Travel Reference
In-Depth Information
days before arrival and continuing daily until seven days after departure. Side effects are
typically mild. Doxycycline is relatively inexpensive and easy to obtain, but it is taken
daily and can cause an exaggerated sunburn reaction.
For longer trips it's probably worth trying mefloquine; for shorter trips, Malarone will
be the drug of choice for most people.
Protecting yourself against mosquito bites is just as important as taking malaria pills,
since none of the pills are 100% effective.
If you may not have access to medical care while traveling, you should bring along ad-
ditional pills for emergency self-treatment, which you should take if you can't reach a
doctor and you develop symptoms that suggest malaria, such as high spiking fevers. One
option is to take four tablets of Malarone once daily for three days. However, Malarone
should not be used for treatment if you're already taking it for prevention. An alternative
is to take 650mg quinine three times daily and 100mg doxycycline twice daily for one
week. If you start self-medication, see a doctor at the earliest possible opportunity.
If you develop a fever after returning home, see a physician, as malaria symptoms may
not occur for months.
Typhoid Fever
Typhoid fever is caused by the ingestion of food or water contaminated by a species of
salmonella known as salmonella typhi. Fever occurs in virtually all cases. Other symp-
toms may include headache, malaise, muscle aches, dizziness, loss of appetite, nausea and
abdominal pain. Either diarrhea or constipation may occur. Possible complications include
intestinal perforation, intestinal bleeding, confusion, delirium or (rarely) coma.
A typhoid vaccine is a good idea. It's usually given orally, but is also available as an in-
jection. Neither vaccine is approved for use in children under the age of two.
It is not a good idea to self-treat for typhoid fever as the symptoms may be indistin-
guishable from malaria. If you show symptoms for either, see a doctor immediately -
treatment is likely to be a quinolone antibiotic such as ciprofloxacin (Cipro) or levofloxa-
cin (Levaquin).
ONLINE RESOURCES
MD Travel Health
(
www.mdtravelhealth.com
)
World Health Organization
(
www.who.int/ith
)
