction. After a week she
began to sleep a little more, but it was at least a month, probably 6
weeks, before she could sleep through the night. 7 months later, she
still does not sleep as well as she did before Lariam. The reaction may
have been triggered by an extremely stressful period with a death in the
family and other outside factors. Fortunately, our son had no apparent
reaction.
We had lots of mosquitoes, despite leaving the windows closed. The
mosquito net was vital, but we did not use other repellents because of my
wife's allergies. Next time, we would investigate Malarone if we felt
that the area where we were going would have as much mosquito problem as
Lucknow did. Malarone, by the way, is not available in India, and our son
was too small to take it. Finally, if you give Lariam to a child or even
a small adult, the correct dosage is 3-5 mg/kg (we think), so the adult
dose, or the half dose for older children, can be an overdose.
Good luck with a tough choice,
Steven Ramey
University of North Carolina
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Message: 5
Date: Thu, 29 Aug 2002 10:41:01 -0500
From: Whitney Kelting <kelting@grinnell.edu>
To: risa-l@lists.sandiego.edu
Subject: RE: [RISA-L] prevention-of-malaria pills
Reply-To: risa-l@lists.sandiego.edu
Over the years, I have tried taking Larium (no problems at all other than cool
spy-thriller dreams), chloroquine which I was told are minimally effective,
doxocycline which was unpleasant--stomach problems etc. and nothing at all
(esp. risky for me because I cannot use DEET). Lately, I try to remember to
take Larium for the couple of weeks before the monsoon sets in and the first
month afterwards. In Pune there is another spike of malaria risk around the
October rains too and I'll try to do it then too. In sum, I am unreliable.
That said, I never had any terrible experiences with Larium but I always tell
students going abroad to start a week or two early with Larium to see how it
sits. Too often the symptoms of a bad reaction to Larium (anxiety,
nervousness, sleeplessness, weird or scary dreams) can be conflated or
confused with those stress reactions of a first trip to India, jet lag and
culture shock, which can be quite serious. That said, there are clearly cases
of folks who have terrible reactions. I looked into Malarone before my most
recent trip and it just didn't have enough testing done yet for my taste, I
hate to think of being a guinea pig personally. I did notice that it has a one
week half life (as opposed to Larium's six weeks) which means if there is a
problem for you, it is out of your system quickly which seems like a good
thing. I think it is important to acknowledge the part that taking malaria
prophylaxis plays in the mutation of malaria parasites while balancing this
against your own reliability in protecting yourself against mosquito bites.
Keep in mind that areas vary widely in malaria risk, Bob mentions that he has
seen very few cases of malaria while I have seen many (though Maharashtra
seems to be working on this). You should be aware that while most malaria
cases can be treated fairly effectively, there are increasing cases of a more
serious strain of malaria in South Asia and event those of the less serious
kind need to be treated quickly and aggressively. Regardless, I recommend
finding a cool doctor to talk to about all your variables, reading up on the
meds in detail (CDC has some but your travel doc should have this big book on
malaria and meds which they might let you make a xerox of), and be sure to
make a decision based on what feels right to you intellectually and
physically.
Whitney Kelting
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Message: 6
From: "Kathleen Erndl" <kerndl@mailer.fsu.edu>
To: <risa-l@lists.sandiego.edu>
Subject: Re: [RISA-L] prevention-of-malaria pills
Date: Thu, 29 Aug 2002 15:06:16 -0400
Reply-To: risa-l@lists.sandiego.edu
Dear Folks,
Several years ago I took Mefloquin (sp?) which was presrcibed by a physician
because I was going to Assam (a chloroquin-resistant area) during the rainy
season. A pharmacist warned me about the side effects (which she said had
been written up in the travel magazine Conde Nast), but I took it anyway.
Later I developed strange neurological symptoms such as tingling and
numbness in the arms and legs which would subside by the end of the week but
start up again after I took my weekly dose. All of this my doctor figured
out after I returned to the states. he told me to stop taking it and not to
take it again. Since then I haven't taken any malaria prevention
medication.
Kathleen
Kathleen M. Erndl
Associate Professor
Department of Religion
Florida State University
Tallahassee, FL 32301-1520
850-644-0207
Fax: 850-644-7225
kerndl@mailer.fsu.edu
----- Original Message -----
From: "christopher lee" <lee4@canisius.edu>
To: <risa-l@lists.sandiego.edu>
Sent: Wednesday, August 28, 2002 12:35 PM
Subject: RE: [RISA-L] prevention-of-malaria pills
> I wasn't totally comfortable with the effects of larium either, so i quit
> taking it after a month or so my first year in India. When i worked for
the
> International Committee of the Red Cross, they actually recommended that i
> (or anyone else going to South Asia -- except, i think, the northeast) NOT
> use larium. I eventually settled on a plan of using chloroquine only
during
> the monsoons (and for some time before and after), drinking a lot of tonic
> water when it was available, and using a Good Knight - one of those
things
> that heats up a pad which had been soaked in some (no doubt caustic)
> chemical.
> That worked... until i gave my Good Knight away two weeks before leaving
(to
> someone who had just arrived), got a little sloppy, and was diagnosed with
> malaria upon my return to the states (by the second doctor i went to;
the
> first doctor told me i had the flu, and to 'stop being a baby'). I was
> proscribed several times the prophylactic dose of larium (just in case),
> which destroyed my internal gyroscope for about a week - i couldn't walk
> without listing like a drunken sailor unless i felt my way along a wall,
in
> which case i was fine.
> I occasionally have night sweats, which i associate (perhaps wrongly?)
with
> the malaria - but they are nothing like the frequency or vehemence of the
> attacks my grandfather, who had caught malaria during WWII, used to have.
> One last vignette: while i was in Banaras, there were several incidents
> where people with previously diagnosed psychological conditions (chemical
> imbalances) had some real problems which seemed to go away when they went
> off larium. Or maybe it was because they visited Pishach Mochan or
Bahadur
> Shahid.
> Hope this helps,
> chris
>
>
> _______________________________________________
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