Melting

Anyone who plans a multi-country, extended trip invariably has to deal with the problem of malaria prevention. Unlike many other diseases, malaria does not have a vaccine. Simply put, the best way to not get malaria is to not get bitten. The best way to do this is to cover up and use bug spray with DEET or some recommend lemon eucalpytus extract. But that doesn’t always work, especially when mosquitoes somehow make it their life’s mission to find only you in a crowd of thousands. There is also a rumor floating around in travelers circles, that there is either a homeopathic cure or that you somehow build up an immunity to malaria once you get it. If there is a homepathic cure, can you let the medical community know about it please? Thanks much. And if you intend on getting malaria just to build up an immunity, talk to the estimated 2 million or so people who die from malaria every year and see if it worked for them.

So we are left with taking pills. Lots and lots of pills. In certain places, the skeeters have built up an immunity to certain drugs, so you need to research where you are going and what to take. I think the main reason that travelers don’t take malarials is the cost and side effects that come with certain kinds. There are three main anti-malarial drugs out there, mefloquine (brand name Larium) which can cause anxiety and nightmares in some people. Then there is doxycycline, which is an antibiotic, and not only are you not supposed to drink alcohol while taking this (what’s the point?) but it can cause sun sensitivity, reduces the effectiveness of BC pills, and makes you at greater risk for yeast infections. Sign me up! The last one is Malarone, which is fairly new, reportedly has no side effects and the skeeters aren’t immune to it. The kicker is that not only is this pill insanely expensive (I was quoted $4.75 A PILL) but you have to take it everyday. So, if you are like me, and plan on being in malarial zones for about 9 months, this will put a major crimp in your budget. Not to mention the hundreds of dollars I spent on my vaccines or “jabs.”

For my trip, I decided to get the Jap B Encephalitis (3 shots at $110 each), since I’ll be in Asia for part of the monsoon (read: skeeter) season. I also got Hep A&B, Yellow Fever, Tetanus/Diptheria booster, MMR booster, Polio booster, Meningitis (why I didn’t get this FOR FREE at college I have no idea) and a flu shot. I also have to take my typhoid vaccine, which is 4 pills. All of these, not including the malaria meds, cost me over $600. And my insurance even paid for the Hep A&B and Tet/Diph booster. Supposedly my insurance will also pay for a 90 days supply of Malarone, but I’m thinking they may catch on that if I need 90 days of Malarone, I might not be working or have their insurance anymore. We’ll see how that goes, I’m going to try and get my script filled today at Sam’s Club, which quoted me the cheapest price. The hard part is to not buy too many, as it is a waste of money, but to not run out either, since Malarone is really only available in western countries right now. So if I run out I can’t really get any more on the road. These are the issues that suck about planning a trip like this.

None of this addresses any of the diseases that don’t have any vaccines or preventative medicine at all, not to mention post-infection care. Dengue fever, another awesome little disease, is also transmitted by mosquitoes. Difference is, these mosquitoes bite during the day, while malaria mosquitoes bite at night. I wonder how they decided that? Did they have a little Darwinian pow-pow one day?

Almost 50% of travelers will also get “sick to their stomach” at one point. When someone says they are sick to their stomach, they are really referring to poop. And this usually means some form of diarrhea, more affectionately known as “Delhi belly” or “Montezuma’s revenge.” The best advice to avoid diarrhea is to not drink local water, ice or any fruits and vegetables that have been washed in said water and not peeled. But if you read this article, you’ll understand how even the most careful of travelers end up with a dodgy stomach. (Not for the faint!)