Malarone suggested for a maximum of 28 days.
Lariam suggested for a maximum of 3 months.
I don't know the maximum period suggested for Doxycycline, but I know that it isn't so effective and I 'll travel to high risk areas. Also I have heard that sometimes it has serious side effects.

I am planning a trip from Greece to India for something more than 6 months. I 'll start travelling at April. Of course, I 'll protect myself from get bitten and I 'll have Malarone as treatment, but what about prevention for so long time?

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Asia, 27 months, 73,000 km. - Africa, 3 years, 96,000 km. - Honda XR 250 - http://madnomad.gr

Hi there,
The whole problem is getting a correct balance of risk against reward. A case of malaria is nasty, but almost always cureable. The medicines that are most effective in any given area are often not so effective outside that area. They are also usually freely available in the area and difficult to get hold of outside. Especially in Europe where many are not licensed. Artemisin based drugs are little short of phenomenal in Africa.
From my experience any of the medications you use as a prophylaxis are bad for you to a degree in the long term.
I spend a large amount of time in Sub saharan africa and no longer use any. They are either of limited effectiveness (Doxy) or too expensive (Malarone) or just plain nasty (Lariam).
Obviously every person reacts differently. Most common side effects of Doxy are nausea after taking it and extreme photosensitivity(1 in 10 people). It is a strong broad spectrum antibiotic as well with all that entails.
I have known people use malarone for 18 months without a problem (but the company was paying!)
Lariam sent me barking mad after just one tablet.
In the end it will be a personal choice. I have ended up with Malaria more than 10 times. As long as you are aware of it then you should be OK which ever route you choose and whether you choose to treat or block it.
Finally, as you pointed out, the only sure way is not to get bitten. Cover up and spray well in evenings and early mornings if warm. Beware shady areas during the day also.

Cheers and have a good trip.

George

Hi Furious,

I've been living in West Africa for the last 10 months. The thing with taking preventative drugs is that its not 100% fool proof, and if you do get malaria its harder to detect as the drugs suppress the symptoms. I'd say your best bet is not to take any preventative drugs, but to make yourself aware of what the exact symptoms are. Carry a self test kit or take drugs when you feel the symptoms coming on. It wont cause any damage.

all the best,

Camps

I think this is the best solution. Are there several self kits? Do you have to suggest anyone?

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Asia, 27 months, 73,000 km. - Africa, 3 years, 96,000 km. - Honda XR 250 - http://madnomad.gr

dear furious,
you might find the link below useful. take a look at, the "yellow book" also. many other useful recommendations are included.

http://www.cdc.gov/travel/regionalma...htm#prevention

This quote is from a medical paper on the very subject : "..Backpackers and other travelers who move from one malarious area to another are not usually familiar with local medical facilities, and they are unable to estimate the laboratory quality of malaria testing. Continuous chemoprophylaxis should therefore be encouraged when indicated. Priority should be given to drugs that may be used or both chemoprophylaxis and standby, such as mefloquine and atovaquone-proguanil
(Malarone-NB) rather than mefloquine (Lariam-NB)." ( Long-Term Malaria Prophylaxis for Travelers; Jürgen Knobloch; Travel Med 11(6):374-378, 2004. © 2004 International Society of Travel Medicine)
NB-Nota Bene (my note)
by the way, what made you think there is a malaria outbreak in India -f I didn't get it wrong? But there IS A DENGUE threat in that region; but both malaria and dengue are transported by the mosquitos anyway. so, taking every measure for "not to be beaten" by the mosquitos would help.

wish you a happy and healthy travel.

endurin.

I guess Mr. Camps here is a doctor. Or at least he thinks he is, giving medical
advice to people about a potentially deadly decease.
I find that very very &^$%#!!!

BMW.BEC is absolutely right. Some forms of malaria can kill you before you are
even aware that you have them.
Other forms are un cureable and will course 'flame-ups' for the rest of your
natural life.

Why do we have doctors? Then listen to them!

If you decide not to take any prophylaxis that is fine. But NEVER EVER tell
others to do the same if you are not qualified.

Maarten

ps. Took Lariam for 40 weeks and I am not more screwed up then before that.

__________________
maartensworld.com
beyond-anywhere.com

Firstlly, I am not condoning you risking your health by not taking antimalarial drugs. It is a personal consideration of risk, just like getting on a motorbike, going to distant countries, trusting strangers, hitch-hiking etc etc etc. Then best you can do is inform yourself from the experience of others, and make your own decision.

Going from Greece to India is not particularly malaria-prone. It is said that malaria exists in southern Iran, but I think you'd have to look pretty hard to find it. I worked in the south of India for some time, and half the people working with me (westerners) didn't bother with prophylaxis. Don't think I heard of anyone who knew of any cases of Malaria.

BUT

There is the always the risk . Personally (and embarking on the same trip), I am not taking anything. Lariam and Doxycycline are nasty , toxic chemicals, which are well described above. By taking antimalarials, you're giving your body a small, but significant dose of poison. Inherently, this too has risks, and side effects do not always manifest themselves in the short term. More practically If you're staying in hotels or hostels, you are not as exposed as when you are, say camping. You can buy cheap burning mosquito coils anywhere in India (they will always be the smell of Kerala to me), which are good. Take DEET repellant, and cover up in the evenings.

Make your own decision, it's just another risk you have to think of, like robbery, accidents, terrorism etc.

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4.5 years around Eurasia in a Toyota Hilux|http://eurasiaoverland.wordpress.com/
Pictures Here|https://picasaweb.google.com/113619413612674951960

What actually are the symptons to look out for. And if they show how long has one got to get treatment?

Very good and interesting debate. My travel doc. has recommended that I take Doxy for almost my entire 15 month RTW. I get a few drug breaks in Argentina/Chile and Europe of about a month each, so I won't be on it for more than 3 or 4 months at a time. A person doing an extended trip in a malaria place could CONSIDER drugs for the max time, then take a drug break, then head back on the meds, or switch it up. Less safe than being drugged all the time (or is it???) but safer than no prophylaxis.

I don't have a mossie net, but I'll be getting one when I feel I need it in mainland Mexico.

Always wondered why I couldn't use DEET on clothes. Now I know!

Thanks,
Mitch

PS: Malaria - Wikipedia, the free encyclopedia

Coartem made by Novartis is the best to use as treatment. U-test makes a self test product, it's called "U-test Malaria", i'm not sure if this is a international product of if its only made in South Africa.

Safe travels,

Camps.

Yes, I know about Yellow Book and I 've read it. Thank you. India is a malaria high-risk region and I don't know yet how to protect myself. That's why I am a little nervous. I'm afraid that it's not enough just avoid get bitten. Of course there are another threats too but I already have the best protection I can for them.

Also I have three less serious questions :
1) Can we find inspect repellents with DEET on the road (Tyrkey, Iran, Pakistan, India)?

2) Why Lonely Planet and others suggest DEET for our skin and permethrin for our clothes? Can't we use DEET for our clothes too?

3) Do you carry the suggested mesh? How you put it over the bed at hotels?

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Asia, 27 months, 73,000 km. - Africa, 3 years, 96,000 km. - Honda XR 250 - http://madnomad.gr

3) I intend to use the inner part of my tent for this purpose. Has the added advantage of being free standing, if I use the poles. Don't know how well this will work.

On my previous trip we ended up buying a mossie net in India because they were so bad.

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Cheers,
Peter.

Europe to NZ 2006-10

Thank you for your replies. I am starting to understand the thing.

Do you mean to put my tent over the hotel's bed??? Will not damage this my tent because the poles will be out of the bed, at the air?

Where did you catch the mossie net in India?

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Asia, 27 months, 73,000 km. - Africa, 3 years, 96,000 km. - Honda XR 250 - http://madnomad.gr

As I wrote, I haven't tried it yet, but I think the tent floor is sufficiently strong to support the two poles. It doesn't have to withstand any storm, after all, unless I turn the ceiling fan on max.

Can't remember where we bought the net, some bazar somewhere.

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Cheers,
Peter.

Europe to NZ 2006-10

Thank you very much! This site

http://www.travmed.com

that maria41 mentioned is veeeery useful.

I understood that the best chemoprophylaxis for a motorcyclist in that area for so long time is the doxycycline. I thought that it isn't so effective but I read in this site that it's more than 90% effective against chloroquine-resistant falciparum malaria!

I only have the question if we can find DEET and permethrin on the road (Tyrkey, Iran, Pakistan, India).

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Asia, 27 months, 73,000 km. - Africa, 3 years, 96,000 km. - Honda XR 250 - http://madnomad.gr