Should I take anti-malaria medication on my next holiday?
I have been travelling to Southeast Asia, on and off, for the last eight years and it is still a question I ask myself every time I organise a new trip. After all this time you would think that I would have it all figured out, but alas I am no closer to a definitive answer than I am to understanding why the Twilight movies were popular or whether a tomato is a vegetable or a fruit.
For the uninitiated, malaria is a mosquito spread illness that is transferred by being bitten. Mosquitos who carry malaria are found in certain parts of the world, like areas of Southeast Asia, South America and Africa. A quick internet search will tell you that symptoms include- amongst other things- fever, sweating, diarrhoea, vomiting and death. Traditionally, it usually takes around three weeks for symptoms to show themselves so while it is completely treatable, after looking at the full list of symptoms, one can safely assume that avoiding contracting it all together is probably the most desirable option.
So here in lies the dilemma; is anti-malarial medication the best solution?
You hear different opinions depending on who you talk to. I’ve been told by doctors, “You’ll be fine. You can’t catch malaria if you don’t get bitten.” This logic is solid, incredibly simple and you don’t have to be overly qualified to understand it. But if I was to attempt this approach, I’d have to walk around in a hazmat suit. I hate mosquitos and have written about them before. I naturally attract them like a tourist to a market. I am the first person to be attacked and my friends use me as a litmus test on whether the mozzies are out. I can categorically state that there hasn’t been one trip to a mosquito infested destination that I haven’t been bitten- no matter the precautions. (Just quietly, some of the mosquitoes I have seen throughout Asia are the size of small birds. I’m not kidding. Forget about malaria- get bitten by one of those suckers and you’ll be in danger of blood loss.)
Do you then go with using repellent often and always?
I’ve used this method. I spent a glorious two weeks kicking around Thailand with a nice healthy glow made up almost exclusively of insect repellent. It was the good stuff too; the kind that would make your tongue go numb if you accidentally forgot to clean your hands properly after applying and it left you with a slight burning sensation. It’s the burn that lets you know that it’s working.
I’ve even heard of people soaking their clothing in Permethrin- an insecticide- although the feedback from that not as positive. The general consensus is that if your clothes are covered in such a chemical, surely that can’t be good for your health.
Finally, anti-malarial medication is the other option I have used.
I have an upcoming trip to Borneo and was toying with the idea of ignoring drugs all together. I figured two weeks is a short enough period of time and that I should be fairly safe. It is a theory that many people use- anything less than two weeks, no drugs. I mentioned this to my doctor. He looked at me and typed something into his computer. A map of the world flashed up. “Everywhere coloured red is considered a malarial zone and should be treated with caution,” he said.
Borneo was as red as an English tourist on an Australian beach. It’s a pretty convincing visual aide. Well played, Doc.
Generally speaking, there are two options for anti-malaria medication; a tablet you can take either daily or weekly. The thing to remember, regardless which you decide on, you need to start taking the pills before you leave and keep taking them for weeks after you return to ensure they have worked correctly.
As with all medication, there are side effects. For example, some types increase the user’s sensitivity to the sun. Others come with the chance of hallucinations and dizziness. I have used both and suffered side effects with both, although I have been known to get sunburnt in the middle of winter, so my sensitivity to the sun should be taken with a pinch of salt. Whilst on the weekly tablets, however, I had the horrible sensation that my brain had detached from its stem and was bouncing around in my skull. I could feel it every time it bounced off the wall of my head to the point I couldn’t stagger in a straight line to the toilet to throw up. I was so affected, I was petrified of falling back to sleep. I changed medications immediately.
Through all of this process though, I remembered that I have witnessed someone suffering the effects of malaria. I was in Chiang Mai in Northern Thailand and a Scottish guy staggered down the stairs of the hostel where we were staying. He was by himself and looked like he had just taken a shower. He had not. He was dripping with sweat and shivering.
“Had my sheets changed four times already,” he told me in a thick Scottish accent. “I’ve only been here two days. This is the first time I’ve tried to eat,” as a small bowl of plain rice was brought to him. “Been throwing up for the last few days. They tell me its malaria. I’m going to have to go home.”
He was so grey and clammy he could have been mistaken for a corpse. I know that the Scottish are a naturally pasty people, deep tans not being a particularly common thing, but even I know that any normal, healthy person shouldn’t be grey.
He had not been using anti-malarial drugs and had barely been bitten. Once you’ve seen someone that ill, you don’t tend to forget it. (I later learnt that his mates weren’t great people either. They left him. They loaded him onto a train, by himself for a seven-hour plus train ride to Bangkok so he could catch a plane back to Scotland all because the train was the cheapest way to get him there. They at least took him to the doctors first, I suppose.)
There are people who think that anti-malaria medication is a waste of time, that the chance of contracting malaria is minimal and that the side effects outweigh the benefits. If you are sticking to the main cities, that might be true. At the end of the day it doesn’t matter, just so long as you take precautions of some description. After all, it only takes one bite.
Wayward Tip: Know the risks of where you are going. The more rural you are going, depending on the length of your trip, the higher the chance of malaria carrying mosquitos.