Post by LSDeep on Nov 30, 2005 9:26:25 GMT -5
By Alex Brylske
Q: Tim Chatterley is off to the far Pacific, but has a concern. "I'm going to Papua New Guinea in two months for a live-aboard trip. I've learned that it's a country with quite active malaria, but I'm hearing contradictory advice about malarial prophylaxis. Some have told me that the side effects of various anti-malarial drugs outweigh the risk of contracting the disease. Others have insisted that I'm crazy if I don't take them, and shouldn't go if I can't take them. I was even told by a dive shop owner who took a tour group there that two of his guests got malaria, so the concern is real. In addition, I understand that some medications can mirror the symptoms of decompression sickness, and that other meds will make me very prone to sunburn. I also have heard that some new drug is available. Anything that you can tell me would be most appreciated."
A: As I normally do with medical issues, I asked Joel Dovenbarger, vice president for medical services at the Divers Alert Network (DAN), to weigh in on the subject. Here's a synopsis of what I learned from him, from doing some research at credible diving medical Web sites, and from my own experience.
As you probably know, malaria is a mosquito-born disease, so the first step in preventing it is preventing mosquito bites. Take particular care during dusk and dawn, a time when mosquitoes are most active. Insect repellent containing at least 35 percent DEET is recommended. One hundred percent DEET is probably overkill, and not something you'd want to expose yourself to every day for several weeks. Long pants and long-sleeved shirts are advised during the times when mosquitoes are active, too.
You should always consider malaria risk when traveling to any tropical destination. What complicates matters is that there are various forms of the disease that are resistant to traditionally prescribed medications. The form of malaria found in Papua New Guinea , specifically, is resistant to chloroquine, and some believe it may have also developed resistance to mefloquine, as well.
You're unlikely to have any mosquito problems if you're at sea on a live-aboard, but you'll surely be exposed to the possibility in transit. DAN's advice is that anyone spending time in Papua New Guinea , below 1,800 feet of elevation, should absolutely take some form of malaria prophylaxis. As many malaria victims can attest, most who get it feel like they are going to die, wish they would die or thought they were dead. There are also some possible long-term consequences, including liver damage.
The drug that you refer to that mirrors decompression sickness is called mefloquine. In fact, precisely because of this concern, some dive operators won't allow those who take it to dive. However, it's nonetheless commonly prescribed by doctors in the United States , though docs from Australia and the South Pacific region rarely prescribe it. I've been to Papua New Guinea myself, and the consensus among the medical professionals that I spoke with before my trip was a tried-and-true (and inexpensive) medication called doxycycline. It's a broad-spectrum tetracycline drug. However, be aware that it will make you very photosensitive, so nix any plans for sunbathing, and make sure that you use a sunblock with at least an SPF of 15.
The new drug that you're probably referring to is called malarone. It's actually a combination of two drugs, atovaquone and proguanil, and has been used for quite awhile in the treatment of malaria. Only recently has it been prescribed as prophylaxis. It, too, is a good choice, but it costs a lot more than doxycycline.
As in all medical matters, it's always best to check with your personal physician, because he or she will know your situation best. However, make sure that he or she knows exactly where you plan to travel, how long you intend to stay and that you'll be scuba diving. If you have any special medical concerns, you might want to consult a tropical disease specialist.
Q: Tim Chatterley is off to the far Pacific, but has a concern. "I'm going to Papua New Guinea in two months for a live-aboard trip. I've learned that it's a country with quite active malaria, but I'm hearing contradictory advice about malarial prophylaxis. Some have told me that the side effects of various anti-malarial drugs outweigh the risk of contracting the disease. Others have insisted that I'm crazy if I don't take them, and shouldn't go if I can't take them. I was even told by a dive shop owner who took a tour group there that two of his guests got malaria, so the concern is real. In addition, I understand that some medications can mirror the symptoms of decompression sickness, and that other meds will make me very prone to sunburn. I also have heard that some new drug is available. Anything that you can tell me would be most appreciated."
A: As I normally do with medical issues, I asked Joel Dovenbarger, vice president for medical services at the Divers Alert Network (DAN), to weigh in on the subject. Here's a synopsis of what I learned from him, from doing some research at credible diving medical Web sites, and from my own experience.
As you probably know, malaria is a mosquito-born disease, so the first step in preventing it is preventing mosquito bites. Take particular care during dusk and dawn, a time when mosquitoes are most active. Insect repellent containing at least 35 percent DEET is recommended. One hundred percent DEET is probably overkill, and not something you'd want to expose yourself to every day for several weeks. Long pants and long-sleeved shirts are advised during the times when mosquitoes are active, too.
You should always consider malaria risk when traveling to any tropical destination. What complicates matters is that there are various forms of the disease that are resistant to traditionally prescribed medications. The form of malaria found in Papua New Guinea , specifically, is resistant to chloroquine, and some believe it may have also developed resistance to mefloquine, as well.
You're unlikely to have any mosquito problems if you're at sea on a live-aboard, but you'll surely be exposed to the possibility in transit. DAN's advice is that anyone spending time in Papua New Guinea , below 1,800 feet of elevation, should absolutely take some form of malaria prophylaxis. As many malaria victims can attest, most who get it feel like they are going to die, wish they would die or thought they were dead. There are also some possible long-term consequences, including liver damage.
The drug that you refer to that mirrors decompression sickness is called mefloquine. In fact, precisely because of this concern, some dive operators won't allow those who take it to dive. However, it's nonetheless commonly prescribed by doctors in the United States , though docs from Australia and the South Pacific region rarely prescribe it. I've been to Papua New Guinea myself, and the consensus among the medical professionals that I spoke with before my trip was a tried-and-true (and inexpensive) medication called doxycycline. It's a broad-spectrum tetracycline drug. However, be aware that it will make you very photosensitive, so nix any plans for sunbathing, and make sure that you use a sunblock with at least an SPF of 15.
The new drug that you're probably referring to is called malarone. It's actually a combination of two drugs, atovaquone and proguanil, and has been used for quite awhile in the treatment of malaria. Only recently has it been prescribed as prophylaxis. It, too, is a good choice, but it costs a lot more than doxycycline.
As in all medical matters, it's always best to check with your personal physician, because he or she will know your situation best. However, make sure that he or she knows exactly where you plan to travel, how long you intend to stay and that you'll be scuba diving. If you have any special medical concerns, you might want to consult a tropical disease specialist.