Vagatorsunset

The price of those has gone from £30.00 to £80.00

Just interested in views of long termers in Goa.

I have talen them before but have also not taken them. Of course best to be safe than sorry
but I cannot risk some of the side effects as they relate to my job and they would be career ending potentially.

I obviously use DEET based repellent and I wonder if there is correlation with malaria more so in monsoon and
early winter (end of October when it is greener and there is much more pooled stagnant water) rather than January.

It's a tricky balancing act.

I am thinking get the tablets and have them with and just avoid getting bit as far as is possible.
Tonnes of DEET and long clothes in the evening.

Vagatorsunset

Made my own decision on this based on research. Chloroquine tablets are no longer suggested for Goa as there are chloroquine resistant strains in Goa.

Fact : Malaria is present in Goa and it is not predictable.

UK recommends Atovaquone/proguanil. Proguanil is the same as years back. Atovaquone seems new.

So going to get £100.00 worth of tablets for the journey duration that myself and partner can share if we deem there to be a lot of mosquitos about. Protection apparently within 48 hours. So if we do not get bitten no need to take them. If we get bitten to buggery then of course we are likely to start them.

This seems like the balanced choice until we know the situation a bit more clearly.

Last time I went Goa I was not bitten once and my partner only once in a 3 week holiday which included some bamboo hut nights.

Got 3 bottles of 50pct DEET mossy spray today so have plenty of it.

hemingway

Well, the advice IS to take them - some do & some don't.

As is often said: it only takes ONE BITE!

Malarone is one I think I hear about people taking & the figure of £60 for a fortnight's supply is in my memory - that's UK prices of course. I also hear of unpleasant side effects.

Some people have never taken anti-malarial drugs over quite a few years & multiple trips to Goa - I'd strongly suspect these people get themselves behind Mozzie screen doors by dusk, always keep away from standing/stagnant water & wear plenty repellent when going out for an evening meal - for those who don't show a tendency for getting bitten, generally Odomos does the job & for those who the Mozzies like the taste of, then Repel (100% Deet) is the order of the day.

Unfortunately, it's a case of: when you are over 18, you pays your money & takes your chance!

Thankfully, Goa is not West Africa where it seems visitors who don't take every possible form of protection stand a very good chance of getting bitten AND infected.

H.

a_f_d

1) this has been discussed 'threadbare' here and on IM - try a search.
2) Goans don't take them prophlactically
3) They don't prevent you getting malaria - they don't kick in until the parasites have multiplied in your spleen - so if you feel ill you could take them then.
4) There's also Dengue and Chichengunga (sp?), and snake bites, and mad traffic, and ...
5) the medicine is not good for you.

yes, you takes your choice and pays your money - or not as the case may be.

AndyD 8-)₹

msj5

I seriously cannot believe that you have or are going to spend £100 on anti malarials " in case you get bitten!
Why not buy the tablets here if you get bitten!

I`ve been living in Goa all year round for 5 yrs now and there probably isn`t a day goes by when i don`t get bitten.....watering my garden and tending my plants is the biggest hazard ...if by chance I get malaria or God forbid Dengue which is worse then I will take the anti malarials.....these tablets are seriously not good for your health.....
Just have a routine and shower before sunset and put local mossy cream on.....do not use anything perfumed unless lemon or lavendar.

Vagatorsunset

Appreciate the advice, just thought at least I know I have them and they are Kosha and not counterfeit tablets. The sell by is 2018 so they will last a while. I got them for £65.00 in the end.

I know they are not good for your health, thus the controversy and doubt about taking them. I heard Malaria is hardly good for you either !

wookiebt

Nor is cancer, but can you imagine having regular bouts of chemo in case you get it?

The (ineffective overall - see post#4) preventative medicine for (Indian strain) malaria is the same as the treatment........... what are we not understanding here?

Africa is a whole different ball-game, their malaria kills.

Vagatorsunset

Say what ?

Malaria is a serious illness and the very terrible strain does exist in Goa, 2 cases reported in 2013. The only thing *not understanding here* is that I have now made my own personal choices and preparation.

So

The analogy with chemotherapy is completely inappropriate and a point badly articulated, chemo puts you on your knees for weeks on end and has no guarantee of working. (In fact it literally finishes off your immune system completely as well as having a bash at cancer cells)

Anti-malarials work 90pct of the time and in the cases they do not work fully they massively reduce symptoms. I do not recall anyone ever report symptoms like "It was like a cancer sufferer on chemo" from anti-malarials. I have taken them before without side effects (though it was cloroquin/proguanil combo) not to say that they are not harmful.

They are not good for you, it's understood (thus the reason for the post), but better safe than sorry to have non counterfeit versions with me for immediate administration should it be deemed necessary.

I appreciate the replies.

Bipat

Malaria in India can also "kill" if untreated, but the number of deaths has very much reduced over the years.
If prophylaxis fails the treatment is different.
As said above it is a balance of risks and a personal choice.

As was said above, to compare malaria preventative drugs with chemo-therapy (a treatment, not prevention) is totally inappropriate.

a_f_d

Conventional antimalarials do not prevent the disease - so they are not prophylactic! They are treatment taken 'just in case'.


AndyD 8-)₹

wookiebt

Thank you, my point exactly!

Bipat

WHO-- quote-- "Malaria can be prevented through chemoprophylaxis which suppresses the blood stage of malarial infection thereby preventing malaria disease".

A person would not get physical symptoms until the onset of actual disease, correct diagnosis, blood tests can take time.

http://www.who.int/mediacentre/factsheets/fs094/en/

a_f_d

Surprisingly ambiguous wording from the WHO - by the time the parasites are entering red blood cells you are fully infected.
All my comments about the difference between prophylaxis and treatment come from an earlier very detailled post (either here or on IM) which explained the lifecycle of the parasite in humans (and was news to me): very roughly, you get bitten, parasites migrate to the spleen where they multiply exponentially, these are then released into the blood stream (and enter the red cells) - it is at this point and not before that conventional antimalarials can act (which the WHO article obliquely admits).
Don't take my word for it. search for the original post or research the parasites' lifecycle yourself.

Earlier the conventional drugs were used for both 'prophylaxis' and treatment, other drugs are now recommended for treatment, but even they are meeting resistant strains:
AndyD 8-)₹

** Derived from wormwood - perhaps they should make absinthe available on prescription!!!

Vagatorsunset

All good info, thanks.

Bipat

Andy there is a difference between 'infection' and 'disease', bacteria or virus get into the human body and multiply. If they are prevented at this stage from causing damage to the body-- by drugs you are taking or your immune system (putting it simply) 'disease' does not follow.
Whether you get quick diagnosis or not depends where you happen to be.

I am of the personal opinion that this 'infection' can produce an immunity in those who live long term in an area, so I don't take anti-malarials. Others disagree including OH who thinks being out of the country 3 months negates this so he takes them; and he in his younger days worked in malaria wards in Mumbai hospitals!!
For the short term tourist this does not apply.
As I said personal opinion and a balance of risks.