Harriet Vane Posted January 6, 2016 Share Posted January 6, 2016 My dd will be spending two months in a small town in South Africa, volunteering/doing an internship at a school. Her doctor advocates taking anti-malarial drugs, as do many travel advisory sources. However, a dear friend of mine says otherwise. This friend married and lived in SA for a few years. Now they live in US but go back to SA every few years for an extended visit with family. She says: We do not take antimalarials unless we are in an area that needs them. This would be limited to Kruger Park and maybe a few other game parks. Her host family can guide her and give her what she needs if she needs them for a short period of time; that’s what they do with us. :) I also never took them when I lived there if that helps :) The head of the host family is a doctor, recently retired. On the one hand, malaria is nasty and I would not want dd to suffer with it. It can be deadly, also. On the other hand, the meds are powerful and nasty, and taking them for three months is hard on the system, too. I worry a lot about medicine reactions, as I have suffered twice from massive, systemic over-reactions to antibiotics, one of which nearly killed me. I am now considered antibiotic sensitive and must avoid them at all costs. Dd is not me, but I worry all the same, especially as she has been exposed to the superbug that put me in the ICU. FWIW, dd will be taking probiotics and vitamins also for the duration of her trip. Let's debate-- Anti-malarials or not? Why or why not? Quote Link to comment Share on other sites More sharing options...
sahm99 Posted January 6, 2016 Share Posted January 6, 2016 I have been to SA many times, as has my family. My Aunt has been living there for over 20 years. Never have I heard about Anti-malaria drugs being used (as opposed to many other African countries - and when travelling through these we have all taken the drugs repeatedly!). But then, I have certainly not been EVERYWHERE in SA, so maybe my experience does not apply... My instinct tells me to do as the locals do - particularly with a doctor in the host family, I wouldn't give it a second thought. 1 Quote Link to comment Share on other sites More sharing options...
DawnM Posted January 6, 2016 Share Posted January 6, 2016 I would take them. I only spent 4 months in SA, but I grew up in Kenya. We have had friends die of malaria (cerebral) and I have had malaria (age 16.) The preventative medicine is far less hard on the system than the disease. I have had two reoccurring bouts many, many years later. Not fun. Dawn 7 Quote Link to comment Share on other sites More sharing options...
Ravin Posted January 6, 2016 Share Posted January 6, 2016 If she is going to be in a malaria prone area, it may be worth it. But I would probably listen to your friend, and consult with the host family. I would want to make sure she has a mosquito net for her bed, just in case, and plenty of bug repellant with DEET (or access to it while there if she can't take it thru customs). 3 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted January 6, 2016 Share Posted January 6, 2016 (edited) Where exactly will she be? CDC publishes maps that track known cases of malaria. Here is South Africa's (scroll down about a page's worth of text). The northern third, more or less, is where they recommend taking prophylactics. Parts of Kruger and some of the big game reserves are in the affected region if she plans to go there. Also note that mosquitoes there are resistant to choroquinine, one of the old/cheap medications. Others can be quite expensive and some have side effect that are significant for some people, so there really is a side effect and $$cost vs. probable risk of exposure to weigh. (Your doctor should be on top of all that, but some doctors see more internationally-traveling patients than others.) That said, our whole family of 5 was on Malarone (atovaquone/proguanil) for 2 months when we were elsewhere in Africa and not one of us had significant side effect problems. FWIW, we went off when we got to South Africa because we were not in the affected regions. What a great opportunity for her! Try not to worry too much. We loved South Africa. PS And definitely send her with a good net. We take these whenever we go anywhere where it might be an issue, and just leave them behind someplace that can use them. They come with eye hooks and cords and can be easily put up just about anywhere. Edited January 6, 2016 by Pam in CT 4 Quote Link to comment Share on other sites More sharing options...
Spryte Posted January 6, 2016 Share Posted January 6, 2016 Hello fellow victim of the same superbug! I would follow the advice of your DD's doc on this. I spent years fighting a cousin of malaria, and the treatment was brutal, the illness was brutal, and the relapses are worse. I will never be the same, will never give blood, will always fear relapse. So, thinking that my cousin of malaria is not as bad as actual malaria... I would consider the benefits greater than the risk. Especially since your DD has potentially been exposed to our shared superbug spores - because that would make treating malaria much riskier. Whatever you decide, it will be right for your family, and I hope she has a wonderful time! 2 Quote Link to comment Share on other sites More sharing options...
Farrar Posted January 6, 2016 Share Posted January 6, 2016 I don't have a ton of experience... but I also had a huge internal debate about this before we went to southern Africa for a month. In the end, we all took the anti-malaria meds and it was nasty stuff for the kids because they couldn't just take the antibiotics. And then... except for one single evening at one place in Botswana where there were actually a lot, I couldn't believe how few mosquitoes there were. Like, the way people talked about it was like it was going to be a lot - like an amount of mosquitoes that I had never seen before. Please. My backyard in DC is way, way more mosquito infested. And those ones bite. The ones in Africa never bit us. In fact, there were many days in the exact places we were supposed to be worried about - especially out camping in National Parks (though not in SA - in Namibia) - where I don't think I saw hardly a single mosquito. So... I don't know. I do feel like if I went back ever that I probably wouldn't bother with the anti-malaria stuff. The actual risk seemed so low once we were there. And talking to people once I was there, I began to feel silly that I had bothered. But places may be very individual... and maybe there are sudden swarms of mosquitoes like the one we saw that one day in Botswana and we just got lucky. Like I said... I'm no expert... 1 Quote Link to comment Share on other sites More sharing options...
J-rap Posted January 6, 2016 Share Posted January 6, 2016 Are you able to go to an immunization clinic for international travels? Our health insurance group has a clinic that specializes in that. They have been very helpful to us in deciding when to get vaccinated and when it's really not necessary. They seem pretty up to date on all of that, with all the latest statistics, etc. 3 Quote Link to comment Share on other sites More sharing options...
Harriet Vane Posted January 7, 2016 Author Share Posted January 7, 2016 Thanks for the replies. Still agonizing over the best course of action. Quote Link to comment Share on other sites More sharing options...
Spryte Posted January 7, 2016 Share Posted January 7, 2016 Thanks for the replies. Still agonizing over the best course of action. Here's an idea: do you keep in contact with any of the specialists who helped with your superbug? Could you ask for their thoughts re: that angle? Hugs. You'll find the right answer! 2 Quote Link to comment Share on other sites More sharing options...
Amira Posted January 7, 2016 Share Posted January 7, 2016 If you're still agonizing, I'd base my decision on the CDC map Pam posted. Malaria meds have enough side effects that I wouldn't take them in areas where they weren't needed. But if she'll be in the part of the country where they are recommended, I'd have her take them. Malaria can affect your health for years after getting it. I've had friends who have lived in South Africa for years (not in the part of the country where anti-malarials are recommended) who don't take them there. 1 Quote Link to comment Share on other sites More sharing options...
Lanny Posted January 7, 2016 Share Posted January 7, 2016 I wonder if you can check with people who live in that town, to see whether or not there is a problem in that specific area. I suspect there may be people who come to our area in Colombia, who take measures like that, that are not at all necessary. S.A. is a large country, so the existence of Malaria probably varies, from one area to another. Check it out before taking the medicine and GL to her. P.S. A Mosquito net for her bed might be a worthwhile thing for her to take with her... 2 Quote Link to comment Share on other sites More sharing options...
redsquirrel Posted January 7, 2016 Share Posted January 7, 2016 Thanks for the replies. Still agonizing over the best course of action. It is agonizing and I would be feeling the same way. If people who live there or are visiting are taking the meds...then I would. My brother caught malaria when he was in Ghana, so very, very far away. It was horrible and I can't even think too much about what he said it was like being in the hospital there. He was in a big room and there was a dead body in there for at least a day before family came to get it. And in Ghana, at least when he was there, it was family who took care of sick people when they were in the hospital, bringing them food, bathing the sick people, changing sheets etc. He had no family, and he is pretty sure the nurses were feeding him food that should have gone to their own families. The medical staff was wonderful to him, but they had no resources. Maybe she can get the medication but wait to take it until she gets there and talks to people who are there? Or is it the sort of medication you have to take for a month or so before it works? 1 Quote Link to comment Share on other sites More sharing options...
Hannah Posted January 7, 2016 Share Posted January 7, 2016 I agree that it depends where in South Africa she will be visiting and at what time of the year. The malaria season in the affected areas is from Sept to May. In my view this map is more accurate (subtler boundaries) on the danger areas than the one linked up-thread. Since having children, we have only travelled to Malaria areas in the 'off-season". We do not take the prophylaxis at that time, but we do wear long sleeves at night, apply insect repellent when outside and we sleep under nets. 2 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted January 8, 2016 Share Posted January 8, 2016 Yes, Hannah's map is definitely better -- I wish CDC would do that low/medium/high risk thing! And also the point about time of year. When we were planning to go to the heart of malarial darkness in Zambia and Malawi, and I was working out what medications to do, I didn't think to think the seasons part through; I just looked at the maps. Turns out we were there at the tail end of their 6 month dry season, during which literally not one drop of rain falls from the sky, so there were virtually no mosquitoes at all. We carried on with the Malarone anyway since by that point we had it, and no one was having side effects; but if I had to do it over again I'm not sure I'd make the same decision. 1 Quote Link to comment Share on other sites More sharing options...
Starr Posted January 8, 2016 Share Posted January 8, 2016 Will the people she's living with use a sleeping net? Will she be comfortable using one if others don't? Will she use repellant and long sleeves? These things play in to your decision . 2 Quote Link to comment Share on other sites More sharing options...
Plink Posted January 8, 2016 Share Posted January 8, 2016 My BIL caught malaria in Liberia. It is nasty. I've never seen anyone that sick in my entire life. He looked worse than 99% of my end of life patients at the nursing home. Luckily he had the right blood type for a cure, but before he got better we were sure we would loose him. I would never subject one of my children to that. IMHO the meds work, and have for many years. Why risk it? 1 Quote Link to comment Share on other sites More sharing options...
Bluegoat Posted January 8, 2016 Share Posted January 8, 2016 I would want to know what the host family dad says. Not so much whether they take them, but whether they think visitors should. 1 Quote Link to comment Share on other sites More sharing options...
Harriet Vane Posted January 8, 2016 Author Share Posted January 8, 2016 I emailed the host family and got a very reassuring, intelligent response from the doctor/head of the host family. He looked at the maps I sent as well as some charts. They are not in a malaria area. There have been no cases there. The nearest malaria area is 400 km away. He is familiar with malaria maps and promised that he would be proactive in making sure dd and the family are all on prophylactic meds if they choose to travel to such areas. He also worked for many years as an army doctor in a malaria area. Of the 400+ soldiers he was doctor for, none contracted malaria. The host family are people we know. I feel comfortable trusting them with my dd, and the informed, intelligent response to my questions just adds to that trust. I feel much better about the risk now. Thanks for your thoughtful responses. 5 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted January 8, 2016 Share Posted January 8, 2016 :001_smile: Doesn't get much better than that. 2 Quote Link to comment Share on other sites More sharing options...
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