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Antimalarial Tablets & DR & some further info for all...

london
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Antimalarial Tablets & DR & some further info for all...

Hi All,

Further to the last post re antimalarial tablets, I contributed explaining that my GP Nurse had advised it wasn't necessary WELL.... this advice is indeed wrong!

I was at the pharmacy yesterday evening picking up my daughters Hep A dose injection and the pharmacist asked me if the nurse had given me antimalarial tabs. I told him what I was informed and as he knows my GP surgery very well, he said he was going to have 'a word' (a bit of a go at them actually) as it is definite - you do need them.

He showed me a vacs list from the national travel & health authority which was dated for October 2005 and under the DR it states that you have to have antimalarial drugs. It advised one called chlory.....(something or another-cant remember the full name) apparently no side effects with this one.

I explained to the pharmacist that the GP had said it was only if I was travelling through the rainforest areas, etc... but he advised this also includes day trip excursions which I may go on (outback safari trips, etc...) he also said to not take any risk and to get the tabs on monday when my daughter goes back for her Hep A injection. He mentioned, it would only take one mosquito bite from one carrying malaria to catch it! And repellant wont warden off every mosquito. If any of you have ever seen someone infected with malaria you probably wouldn't think twice about taking them (my mum contracted this disease years ago whilst in Brazil - not a pretty sight believe me)!

For my daughter, he mentioned a liquid as he said the tabs are extremely bitter and in his experience it is very hard to get children to take them.

He stated the following also, which I thought I would note for those who are unaware;

1. Tabs to be started 7 days prior to trip (possibly due to when I'm leaving).

2. Tabs to be taken every day and in my case of a 15 day stint, altogether my course should run for 7 weeks from date of commencing them.

3. On arrival back to the UK, absolutely MUST continue these until course is finished. If you don't finish the whole course its as good as not even taking them in the first place so this is extremely important as otherwise, the infection could develop. (similar to in the case of antibiotics, etc... must always run the full course).

First warning signs of malaria after returning home are extreme flu like symptoms. If in doubt, get yourself checked out!

I hope that this helps and I'm assuming although I'm here in the UK, this info would be the same for all.

Also - my lovely pharmacist advised the following info which I thought I'd note below. Many of you are probably all aware of it but hey, some of you may not be and he said it will just assist in preventing stomach/sickness problems whilst away;

1. The most obvious - do not drink the water and again, as others mentioned here, brush your teeth with bottled water and keep your mouth shut in the shower! lol... Also, be weary especially on day trips of having ice in your drinks as it may not have been made with purified water but resorts normally are okay.

2. Recommended to stay away from eating salads, fruit, etc... as you do not know what they were washed in. Again, the water issue.

3. Recommended again to eat hot food rather then food that been sitting around or maybe slightly cooled down and to ensure the food IS hot when eating. Basically common sense with regards to seeing hygiene levels in places where you eat.

4. He did say that I'd probably be alright as I've travelled to so many countries and eaten locals foods and drank their water so would have built up good immunity however, still better prevent then cure!

Pharmacist also stated that in the event of developing sickness/stomach problems best things to do are as follows;

1. Drink plenty of fluids, stay away from alcohol, fizzy drinks and definitely don't drink milk.

2. Gave me Diarolyte however, also stated that in case the children don't drink it if you buy a bottle of fizzy drink and let it go flat prior to drinking it, basically this acts exactly the same as your diarolytes, immodium, etc... and is much cheaper way to do it and again, easier to get the kids to drink it. He said these medications that we buy in the pharmacy's and spend alot of money on are basically this, flat fizzy drinks!

I do hope this info assists in any way. I do not mean to cause any scaremongering however, its always good to be informed of these things.

Other then that, chill and have a fantastic time as I plan to do!

Best wishes,

Eva-Maria

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Nova Scotia
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1. Re: Antimalarial Tablets & DR & some further info for all...

Hi Eva-Maria,

Nice post.

Just a few of relatively minor clarifications to the best of my accumulated knowledge (NONE are major issues just minor points).

1) The usual anti-malarial prophylactic meds of choice for the DR is chloroquine - unless for some reason it is contra-indicated.

2) ALL drugs have SOME potential side effects - none are entirely free of side effect; but some definitely have fewer usually (like chloroquine).

3) Interestingly while Britain routinely recommends (I'm not sure the use of the words "have to have" are exactly proper but I'll not debate this) anti-malarials, the two largest contributors of tourists to the DR (Canada and the US) do not. Same people; same destination; different recommendation - and malaria (excluding the post-hurricane Jeanne outbreak, in which the numbers were still small) is virtually unheard of in returning DR tourists in North America.

4) While your pharmacist’s statement about only needing one mosquito bite is correct, there is no such thing as 100% guaranteed coverage, even while taking a chloroquine prophylactic.

5) Sorry for you Mum's malaria problem but there are different malarial strains with different treatments and different severity of disease in different parts of the world. I am not qualified to say, but the use of a Brazil case may or may not be a valid comparison for the DR. Hope she is doing better.

6) Generally good advice re: food, water, etc. although I have never had an issue with salads as I always verify whether the rinse water used to wash fruits and vegetables in our resorts is purified. Have never found one that doesn't use purified water - yet.

Like I said these points are minor and may have more to do with my North American attitude vs. those encountered in the UK. Great post.

Gregg

NJ
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2. Re: Antimalarial Tablets & DR & some further info for all...

What about the risk on the day trips etc? whats your take on this?

Nova Scotia
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3. Re: Antimalarial Tablets & DR & some further info for all...

This is my PERSONAL opinion and I recommend that if you have any concerns at all you discuss this with a trusted medical professional of your choosing.

In the areas of the DR normally associated with tourists (North Coast from Luperon to Samana; South Coast from Boca Chica to La Romana and East Coast from Punta Cana to Uvero Alto as well as the corridor from Puerto Plata to Santo Domingo including when on excursions) unless there is a known outbreak (such as followed Hurricane Jeanne, and has since been rescinded) I would not personally have any abnormal concerns at all about the possibility of contracting malaria. While the risk is minimal IMHO I do recognize that it is not zero - nor will it ever be; including when protected by anti-malarial prophylactic medicines. These will lower the risk still more but they are not without potential side effects.

I always take preventative measures (OFF - Deep Woods Formula when and as appropriate; hotel room windows and patio doors closed around dusk and evening hours; long pants in the evenings, when I can stand it; etc.) and I am vigilant upon my return for the occurrence of any flu-like symptoms for several months.

If I were travelling to the western borders of the DR where I would be significantly closer to Haiti I would reassess my plan and may well change what I do - but I have no need or desire to go near Haiti at present so this is unlikely for the foreseeable future.

Gregg

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london
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4. Re: Antimalarial Tablets & DR & some further info for all...

Hi Gregg,

Thanks so much for your input! And yes, you are right, I had read that it is not a 'have to have' thing but the pharmacist seemed to be adamant about taking them, again, it may just be a UK thing. Although, its pretty contradicting advice though, pharmacist thinks I have to have them and Doctor thinks the opposite... I'll be seeing the doctor this evening so am going to double check this.

I found it a bit strange at first TBH as I've been to quite a few areas in the caribbean and south america and have never had to take any.

Again, I think you are correct - cloriquine sounds like what he recommended me to take. He stated no side effects however, I'm not to naive to think there potentially couldnt be any. In fact, you couldnt advise exactly what are the commonest side effects by any chance?

Re my mum - she is fine, it was quite a number of years ago now when she was out there and got infected and as you say, there are so many different strains (like you have with flu's and other bacterial/viral infections), unfortunately she possibly had picked up a pretty bad one!

Thank you for the comment re my post. I always think its good to share information but obviously, without the want to cause any scaremongering. IMO alot of it just comes down to common sense however, many of us do tend to overlook the obvious so its always good to remind each other of these things.

Thanks again and if you can provide any input on the side effects that would be great, also, possible side effects for my daughter (just so I can bare them in mind).

Eva

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5. Re: Antimalarial Tablets & DR & some further info for all...

Hi Eva,

The most commonly reported side effect seems to be blurred vision.

Others are listed here, also.

www.drugs.com/MTM/chloroquine.html

Gregg

london
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6. Re: Antimalarial Tablets & DR & some further info for all...

Hi Gregg,

Thanks for that. I've done LOADS of research of chloroquine this morning.

You mentioned blurred vision as one of the commonest so that should be okay - probably have that anyway with all the cocktails I plan to drink! LOL

Only one prob I've encountered in my research, I suffer from psoriasis and apparently this drug brings it up severely but will check with the doctor this evening.

Thanks again for your help.

Eva

chigwell, essex. uk
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7. Re: Antimalarial Tablets & DR & some further info for all...

Hi Eva,

We took anti-malaria tablets but only had to take one tablet a week for seven weeks. Much less hassle. They really do taste discusting, especially if you manage to get one stuck at the back of your throat. I think that they can upset your stomach a bit as well. Take along something soothing, a couple of plastic bottle of Pepto-Bismol just in case (very expensive in resort). Have a great holiday!

Lorraine

london
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8. Re: Antimalarial Tablets & DR & some further info for all...

Thanks Lorraine - will get some pepto! Think I'm gonna look like a chemist by the time I get there! lol...

Eva