Serious reading about malaria.

[Cat Driver]

If you want to get some insite into the dangers of malaria there is a good thread running on Pprune in the Africa forum.

It's called " Pilots and malaria " very sober reading.

[chipmunk]

Thanks Cat.

Some interesting tidbits there to add to the knowledge bank.

Off to the Dark Continent next week (visa permitting!) to try to evade that and all other nasty diseases once again!

[Cat Driver]

Take care...where you going?

[rsandor]

awsome read. thanks cat

[KAG]

While in Kenya I used malarone. ripped my guts apart, as it did my copilot after 3 days of use then it settled down. My mechanic who is african recommended to drink bitter lemon, says it's a natural anti malarial.

[2R]

Schweppes Bitter lemon contains quinine .

[wrenchturner]

I never had trouble with Malarone, but with what KAG said, that may have explained a minor inconvenience I experienced pretty much daily. Sounds like I may also be going back over there soon too, hopefully all continues to go well on the Malaria front.

[Panama Jack]

Don't forget to take the condoms either. All sorts of things that can make you deathly ill in Africa after night falls.

Also on PPRuNe, a thread about the dangers of living in Hong Kong, appropriately named:
Hong Kong: DANGER posting

Can anybody point the direction to the Canadian frostbite and polar bear hazards thread?

[wingspan]

Can anybody point the direction to the Canadian frostbite and polar bear hazards thread?

http://canadian-health-network.ca/servl ... HNResource

http://www.pc.gc.ca/pn-np/nu/auyuittuq/ ... ain1_E.asp

[Springbok 3]

Schweppes Bitter lemon contains quinine .

Not enough to help so at your own peril if you rely on that rumour.

I have had malaria too many times to count. I once spent 14 days in a coma induced by cerebral malaria while in Malawi. Thanks has to go to a Canadian Dr by the name of Cattehorn who saved my arse.

If you are going to be staying in a malaria area for an extended period of time, take this advice from someone who knows the drills:

Stay off the malarial preventative drugs for more than four weeks. They are lethal and will give you permanent liver damage. It is safer and healthier in the long run to prevent malaria or to treat the actual malaria early with quinine when contracted. remember the avrge incubation period is 10 days after being bitten. Most times you will not even know you have been bitten.

Learn to recognize the symptoms. Just like getting the flu. Body aches and pains, mild headaches, loss of appetite, pain behind the eyes, sensitivity to light etc.

Get regular blood counts at a clinic. (every 14 days) Takes 5 mins to draw blood and another 10 for the technician to do the blood count.. If you catch it with a count of 1-3 out of 6 treatment is very easy and you will scarcely feel the symptoms.

Sleep under a mossie net even if indoors.

Use bug sprays bought locally and apply generously. Cover as much skin as possible when staying outdoors after dark.

Malaria carrying female anophalese (apology for the spelling) mosquitoes are mostly active after 21h00. So get indoors before then if possible.

Blast your air conditioner in your room if you have one. Mossies hate the cool/cold air and will stay away.

Alternatively, crank a bedside or rooftop fan....it blows the bastards away.

Light mosquito coils an hour before you go to bed.

Natural preventative medicines are not really effective but drinking aloe powder daily makes your blood bitter as does a healthy mixed dose of epsom salts and creme of tartar (latter form the fruit of the Baobab tree) every morning. Keeps you regular as well

PM`s welcome if you have any more questions

[TG]

Stay off the malarial preventative drugs for more than four weeks. They are lethal and will give you permanent liver damage. It is safer and healthier in the long run to prevent malaria or to treat the actual malaria early with quinine when contracted.

I noticed this way of dealing malaria amongs South Africans.
No preventative drugs except huge amount of it when contracted (to save their livers on the long time run)
Might also be sometime to save money on the long run as those pills can be quite expensives

Could the initial liver problems be related to this !?:
http://www.cdc.gov/malaria/faq.htm

Buying medications abroad has its risks. The drugs could be of substandard quality because of poor manufacturing practices. The drugs could contain contaminants or they could be counterfeit drugs. Such products may not provide you the protection you need against malaria. In addition, some medications that are sold overseas are not used anymore in the United States or were never sold here. These drugs may not be safe or their safety has never been evaluated.

But now, who really knows if it's still the case that current medical's preventions are bad for liver. Any real studies, results, etc...!?
What would be the point of saving your liver if you miss only one time your malaria's symptomes and died out of it, before getting a chance of stuffing yourself with quinine.
Your 14 days in the coma Sprinbok put you really close to it no !?.
After all, you can always get a liver transplant if you f@ck them up badly

I used nivaquine (quinine) for years when I was kid with no problems, as well as everybody I knew around. Then, I might get a surprise when I'll get much older who knows
Now it's Malarone when I have to. And I don't want to miss a day of prevention. That's only me. On the other side, I know I'm not getting trash recycle pills made in China.

Sorry, long post I just wanted to give another point of view.

[yak driver]

If you want to take your chances coming home in a box by all means follow springboks advice.

If you are working in an air conditioned office environment in a "civilized" part of africa, where you don't have to be outside at or around sunset and sunrise you can probably get by not taking the anti malarial medication. If you are a pilot, it means you are probably out at the airport at the worst times of day, and there is about NO WAY you are gonna avoid getting mosquito bites. You probably don't want to go off the anti malarials.

My background, I didn't grow up in Africa, or spend my whole life there. Between 1998-2005 I probably spent close to three years working in africa 2 months at at time. My first rotation was Burkina Faso at the end of the rainy season. I went to the travel clinic before going, got all the shots, and doxycycline as antimalarial. 2-3 weeks into the rotation I was having a hell of a time with stomach problems (it takes a while for you stomach do get strong enough to handle the crap you eat over there.) I kinda thought it might be caused by the antimalarial medication. That and the two experts with tones of africa time (one south african, and one aussie) saying how the medication is worse than the disease etc.... I stopped taking the meds.

10 days later I woke up in bed and thought I had wet it, cause the sheets were all soaking wet. So I changed them and went back to bed, not long after I woke up again with the same problem, only this time when I turned the light on I saw than my shoulder which wasn't under the sheets was covered in beeds of sweat. Off to the clinic in the morning with a smashing headache, and bingo CONGRATULATIONS, you have Falciparum malaria (cerebral malaria).

I really didn't know how or understand how sick I was or how much worse it was going to get. I just kinda figured the next few days wouldn't be very good. The reason they call it cerebral malaria is because if the parasite count gets higher than a certain level (the parasite doubles roughly every 12 hours) you get cerebral menengitis, and most like don't get to go home. If I had jumped on a flight to come home without getting on the meds I would most likely have died.

Got on heavy doses on quinine right away, which immeadiately gives you ringing in the ears, hearing loss, and everything tastes like metal. The taste part doesn't really matter cause in my cause I couldn't hold anything, not even water down for the next few days. At first you are kinda worried that you might die, after 2 or 3 days you wish you would. The only way I could keep the meds down was taking them dry, and then lying still in bed for an hour. Other than the smashing headache, ringing in the ears, hot/cold flashes, constant barfing/dry heaving, having your pee get darker and darker, and just generally feeling F#$@)&G aweful, it's not that bad

5 days later I was good enough to travel home (15 lbs lighter) and spent the next 3 months on medical leave. Malaria is a parasite in your blood system, and one of the after effects of killing it, is an enlarge spleen (which I found out is a sorta blood filter). In my case it was enlarged enough to push out my ribs and be painful rolling over in bed. The doctor said, if you fall down, get hit, are in a car accident or anything, get your ass to emergency ASAP cause if that thing burts you will bleed to death pretty quick. The same doctor went over the initial test results that I got, and told me another 12-24 hours and I was pretty much guaranteed to have cerebral meningitist. Had to get an ultra sound of my kidneys to see if they got damaged.

Since that first wonderful experience I have been back to africa many many times. Each time, I go to the travel clinic and go over where I am going, how long, what I am gonna be doing, and that you are a pilot (out at the airport getting ready to be airborne just before dawn) no larium . There have been a few places where they didn't suggest meds, but always have the prescription filled and when you get there if there is mosquitos take the pills. It really is pretty damn easy. For me, doxycycline in pill format works out really well. Take it with a meal, drinks lots of water, no big deal. There are a couple new antimalarial meds that are out, and okay for pilots I'm just not familiar. Couple of friends that have taken whatever it is said it was awesome.

Most of you that go over to work in africa are not moving there permanently, you are gonna go and do rotations between 6-10 weeks or whatever it works out to. If you are working in an environment where people are getting malaria, and you listen to one of the "experts" that say the medication is worse than the disease, you are a moron. Just nod and smile, and take your pills and you won't get sick.

Schweppes Bitter lemon contains quinine, that's what the sorta metalic taste is. It does not have enough to keep you healthy, just happens to be a great drink with gin.

A few intersting points about that first job I worked in Burkina Faso. The job totaled about 7 months, we always had air conditioned rooms with mosquito nets. There was probably 20 people that worked the job between start and finish. The only two people to get sick with malaria were myself, and the expert south african who's advice I took. He got the same thing a few days after I left.

[Lost in Saigon]

Besides Malaria, there are other diseases to watch out for.

In February of this year, a 56-year-old Air Canada pilot on vacation in Vietnam contracted Dengue Fever and died.

There is no vaccine or treatment for it.

http://www.answers.com/dengue%20fever

Dengue fever is a disease caused by a virus that is transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with headache, fever, prostration, severe joint and muscle pain, swollen glands (lymphadenopathy) and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue.

Dengue (pronounced DENG-gay) is now reaching the peak of a roughly five-year cycle. It strikes people with low levels of immunity. An attack of dengue produces immunity for a year or more. Once this outbreak ebbs, more people will be resistant to the viral disease and the cycle will begin again.

[Springbok 3]

Stay off the malarial preventative drugs for more than four weeks. They are lethal and will give you permanent liver damage. It is safer and healthier in the long run to prevent malaria or to treat the actual malaria early with quinine when contracted.

I noticed this way of dealing malaria amongs South Africans.
No preventative drugs except huge amount of it when contracted (to save their livers on the long time run)
Might also be sometime to save money on the long run as those pills can be quite expensives

Your 14 days in the coma Sprinbok put you really close to it no !?.
After all, you can always get a liver transplant if you f@ck them up badly

I was on preventative medicine the first time when I contracted that really bad dose of malaria. It actually hid the initial early stages of recognition hence the fact that I felt fine but the malarial count was climbing all the time and I felt fine. By the time it got bad, I had a count of 5/6 which borders on fatality.

For the first two days I was in a coma but with intravenous quinine, I started recovering. Dr. Cattehorn then induced a comatose state for the rest of my recovery period by using pethadine and morphine. Saved me waking and having to deal with the intense headaches. His method of treatment I guess but I was in no position to complain.

[PITA]

Thanks Cat for the thread

I worked in Africa for most of my adult life and my experiance with Maleria is exactly is what is discussed in this thread - basically North American treatment verses African experiance.

North Americans are very hyper regarding the disease and with good reason but I believe that you develop a natural immunity if you are born and breed in a maleria enviroment.

And I believe that you develop a resistance if you slowly intergrate into the indigenous (sp) mode and allow your body to develop immunities against maleria (and a host of other) problems.

I also have the opinion which agrees with Springbok to aviod the bite, and this where you should be most concerned with.

I have had maleria and was treated with in Nairobi with profession and the treatment was effective. I did not take any maleria precautions with pills after a year of living there except precautions as stated by Springbok.

As far as pilot exposure I am in maintenance and was at the aircraft before the pilots were out of bed and again when the flying was over, after sunset.

So in conclusion I don't cotton to the North American chemical evasion and treatment. It is typical North American hypocondratical approach - again the spelling my vocaburaly exceeds my spelling.

PITA

[Springbok 3]

[quote="yak driver"]If you want to take your chances coming home in a box by all means follow springboks advice.

No need to be a fucking drama Queen. The simple fact of the matter is this. Spending 4 weeks at a time and then leaving is fine and it is probably advisable to stay on preventative anti-malarials. I said as much. On the flip side, you cannot stay on anti-malarial drugs for extended periods of time. They will kill you. I spent 7 years in a malarial area on the Southern shores of Lake Malawi. I would not be here today if I stayed on preventative drugs the whole time.


If you are working in an air conditioned office environment in a "civilized" part of africa, where you don't have to be outside at or around sunset and sunrise you can probably get by not taking the anti malarial medication. If you are a pilot, it means you are probably out at the airport at the worst times of day, and there is about NO WAY you are gonna avoid getting mosquito bites. You probably don't want to go off the anti malarials.

Bullshit. You can prevent getting bitten. I covered that in my first post and I lived it while night fishing, game viewing, tracking animals all night, having BBQ`s and entertaining guests etc etc. Protective spray, clothing, Swiss made sonic sensors that emmit a high pitched sound that mimics the flight of the male mosquito are all precautions to prevent being bitten. Prevention is the first step and if done properly works. My own kids never got malaria in 7 years by following these rules and they were never on preventative drugs. Lethal for kids. Adults are not as well disciplined and not monitored by other adults, so as a result, I got sick at least once a year, treated it and moved on. Local residents and expatriates tend to treat malaria like the common cold. It is no big deal when caught early and treated. If you do not treat it and do not have access to the drugs....well you are in big shit.

My background, I didn't grow up in Africa, or spend my whole life there. Between 1998-2005 I probably spent close to three years working in africa 2 months at at time.

There you go son, by your own admission you do not have the experience needed to dish out sound practical advice.


My first rotation was Burkina Faso at the end of the rainy season. I went to the travel clinic before going, got all the shots, and doxycycline as antimalarial.

Classic, some fucking tool who read up on text books gave you a strong antibiotic malarial treatment drug as a preventative anti-malarial. Stupid mistake. Doxycycline is used in conjunction with a quinine based drug to TREAT malaria and to ensure that all the organisms are killed off which helps to minimize repetitive malarial outbreaks. Doxycycline penetrates deep into the liver and kidneys to get at the malaria that hides and goes dormant. Some strains can lie dormant for up to 12 months before re-entering the blood stream and giving you another bout of malaria which is usually timed for when you are relaxing back home in Canada after your African trip. Many people have died that way.


There is no doubt that you had a rough time of your first malarial experience. We all went through that. We all made the same mistake of not being able to recognize the impending malarial contamination.

After that is is relatively plain sailing. Stay off the preventatives if you are hanging around the area for a long time. This saves on all the damage and also enables you to recognize the symptoms early without the negative effect of preventatives hiding the symptoms. Those living permanently in malaria areas for a long time do build up resillience to the disease.

If you are popping in an out of Africa and do not want the added stress, by all means take preventative medicines and try to avoid Doxycycline. Use larium.

Anyway, happy travels to all those off to the dark continent. Do whatever the @#$! you want. Shove Doxycycline up your arse for all I care, there are far more serious issues to contend with such as violent crime, gun violence, dangerous fauna, deadly viruses concocted and perfected by our African brothers and of course there is AIDS.

[sky's the limit]

There's some really good info on this thread, can we TRY to keep it civil? Just once?

As for the poor AC driver in Vietnam, my wife works there 3 months a year, and I've been as well, you do have to be careful about the mozzies, but generally speaking, younger, healthy folk won't die of it. Sad to hear. Vietnam is a great country - highly recommend it...

stl

[PITA]

Springbok -
My guess is we responded at the same time but in different languages.

PITA

[Golden Flyer]

Besides Malaria, there are other diseases to watch out for.

In February of this year, a 56-year-old Air Canada pilot on vacation in Vietnam contracted Dengue Fever and died.

There is no vaccine or treatment for it.

http://www.answers.com/dengue%20fever

Dengue fever is a disease caused by a virus that is transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with headache, fever, prostration, severe joint and muscle pain, swollen glands (lymphadenopathy) and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue.

Dengue (pronounced DENG-gay) is now reaching the peak of a roughly five-year cycle. It strikes people with low levels of immunity. An attack of dengue produces immunity for a year or more. Once this outbreak ebbs, more people will be resistant to the viral disease and the cycle will begin again.

A topic that I can speak on. And it's simple. There is nothing you can do to protect yourself from this disease. In one of Springbok's post, he mentioned fishing, being by lake and other large bodies of water. He is obviously experienced, but this can be a recipe for death, especially in the Carribean. Once you get bitten by the infected mosquitos, your head will swell, your joints will become like rusted bolts on the flaps of an airplane. You will not be able to move them. There is nothing doctors can do but to wait till you die. This disease have become extremely common during summer periods in the Carribean and African countries. As I stated before, mosquitos love large bodies of water. Please try your best to stay away.

[Golden Flyer]

P.S. Avoid black clothes, use nets around your sleeping area. Do not keep buckets and large amounts of water around you. Did I mention clothing? Long sleeves, long panths. Please ppl. cover up! Malaria is one thing. Dengue is in a league of its own.

[yak driver]

This has turned into a thread with a lot of good information.

Pilots can't take Larium because of the side effects. Doxy does get the job done, I can't remember what the new med was it's expensive but who cares when the company is paying.

On a much lighter note, one of the mechanics that I worked with a lot was doing a job in Ghana. He spent the whole night working on an airplane and got eaten alive. He thought for sure he would have caught something so he took a double dose of Larium when he got to the hotel. He said the next month was kinda fuzzy.

If you are going to the dark continent do your research, be careful and have fun.

[Springbok 3]

Springbok -
My guess is we responded at the same time but in different languages.

PITA

Hey, no problem. Your post contains a lot of common sense in line with the practicality of preventing malaria and the typical overreaction perpetrated by those unfamiliar with the experinces of living with malaria.

All the tropical disease experts I have come into contact with in malaria areas over the years tend to agree that the prolonged use of prophylactic anti-malarial drugs are extremely dangerous and in most instances subdue and hide the initial contamination.

[Springbok 3]

This has turned into a thread with a lot of good information.

Pilots can't take Larium because of the side effects. Doxy does get the job done, I can't remember what the new med was it's expensive but who cares when the company is paying.

On a much lighter note, one of the mechanics that I worked with a lot was doing a job in Ghana. He spent the whole night working on an airplane and got eaten alive. He thought for sure he would have caught something so he took a double dose of Larium when he got to the hotel. He said the next month was kinda fuzzy.

If you are going to the dark continent do your research, be careful and have fun.

I agree, Larium can be bad news. Reaction to the drug differs from person to person as is the case with all prophylactic drugs. In my case, Doxycycline wiped me out during the post malarial recovery process but it was necessary to purge the system.

I had guests, especially from Europe who were on larium two weeks before arriving in Malawi. Once settled in, the combination of booze and a good time caused some of them to suffer severe hallucinations, nightmares, restlesness, lack of appetite and even headaches. Some of the poor tossers thought that they had caught malaria on their regional flight to destination. I had to explain the whole incubation process to them and get them off Larium. Obviously did not want them to slack off running up their bar tabs...bad for business.

One young lass even dreamt that she had been raped at night behind closed doors, She caused quite the shit shir until her boyfriend realized that she was tripping on Larium. Then again, maybe he doodled her during the night after feeding her larium and used the drug to his advantage

[TG]

It says it all:

The only two people to get sick with malaria were myself, and the expert south african who's advice I took. He got the same thing a few days after I left.

On my side, the only persons I hear getting malaria are people using Springbok's methods, or people not taking their prevention meds regularly, or simply just locals who cannot afford medications if they ever heard about it.

You get some bad side effect with the preventive medications ?
Just change it.
Malarone is doing a good job with me. And not wanting to take it is in my view like not wanting to put your seatbelt, some of the pretexts being:
"you're going to get kill anyway if you are involved in a big crash"
"I don't need it, I'm driving safely and slowly"
"it restricts my movements"
"it's gonna give me skin cancer"

But again, that's only me.

[Springbok 3]

Here is the bottom line:

As TG and Yak Driver mentioned, for short visits (up to 3 or 4 weeks) use a prophylactic anti-malarial.

For extended stays in malaria areas, follow my advice.