Bill's Comment Page

Potentially damned if you do (?), potentially doomed if you don't

You're planning a trip to a country where malaria-carrying mosquitoes are endemic. How do you protect yourself? Or should you bother, if some of the preventatives have potentially alarming side-effects?

I lived for many years in various countries where malaria was an all too frequent danger. At that time, many years ago, I used to take a daily Paludrine tablet, indeed I took it continuously for about 10 years; luckily I never succumbed to malaria and the side-effects I experienced were relatively minor - a sort of itching around the eyeballs, one of the documented contra-indications.

In any case, the disease moved on and it became known that this drug's effectiveness had diminished if not entirely disappeared. Luckily, for a few years I moved to live in countries not affected by malaria.

By the time I moved to a country where this was again a problem a new drug Lariam came along and you only had to take it once a week, rather than daily. However, as with many new drugs, some seemingly very alarming side-effects began to show up, in this case what were alleged to be psychiatric disorders. It so happens that I had good friends there, a husband and wife, who were both research scientists for a well-known pharmaceutical research institute [they were in the country becasue it is one of the few places, apparently, where bubonic plague is endemic in certain isolated regions and that was their main field of study] and their best advice to me then was only to take Lariam if I planned to travel to certain areas and only for brief periods, but otherwise I should concentrate on keeping my skin covered, specially at dusk, and make use of DEET spray or gel (a substance which had only relatively recently been developed); I got myself some and have used it on numerous occasions when I have travelled to countries where a risk exists. So far I have avoided malaria completely (touch wood!). The drawback with insect repellents, and the DEET-based 'Jungle Juice' I use is no exception, is that they are not particularly pleasant to use - either they smell strange or unpleasant or they leave a sticky film on the skin or they stain clothes. Despite all this I have persevered; I can easily buy new clothes and a regular shower soon sorts out the problem of stickiness.

This Guardian story is a timely one, specially as the summer vacations approach when many people from malaria-free countries such as the UK travel to some pretty exotic locations where not all the local exotica is entirely welcome, even for the usually adventurous and adaptable.