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Old 09-24-07, 03:12 PM   #1
gizem310
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Malaria in SE Asia

We will be cycling in SE Asia for about 6 months. I have done a lot of research about malaria and even went to see a travel doctor. I still cant make up my mind about whether I should take preventative medicine or not. I really dislike taking any sort of medicine and this will be a loooong trip so and anti malaria drugs have vicious side effects so I would rather not. On the other hand, mosqies absolutely LOVE me so it is very likely that I will get bitten at some point.
Also, some people that there is no difference between 20% DEET and 100% DEET. Is that true?
I am getting paranoid about malaria! We quit the jobs and sold everything for this trip and it never bothered me. Now I am terrified with the thought of some flimsy buggers!!!
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Old 09-24-07, 03:32 PM   #2
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At some point there is a trade-off between the chance of malaria vs. the risk of taking the medication long-term.

We did not take any malaria medication for the past year in SE Asia.

One option is to carry a malaria test kit and carry the locally available treatment. The kits can be ordered through the internet from South Africa (I think). Purchase the medication only from internationally reputable pharmacies (Boots, Guardian) as fake medications abound in Asia.

We brought a few bottles of 100% deet. It works, period. But, when you are sweaty it does not last long.

More than likely you will be bitten at night, so carry a sleeping sheet sprayed with repellent and/or a mozzie net.

Good luck and happy travels
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Old 09-24-07, 04:07 PM   #3
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I am soon heading to Viet Nam for a 5-6 month stint in Hanoi. I am taking enough Malarone for a few weeks of travel into malarial areas ($5.50 per daily pill at CostCo -- so yes a little expensive for your 6 months. I hated larium but have had no problems with Malarone). Anyway, my physician also suggested I look into clothing with built in insecticide. Here is a link:

http://www.buzzoff.com/index.htm

Enjoy SEAsia!
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Old 09-24-07, 05:05 PM   #4
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Personally I wouldn't "pre-medicate." There are tons of places like Bangkok, Krabi etc where mosquitos aren't a problem at all, and the side effects really aren't worth it.

For example, doxycycline is an antibiotic -- rarely a good thing to pump into your system for 6 months for a disease you don't even have and very well might not get. Among other things, this may well compromise your immune system to an extent, i.e. making doxy & other tetracycline derivates less useful to you in the future.

Mosquito coils work surprisingly well, as do the mosquito nets. Most guest houses in mosquitoed areas will have 'em.
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Old 09-24-07, 06:12 PM   #5
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Here is more detail on the malaria test kits:

$11.00 per kit including shipping

http://www.anytestkits.com/malaria-test-kit.htm


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Old 09-24-07, 06:17 PM   #6
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Here is more detail on the malaria test kits....
So what do you do if you test positive?

From what I've heard, I wouldn't want to get stuck taking Lariam if I could help it...
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Old 09-24-07, 07:23 PM   #7
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So what do you do if you test positive?

From what I've heard, I wouldn't want to get stuck taking Lariam if I could help it...
The CDC has a page on their site dedicated to presumptive self-treatment of malaria for those living long-term in malarial regions who are not always able to take prophylaxis for months on end. Scroll down to the bottom of the page.

http://wwwn.cdc.gov/travel/yellowBookCh4-Malaria.aspx
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Old 09-24-07, 09:56 PM   #8
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Gin and Tonic (Quinine Water )

Old British preventive.....
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Old 09-24-07, 10:05 PM   #9
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I was in Thailand for three weeks and took Malarone the whole time. Not a hint of reaction or side effects...malarial prophylatctics are way different now than used to be. I'd highly recommend it! (...but in tandem with, and not a substitute for, permethrin-treated clothing and DEET based repellents.)
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Old 09-24-07, 10:41 PM   #10
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OK, a couple of points:
- Not everywhere in SE Asia is malaria-prone. Hanoi, for example is not a malaria area and most docs wouldn't recommend malaria prophylaxis in Vietnam unless you are travelling to the Delta, the jungle areas or a few other areas in the south.
- Malaria prophylaxis drugs are drugs that kill the parasite. The medication you need varies depending on the strains/resistances in the area you are travelling to.
- Mosquito avoidance is the 1st line of prevention - long light-coloured clothes, mosquito nets, +/- DEET. The time of day that mosquitos attack (!) depends on the species, in Vietnam daytime is safer but evening/nights are highest risk.

You need to take prophylactic medications before, during and after your exposure. The duration and the frequency (eg. daily vs. weekly) depends on the medication.

So I'd do for myself, no recommendation for anyone on this board of course,
(1) Mosquito avoidance measures all the time
(2) See your travel doctor (you need someone up-to-date on the area) and discuss how risky YOUR PARTICULAR exposure will be, and the options for medications/test kits etc.

-- (edit) --
Oops, I mean MY particular exposure risk, of course
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Old 09-25-07, 07:30 AM   #11
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I took larium, and had no side effects, but others I met did. A friend of mine was affected so badly that he stopped taking it, and then got malaria in India.
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Old 09-25-07, 07:50 AM   #12
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There is this gadget available that emits high frequency which repells mosquitos, you will need to google this as I have seen a friend use this. I usually burn incense sticks as the smoke is heavy and perfumed and the little blighters dont like it..
Best of luck with your trip, love what you have done.
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Old 09-25-07, 02:54 PM   #13
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Thanks to all of you. We dedided that we will not take any preventive medication; 6 months is too long of a time. We are ordering tons of deet (%100 for rısky areas and %20 time release that everyone swears by). We are also taking the tent sans the rain fly, which will provide shelter if we get swarmed during sunrise or sunset. With some Malaria test kits and Malarone tablets, we should be golden.
Thanks again and be safe.
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Old 09-25-07, 04:20 PM   #14
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We are also taking the tent sans the rain fly, which will provide shelter if we get swarmed during sunrise or sunset.
I've biked twice in SE Asia and never met anyone using a tent there. Accommodations are cheap, and secluded spots infrequent to non-existent. Portable mosquito netting for indoor use would be more practical. Much of SE Asia is hot & humid year-round, which makes for awful camping conditions. BTW, Northern Thailand, northern Laos, and northern Vietnam are significantly cooler and more comfortable in winter, which is also the dry season in northern Thailand & N. Laos. I encountered virtually no mosquitoes in that region during the winter.
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Old 09-26-07, 08:14 AM   #15
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That's another issue that we have been thinking about. That and the stove.
We love camping and being independent. The thought of having to rely on guest houses for accommodation bothers us. Also, because we'll be traveling in high season, we figured that maybe we could camp in the gardens of the guest houses if they were full. One of my pet peeves is looking for a spot to sleep every day while I could be spending my time riding
Same thing about the stove. We heard that food is plenty, good and cheap. But we'll be traveling for 6 months so we think we may want to eat some home (???) cooked meal every once in a while. What do you guys think?


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I've biked twice in SE Asia and never met anyone using a tent there. Accommodations are cheap, and secluded spots infrequent to non-existent. Portable mosquito netting for indoor use would be more practical. Much of SE Asia is hot & humid year-round, which makes for awful camping conditions. BTW, Northern Thailand, northern Laos, and northern Vietnam are significantly cooler and more comfortable in winter, which is also the dry season in northern Thailand & N. Laos. I encountered virtually no mosquitoes in that region during the winter.
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Old 09-26-07, 04:55 PM   #16
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Leave the stove at home, too. The food is delicious, cheap, and readily available. "Night markets" (outdoor collection of prepared food vendors) are common, and other markets (for produce, fish, meat, etc.) usually have some stalls selling wonderful prepared food, too. It was pretty easy to get a great meal for US $1, maybe slightly more now. Plus, noodle stands can be found in lots of places too, in Thailand at least.
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Old 09-26-07, 05:34 PM   #17
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+1 what axolotl says.

In Vietnam you will have people offering you accommodation, handing out their cards at train stations/bus stops/where tourists congregate. You will have to book ahead in the big centres (Saigon, Nha Trang) but other tourist towns are usually fine (Hoi An is my favourite).
In the cities there is really no place to camp other than the city parks, which I'm sure is frowned upon as officially you have to be registered (the hotels are meant to hold on to your passport, most don't bother). There are forest areas in the "middle" of the country and in the northwest, but everywhere else I went was pretty well serviced and reasonably crowded.

There is a website on cycle touring in SE asia; Mr Pumpy or something similarly dodgy-sounding. He might have some advice on camping in SE Asia.
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Old 09-26-07, 06:00 PM   #18
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Thanks to all of you. We dedided that we will not take any preventive medication; 6 months is too long of a time. We are ordering tons of deet (%100 for rısky areas and %20 time release that everyone swears by). We are also taking the tent sans the rain fly, which will provide shelter if we get swarmed during sunrise or sunset. With some Malaria test kits and Malarone tablets, we should be golden.
Thanks again and be safe.
Like most folks suggest, you really don't need camping equipment. I sold most of mine in Khathmandu before flying into Bangkok. What I held onto I gave to a friend to take home for me in Vientiene.

Mind that you could find camping spots in "the boonies" of Thailand, Lao, Cambo-but nothing super nice.

If concerned about being caught out perhaps bring a small ultralite tent or a tarp plus mozy netting (the netting not so much for the mosquitos, but for those giant creepy crawlies).

As for a stove, again as most folks suggest, its not needed. Depends on your likes/habits. I held onto my butane (MSR pocket rocket) to use for the occassional oatmeal and my morning Espresso (I make Americano's and add that nifty squeeze sweetened condensed milk).

Have fun!
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