Malaria Prophylaxis


From Dr. Wil:

My standard official recommendations over many years for Malaria prevention is:
1--Chloroquine 300 mg base (500 mg salt, eg C-Phosphate) once weekly starting 2 weeks before and continuing for 2 months after a trip.
2--OR...Doxycycline 100 mg. daily...starting 2 daye pre-trip and continuing for 4 weeks post-trip. 

#1 is simplest re only one dose / week; is available generically (less $$ and just as effective); generally well tolerated.
It should not be taken if there is a history of retinal (eye) disease. The pre trip dosing is primarily to check for any adverse reactions to it.

#2 is a very different generic antibiotic and primarily used when a person cannot tolerate Chloroquine [eg nausea, vomiting, nightmares, etc]. It is taken every day.

Your pharmacist can supply you with detailed info re relative risks, adverse reactions recorded and pricing.

These 2 meds are generally tolerated very well by adults...both are adequately effective.

Now, having said that [my standard official rec for all of our trips per the CDC and FDA recs], I will now speak more 'realistically'.
There are 'standard official recommendations' and there are common sense recommendations based upon the situational specifics that present.
1--the risk of coming in contact with Malaria transmitting mosquitoes [only one species tramsmits it] is VERY low on our short trips.
2--We do not go to any Malaria endemic regions
3--During the 'dry' season [our now] there are generally very few to zero mosquitoes...varies. Malaria is transmitted ONLY by one species of mosquito.
4--What do I personally do over the last 10 years of frequent travel there? I take preventive meds very infrequently to rarely, because the risk is so low.
5--What does our staff do there [they have lived there all their lives]? Typically, they take NO meds for prevention. The citizens of these countries [where we travel] take nothing because ...
6-- ...We virtually never see a case of 'new' Malaria in our clinics and the doctors / staff rarely see or hear of it around them in their daily lives. When it does occur, it is usually 'imported' by traveling to other regions.
7--Will I be taking anything on these upcoming trips there? NO...unless I see lots of mosquitoes around...v unlikely. If so I take the Choroquine as above. It is effective immediately.
8--Why does the CDC and, therefore, USA doctors recommend it routinely? Malaria has been and is a huge disease and death problem around the world. Their recommendations can ''take no chances''
This is the ''broad brush'' approach. My 'brush' has a much finer tip because of my experiences down where we go. ..and I pointedly avoid getting even close to endemic regions...I and wife Pat are with the students every day of the trip. Therefore, on our trips, the students and staff have minimal [although theoretically not zero] exposure.