I'm in the middle of sorting some jabs etc here in france for morocco in oct.
my problem is that my ex g/f who is coming with me is doing the same in wales, but the nurse there is asking for our route so she can give her malaria tablets. she says that different parts of morocco need different tablets! nobody mentioning this in france! as i've not heard of this on here i'd thought i'd ask. any info greatly recieved.

Two possibilities: It's all a misunderstanding, or your friend needs a new health care provider. One or the other....or possibly both.

You can find out what antimalarial is recommended for the area you're visiting by looking at the CDC or WHO sites (google.com is your friend). The parasite responsible for malaria evolves resistance to anti-malarials used against it, and different areas feature different degrees of resistance to the various drugs in use.

Switching from one anti-malarial to another will confuse you needlessly; the different medications require different starts and stops (one, for example, needs to be taken once weekly for a few weeks before and several weeks following your journey; another is taken once daily starting a day before and ending a week after). Confusion increases the risk you'll get malaria—an outcome which is not to be desired (trust me on this).

You need a simple, easily-followed regimen featuring a single anti-malarial taken throughout the period you may be exposed to malarial mosquitoes. Aside from parasite resistance, there are other factors involved in this choice as well, notably cost and side effect profiles. Health care providers should help you sort through these factors; if not, find a better provider or do your own research.

The Thorn Tree (Lonely Planet) forum on traveler's health (http://thorntree.lonelyplanet.com/ca...s.cfm?catid=29) has good information mixed with some of the usual bombastic posturing. A poster named Nutraxfornerves is steady and reliable with respect to malaria issues.

Hope that helps.

Mark

Malaria in Morocco, is virtualy nonexistant.

a quote by MD travelhealth:
Malaria in Morocco: very limited risk only in rural areas of Chefchaouen Province. Prophylaxis is not recommended. Insect protection measures are advised for malarious areas.
There is no malaria risk in Tangier, Rabat, Casablanca, and Fes.
For further information on malaria in Morocco, go to Roll Back Malaria.

I wouldn't worry to much about it, taking prophylaxis is not necessary (in this case) and be sensible with mosquito's.

click the malaria site by WHO
click a malaria-risk map by the WHO

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bart & sophie

A useful map Bart; it shows the usual well known locations; that area on the Eastern borders of Turkey is "interesting".

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Dave

Don't forget that Malaria proflaxis are only 90% effective. If you are vomiting and having diarea g rt to a Dr. ASAP. In Uganda, $10 will get you a blood test a Dr. visit and a corse of medication and will have you back on your feet in a couple of days.
The voice of expierience.

Marty

Vomiting and diarea are usually not signs of malaria !!! The first signs of malaria are very much like a mild flu! Pain in the joints, back pain, headache and that is what makes is so dangerous! If you think you have a mild flu and wait for a day or two to see how it devellops, then you have already missed your window of optimal treatment and the chances are you will get very sick. Taking a profilax does not mean you won't get malaria but it will be a lot less severe and it will certainly not be leathal. But note that due to the profilax it will even be more difficult to recognize the first signs. I have seen people in an overland truck with and without profilax. A couple of people without profilax got sick first but eventually also some people with profilax got sick albeit a lot less.

This does not mean that you should not take profilax. In malaria area ALWAYS take profilax. If you don't take it and your on a streak of bad luck you can be dead in 16 hours!

cheers,
Noel
exploreafrica.web-log.nl

profilax is the name of the drug i need to take as a prevention? if not what do you guys recommend? i've read lots of threads on here and it all gets a bit confusing! do i carry anything for if i get it? got appointment with doc on friday for my jabs .

Hi Kevin, "Profilax" simply refers to anti-malaria meds. There are several. I took Malerone during my trip through Africa. The pills cost $8usd per day but are widely regarded as the best safeguard against the 4 most common and serious strains of malaria in Africa. Safe travels, Hook.

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"And I think to myself, what a wonderful world..." L.B. Armstrong. www.davesgreatescape.net
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Here's another link about Malaria etc:-

Table of Vaccines & Malaria Prophylaxis

Won't try to hand out advice - I'm not qualified for that - but there is a lot of it about, including some in other posts in here.
Probably worth noting that the correct spelling of the funny word is "Prophylaxis" -- this will help if you want to do further searches of your own.

Here you go:-

prophylaxis - Ask.com UK Web Search

Prophylaxis - Wikipedia, the free encyclopedia

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Dave

"This does not mean that you should not take profilax. In malaria area ALWAYS take profilax. If you don't take it and your on a streak of bad luck you can be dead in 16 hours! "

Hi,
Noel what you say is possible however unlikely to happen. Yes you can die of malaria but I doubt this can happen in 16 hours. Although I am not a doctor, I did work in a hospital in West Africa. Many people died of malaria there and sometimes my guys were on burial detail. However these were almost always children who presented late to the hospital because their mother walked for days to get help after symptoms occured in the villages. Other deaths were co-infections combined with overall poor health. With some personal experience with malaria itself, after the first time you get it, you know it. The symptoms are similar to flu but not the same. I´m not saying you should get it just so you know, however for a healthy westerner to die of malaria on a 1 month tour of Africa is extremely unlikely. You´re much more likely to be knocked down by a matatu driver high on quat.
Cam J.

Does anyone know if Malarone is available over the counter in Cambodia or Vietnam? Doctors prescription can only get me 36 tabs here in the UK I need more than double that. £2.10 each tablet is the most reasonable quoted here.

Cam,
I totally agree on the matatus but there is a form of malaria which is called Cerebral malaria or worse, full fulminating cerebral malaria. The fact that esspecially young (local) people die is because they hav'nt had the chance to devellop any immunity yet. But guess what... we westeners do not have ANY immunity either! When you devellop the cerebral malaria (caused by Plamodium Falciparum) you WILL die. You will be ok in the morning and dead in the evening, no cure and no doubt! I am not making this up. Check the July 2007 issue of National Geographic. It is rare but i believe the chance is 1 or 2%! To much for me!

Cheers,
Noel
exploreafrica.web-log.nl

i have lived and worked in Ghana for almost 12 years, and I have had malaria countless times. There are a few certainties about malaria:
1) Initial onset symptoms are slightly different for everyone. For some it is aching joints, some (me) violent loose stools, bitter taste, headaches etc.
2) There are almost as many different stories/theories/treatments/recommendations as there are mosquitoes!

It sums up like this (and many points have been raised already):
- take prohylaxis if you are just going for a short trip.
- While there if you feel "out of sorts" get a test. Do not asume that the test proves anything (i.e. if you still feel crap and the test is negative) re-test some hours later or just start treatment (I do, as does a very good friend of mine who is an extremely talented Doctor in remote, rural Ghana).
- "best practise" current treatment and probably least harmfull is a course of artesunate type treatment.
- If you suspect it was malaria, and/or on your return you experience any suspicious symptoms then try and get hold of a doctor with tropical experience and make it VERY clear you suspect malaria.
- if necessary take a treatment home with you and be prepared to use it if doctors are giving you the run around: many people have died waiting for developed world doctors waiting to diagnose...
- Cross check everything said here (incl this!!! <BG>) with a tropical doctor if you have any qualms (not the local nurse who does yellow fever jabs in your GPs surgery!)

But as it is Morroco I REALLY wouldn't worry!! BTW cerebral malaria has a 25-50% mortality rate, and it is not actually a type of malaria but just an unusual manifestation of the disease. Symptoms are as above, then convulsions, then coma, then death... In a healthy adult who is taking malaria treatment when the initial symptoms occur it is VERY unlikely to result in death. Even in the convulsion/coma stage medications through IV will most likely get you right. You have to be very unlucky as a healthy adult with access to anti-malarials to die from cerebral malaria. But do be aware that any untreated malaria has the potential to turn into CM.

Gil

I would be suprised if any French doctor would give you a prescription for anti-Malarials for Morocco. I don't know which hospital you are going to but I have a Tropical Health Doctor in Toulouse (Purpan) who is very 'malaria' aware having lost her brother last year on a week's trip to Guinea on business.

If you do go any further south I would recommend getting them. I use Lariam which has dropped in price this year, a box of 8 in France now costs 46euros with a prescription (which will do for a 3 week trip as it's taken weekly & the first starts 10days prior to departure & you continue taking them a month on return).

Malarone is very expensive, taken once a day (Lariam is once a week) but doesn't have the side effects which Lariam does; there's problems such as those with a psychological illness in the family shouldn't take them, some people suffer nasty nightmares. Personally I sleep deeper and don't suffer from hair loss on Lariam - but seem to on Malarone (not funny being female!)

Having had malaria aged 12 it's something I don't wish to have in Africa again ... I am VERY cautious but would NEVER consider it (in the current climate) for Morocco

Kira