Experience with Chloroquine in India-help

http://wwwn.cdc.gov/travel/yellowBookCh4-Malaria.aspx#map4-7

Seems Mosquitoes are resistant there.

I have done a good deal of reading on the subject as I was, and still may do a project on malaria. Many seemed to take up malaria as a project in the last year, so who knows.
When they tire of it I’ll take it up with a different slant.

I’ve gotten Chikungunya in India but never Malaria. Try using a repellant like DEET. Just don’t use it on open cuts.

Repellent, mosquito net, long sleeves, socks, and a quick reaction in case of joint pain and fever is the BEST method.

Unless you want to contribute in increasing resistance levels with mosquitoes (and making it more difficult to treat malaria cases for those who live there), ruin your liver, damage your eyes.

Be careful what you take – it’s too easy to breed another drug resistant super mosquito which adversely affects local populations who have nowhere to turn for help.

Here’s other thread for more opinions and other advice:
http://www.lightstalkers.org/what-are-you-doing-about-malaria

As mentioned by several people, prevention is key: long lasting impregnated mosquito net, long sleeves and repellent. But it might not be sufficient. If you are going to stay in malaria-infested areas of India for some time you have 2 choices: a) go for prophylaxis and live with the relatively minor side-effects; b) do not take prophylaxis but be extremely vigilant, always have the full course of treatment on you and, in case of fever and/or flu-like symptoms or doubts have a blood test done (one finger prick) and start treating. In India there are health centers and dispensarues everywhere. These days the drug of choice for treatment is Coartem and the course costs about 6/7 USD in Bangladesh. As a physician I recommend chemoprophylaxis for visits of less than a year. For visits longer than a year the possible side effects of chemoprophylaxis have to be balanced against the benefits. But Falciparum malaria kills people and tourists every year.

I lived in the Chittagong Hill Tracts (between Bangladesh and Burma), a highly endemic area for malaria, for the past 3 years and did not take prophylaxis as I have been living in malaria areas for the past 30 years. I was ready to take Coartem if needed. But that was a personal criticable educated choice and you have to assess the risks of infection (urban visits versus jungle and rural areas).
Hope this is useful

I spent more than 6 months in South Asia some years ago. I started taking Lariam but a month after that it was TOO strong I had fever, hallucinations and feeling weird. So I decided to stop taking and did not take ANY pills at all. I was lucky. Did not catch Malaria. I guess in Northern India is not THAT BAD. But as I’ve been told Chloroquine helps. If you are going to take for some weeks only it is ok, I guess. I may help!
On the other hand, Quinine is also another good choice. Plus, wear always repellent, long sleeves clothes in places with many mosquitoes and have a mosquito net ready! That’s the best!
Cheers, Christian from Buenos Aires

tried lots of maleria tablets but they drive me crazy and make me feel sick, dream…...............

in india i just use deet from the camping shop, but buy the strongest, and also india has a local cream called odamose everywhere, very cheap about 20p a tube, and does the trick, but god knows whats in it. im in delhi at the moment and i’ve not seen one mosquito. wow.

i think i had all the symptoms of maleria and spent 5 days in hospital in varanasi for christmas this year, but unfourtunately trying to talk to the doctors for the truth was hard work and they wont give you an answer, so will take more tests when i reach england in a few days.

i was in same area this year, and i would recommend taking mosi net as i found especially in orissa and calcutta there bad if they exist. you can get in india but there a bit big and i think not impregnable. if i remember correctly mosquito’s were bad in orissa when i was there. many people use electric plug ins in india at the moment, but i dont know how good they are, but there cheap here.

a recent national geographic has article about maleria in calcutta.

take care safe travels

rich.

hope this is useful,
carmen

good luck and have fun!

Susannah

The neem-based oils sound like a good idea. Neem leaves have been used for centuries in India to keep mosquitoes out of the houses. You still see many houses where the entrances are “decorated” with neem leaves. Neem trees are also present nearly everywhere.

BTW, what I was told (and I’m not a scientist, so this could be BS) is that mosquito bites at night result in malaria while mosquito bites received during the day result in another disease (Dengue, IIRC), which is more dangerous and more difficult to treat.

But wanted to point out another thing: In preventing mosquito bites in the first place, wear long trousers and long sleeved shirts but be aware that the beasts will get thru most light clothing you usually wear in the tropics – a linen trouser and a t-shirt offer just zero protection. So, I usually switch to mosquito-proof trekking gear. I find Fjaelljraeven – a swedish outdoor company, and they have lots of mosquitos up there – and its G1000 fabric the best. The bugs just won’t get thru. Other companies offer chemically treated fabric – “NoSquito” beeing one brand, if I remember correctly – but I fear that the built-in repellent will wash out too early.

So I usually pack the trekking pants/shirts, plus I’m using Permetrin to “impregnate” normal clothing against mosquitos. Also, wearing a hat and, if you want to be on the safe side, high-cut desert/jungle boots is not a bad idea.

(Because, as someone mentioned before, Malaria is just one of the bad things you might acquire…)

thank you for the good advice over here. Actually I will be leaving for India in january, and staying for a fairly long time. I would need a bit of help in choosing…

I do not want to take prevention drugs, but better repellent, nets and a ‘malaria kit’, containing a way to check if you have malaria and enought drugs to keep you up till you reach the hospital. Can you advice on any such kit (possibly containing either Malarone or Coartem as they seems to be good).

Thank you very much,

Alex

I have also taken: quinine, paludrine, halafan, primaquine and Lariam in my lifetime. I have had malaria more times then I can remember with 2 very serious cases. I grew up using mosquito nets and burning mosquito coils and lathering on the DEET before going outside.

Sorry to the posters above but, mosquito nets, repellent, and treated clothing will not prevent all bites. You will get bit. The malaria prophylaxis treatments are designed to prevent you from getting malaria from the one bite you can’t avoid. Think about it, when is the last time you remembered to put mosquito repellent on your butt before using an outhouse style toilet? Anyone who’s done travel in the third world knows outhouses are prime breeding grounds for mosquitoes.

India now has a lot of chloroquine resistant malaria removing that option. I took doxycycline for 4 weeks in Uganda with no problems. The added advantage it that it also protects you from other stomach ailments so it makes eating street food a little less dangerous.

I have taken Lariam/Mefloquine. STAY AWAY FROM IT!!! It is very dangerous. I had to take for 3 summers in a row on trips to chloroquine-resistant countries (S.Africa, Mozambique & Vanuatu). It causes accelerated hair loss in many men and some women. It can cause outright dementia in some cases. Even docs cannot predict the side effects you may have on Lariam. If you have ANY family history of emotional or mental disorders or even a tendency toward them, you are in for a VERY rough time.

My reaction was to go from a full head of thick hair at 19 to mostly bald at 22. Hair loss in my extended family would normally occur at 35. I also had terrible nightmares after every dose of Lariam.

The British Medical Journal (31 August 1996, 313:13) found that “About 0.7% (1 in 140) travelers taking mefloquine can expect to have a neuropsychiatric adverse event unpleasant enough to temporarily prevent them from carrying out their day to day activities. Possible adverse effects listed by Hoffmann-La Roche’s product literature include “convulsions, depression, hallucinations, psychotic or paranoid reactions, agitation, aggression, confusion or forgetfulness.” There are several very large class action lawsuits against Hoffmann-La Roche for concealing the severity and frequency of serious side effects with Lariam.

This site has the best information on malaria in India on the web:
http://www.malariasite.com/
Here is the page that deals specifically with chemoprophylaxis:
http://www.malariasite.com/malaria/Prophylaxis.htm

My recommendations are:

1. Take Malarone for chemoprophylaxis.

2. Definitely use a treated mosquito or No-See-Um net. Either, buy one the day you arrive or get one like this:
http://www.travelhealthhelp.com/nets7.html

3. Definitely use mosquito repellent with high DEET content.
-I always take a few of these along: Deep Woods Off 1 oz pump-spray (98% DEET)
http://www.offprotects.com/sportsman.aspx
I have also used this:
http://www.campmor.com/webapp/wcs/stores/servlet/ProductDisplay?productId=1065&memberId=12500226

4. If you travel very light, make sure you pre-treat your main outfits with permethrin or deltamethrin. Here is a good one:
http://www.cabelas.com/cabelas/en/templates/links/link.jsp?id=0031692516902a&type=product&cmCat=search&returnPage=search-results1.jsp&QueryText=permethrin&N=4887&Ntk=Products&Ntx=mode+matchall&Nty=1&Ntt=permethrin&noImage=0

Remember, all of the above ONLY applies to foreigners visiting an area with know malaria problems. Locals are advised to NOT take chemoprophylaxis and only treat actual outbreaks. They already have some immunity, you don’t. Your reaction to an outbreak will ALWAYS be more severe, especially if you are not on chemoprophylaxis.

Good luck with your trip. Stay healthy, stay strong.
-Andrés