Regarding malaria, prophylaxis and treatment:
Susan has mentioned Malarone (atovakvon/proguanil) from the pharma-company GlaxoSmithKline. This one is more effective against so-called uncomplicated falciparum malaria, which (despite the ”uncomplicated” designation) is the most aggressive one of the four malaria types that attacks humans. Malarone is for both prophylaxis and treatment after being infected with malaria. Malarone can be used in chloroquine-resistant areas, and is as such an alternative to Lariam with reportedly fewer and milder sideeffects. Drawbacks are the relatively high cost per daily pill, and the fact that Malarone is recommended to be used in a maximum of only 28 days. For longer stays in areas with chloroquine-resistant parasites (for instance Africa south of Sahara), Lariam is still the medicine of choice.
The Swiss company Novartis has introduced a medicine called Riamet (artemeter/lumefantrine), or Coartem in some countries. This one is also against falciparum malaria, but as treatment only – not prophylaxis, and is supposed to be more effective against the multiresistant parasites, especially in South East Asia. Both can be used by self medication.
Also, be aware of the self testing kits that are available. These might be nice to have if you`re passing through infected areas. If you experience fever, it may have other reasons than malaria, but before starting using antimalaria-medicine, one might want to test if one actually has contracted malaria. Using the kits correctly, however, needs some training.

Source: Prof. Bjørn Myrvang, department of infectious diseases, Ullevål hospital, Norway (of all places...)

Safe journey, and best regards from
Indu

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HansP
All you wanted to know
about riding in Norway

Malaria - The most important thing is to avoid being bitten - the problem with any of the drugs available is that so many people persist in taking the drugs and not taking any steps to prevent themselves getting bitten, the disease mutates and adapts to the drugs which in turn become less effective.
We have found mixing Dettol (1/3) and Baby Oil (2/3) works well as do garlic tablets and Vitamin B1.
You could go and see a homeopath before you leave - there are alternatives to the traditional drugs. We're taking China daily and Malaria Officianalis weekly as well as the above preventative methods. Early days yet but so far so good - we'll let you know.......
Lisa
www.chasingthesun.org

[This message has been edited by Lisa (edited 18 January 2002).]

I'll go with the garlic tablet theory as that is all I take these days. An ex British Army mate of mine says it was what they used to do. I tried it out on different people in different locations and can say that when I used serious strong DEET I stil lhave the odd bite.. when I took garlic tablets I didn't. Worked on my freinds too. You don;t seem to smell it either.. or so people tell me!
I think it would be a good compliment to any anti malarial.

Incidentally, went to Zambia last year with a group of friends. Most of us took doxycycline which seemed to have no ill effects at all. One guy did take Larium, I wish he hadn't as he was one of those to experience the psychotic effect that some people have mentioned. I guess it depends on the person.

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Dave

I've just started with the six month's vacination-program. I already feel like a walking bio-hazard.
Tonight I'll take my first (of two) Larium pill to test my reaction to it.
During travel I'll also use the dettol-option and the galick-pils. Also a impregnated-muskito net for the night. Better safe then sorry.

Maarten

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maartensworld.com
beyond-anywhere.com

An excellent source of information about various vaccinations, prophylaxis, etc. is the US Government's Center for Disease Control. They have a wealth of information about travel to all parts of the world, and different alternatives for maintaining your health once you get there.

Just to add to PanEuropean's info above, there is already a good overview of vaccination info on this site in the Trip Planning section:
http://www.horizonsunlimited.com/tri...inations.shtml

This info comes from Health Canada, and we have also put links to other publications on their site.

We will add in the links to the CDC as well. Thanks, Michael.


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Good luck and safe travels!

Susan Johnson
Share the Dream at <A HREF="http://www.HorizonsUnlimited.com


" TARGET=_blank>www.HorizonsUnlimited.com


</A>

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Susan Johnson

Inspiring, Informing and Connecting travellers since 1997
www.HorizonsUnlimited.com

Just a postscript about malaria medication: Mefloquine (brand name Lariam®) has been known to cause unwanted side effects, in particular vertigo (loss of balance + dizziness). For this reason, airline pilots are forbidden to take this medication as a malaria prophylaxis. I think vertigo would be just as great a hazard to safely operating a motorcycle as it would be to safely operating a plane.

There are a number of other preventative drug programs available that do not include mefloquine. When discussing your plans with your doctor, be sure that he or she knows you will be riding a motorcycle many hours a day.

I copied the following excerpt from the Canadian Investigative TV program the Fifth Estate. I also watched the program that was just aired last night.

From all reports taking Mefloquine is like putting a gun to your head and playing Russian roulette. There is no doctors or pharmacists in north america who can or will answer your questions giving you a definitive answer to any dangers of it’s side effects.

There is a big push to get this drug taken off the market at least in Canada. From the horrific stories related on the Fifth Estate program about normal people killing themselves or other people after taking this drug. Along with the astonishing report coming first hand from Canadian soldiers regarding the Somalian affair.

This was the report where the killing of Somalian citizens was directly linked to the troops being administered Mefloquine. This alone gives creedence to the fact you will never get a true answer from at least any Canadian government agencies medical or otherwize in regards to this drug.

In short ... don’t take it and I don’t care who tells you it’s safe to do so. As one molicular scientist on the program stated ... the drug is so complex they cannot test it properly and they have NO idea what all the side effects may or may not be.

The Nightmare Drug

For many years both soldiers and civilians have wondered whether the rumours about the anti-malaria drug Mefloquine were true. The word in the military in particular was that it triggered psychotic episodes, sometimes ending in suicide or murder. As evidence mounts that the drug may have serious side effects on more that "one in ten thousand" the fifth estate brings to light some shocking new cases of tourists and troops who were never the same after they took the Nightmare Drug.

Travelling to a Malaria-risk Zone?

Mefloquin is highly effective and convenient, and many doctors continue to prescribe it. If you are concerned, and have questionsabout possible side effects, the place to start is with your doctor or pharmacist.
There are other anti-malarial drugs available in Canada:

*Doxycycline, taken daily, was used by Australian troops in Afghanistan.
*Malarone is taken daily.
*Chloroquine is used in some cases, but there are some chloroquine-resistant areas.

A combination of chloroquine and a medication called proguanil was used by British troops in Afghanistan, and the U.S. Army, in co-operation with the Australia military, is working to develop a new anti-malaria drug called tafenoquine. Phase three of the clinical trials is due to take place in 2003.

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Murphy

[This message has been edited by Windwalker (edited 18 July 2003).]

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Murphy

When it comes to vaccines, take all you can find. I realize they seem expensive, but compare that to the cost of your motorcycle, gear, fuel etc one the road. Checked on hospital bills lately. In the third world you may not have the luxery of a doctor, ambulance etc. If you do it is probably not up to the standards you are used to. Some of these countries just don't have the money. On the subject of the malaria pills, remember the media is selling a story. I'm not saying people have not had problems, but the media tends to blow things well out of proportions. Millions of people have taken the malaria pills with no problems. Also realize some of the people that have taken the pills and had problems blame the pills with the help of a lawyer. Rember drug manufactures have deep pockets.

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John

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John

Well I'm not going to beat this subject to death other then to say, the CBC program The Fifth Estate wasn't and isn't selling anything. There was no mention of any law suits within the program concerning the side effects of Mefloquine. Watching the program from what I consider to be a rationale point of view. I was personally horrified listening to the terrible accounts people had experienced from the side effects of this drug.

The point to all this is and was, to try and determine weather the drug Mefloquine has dangerous side effects. There is no doubt in my mind that the program proved this beyond a shadow of doubt. I also think it is safe to say the producers of this program have far more resources then you or I to investigate and report on this subject. The bottom line that the Fifth Estate program informed the viewers was. Yes the use of Mefloquine is highly effective in the prevention of malaria and it causes horrific lasting side effects to some people.

The really important issue that they tried to find out was. If a person was going to take Mefloquine was there any information or test a person could take to see if they would have any of these negative side effects. The answer that they found was an unequivocal NO.

Now one has or should ask ones self if I choose to take this or any other drug. How is it going to effect me. If you can’t determine this .. why would any rational human being want to take it in the first place, especially in this case where there is other alternative malaria drugs.

I for one certainly do not agree that you should be vaccinated just for the sake of getting vaccinated. Never the less, I’m not telling anyone to do anything. You all have the right to make your own choices. I just hope they are the correct ones so you or your family and friends don’t end up in a situation like the people on that program.

For those of you who are interested you can get a full transcript of the Fifth Estate program on Mefloquine by going to http://www.cbc.ca/fifth/ and look under the list of past programs.

Be safe, Be happy

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Murphy

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Murphy

I guess I wasn't clear on my last post. If a disease is possable in the area take a vaccine if available. On a motorcycle you are subject to the enviroment more than if you are on a bus or car. Also going overland you tend to get off the beaten track a bit, therefore some of the areas may be moore disease than in tourist areas. Also in any country an outbreak of disease can occure at any time. Many countries don't have the recources to recognize them in time, or to treat them effectivly one they are found. In short, get the vaccine.

As for the media they are famious for blowing up a problem, causing attention, law suits start, then they report on the legal problems. It sells!

I am not saying there are not problems with some medications, but malaria is a horrable and deadly disease in many parts of the world. If you want to be trecking through the bush miles from medical care and have an onset of malaria, it is your choice.(It happens FAST) Take the alturnitive meds if recommended. They have side effects as well. Some of the new meds may have side effects that have not been recognized. Take your pick. BTW I worked in the medical field for nine years before changing carrears. I don't claim to be an expert, but I am well informed. In short the risk from the vaccine is far less than the risk from the disease. If you have questions get expert medical advice. Most family doctors are not the ones. In california go to the county health department. They are very helpful and knowledgable. You can also get vaccines for less there than a doctors office. Or do as I did and join the Army. You get all kinds of fun shots for exotic diseases. Yes I had the Japanese Enceflitis series and I did not get sick.

Rabis- its alive and well here in the US. Skunks and bats are big carriers of it.

Dont forget tetnis. I have seen people die of it here in the US. Rare, but it happens even today.

Enjoy the ride!

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John

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John