Malaria and Indonesia - prophylactics or not?

There's reportedly been a lot of dengue in Bali the last few months. I'd recommend taking the tablets no matter where you are in Indo - although there are many contributors who'll have a much more educated outlook on this than me.

Malaria prophylactics will do nothing for Dengue. If fact there is nothing you can take.

With regard to malaria, depends on where you are going and for how long. In my experience, side effects are common and that includes Malarone. I tend not to take them anymore and just try to avoid being bitten. Also remember that even if you are taking prophylactics, they are not 100% effective all the time

Incubation period for malaria is between 7-30 days, so if it's a short trip chances are you'll be back in Aus before you get sick. Which means extra time off work and a bonus trip... to the hospital!

Speaking from experience you can definitely still get malaria while taking the drugs I got Malaria in Sumbawa about ten years ago while taking Larium, it is not a pleasant experience and I feel for all the Indonesians especially the children who get malaria often multiple times during their life and cannot afford or get to a doctor for the drugs for treatment. Do your homework on what your taking and do all you can to avoid being bitten even if you do decide to take preventative drugs. I didnt do my homework and trusted a doctor who in hindsight probably had no idea what he was recommending and just sold me on the fact you only had to take it once a week. I found out later the horror stories from side effects of that particular drug. It was used extensively by the American military and many soldiers suffered serious side effects from long term use of the drug ranging from mild to full on psychotic episodes not to mention it was not always effective. The worst side effects for me were some crazy dreams which were not fun and mild hallucinations which for a young man who was familiar with hallucinogens were not that bad. All of the dreams at the time I would have sworn I was awake and experiencing. The strangest one and one that I still remember today was dreaming there was a tsunami coming. This was long before the boxing day tsunami and growing up in the bush in tassie I had never experienced or had any knowledge of the danger of a tsunami in my life. In my dream I was running for my life amongst all the villagers everyone was screaming and the rumble of the wave was like nothing I have ever heard I honestly thought it was happening and I was about to die I remember feeling just pure panic. I dont know what woke me up but even then I still thought there was a wave coming and tried to run not realising I was in bed I got tangled up in my mozzie net and fell out of bed which freaked me out even more until I finally realised it wasnt real. Do your homework and weigh up the pros and cons but trust me you do not want malaria it is not a nice experience and the effects linger for months.

G'day Rosso

I don't take the anti malarial drugs anymore after bad experiences. On Larium both myself and my lady were having the most fucked up fever - like dreams and endured a depressive state that , whilst not suicidal or anything that drastic ,certainly did not improve what was meant to be a good time.

Just went on a trip to Sumatra that a bad rep for malaria with a few guys that have contracted malaria previously. None of them used prophylactics either, saying they weren't always effective anyway .One fella with a fair bit of knowledge on the subject reckoned the drugs were more effectively used as a treatment by bombing the entire course after contracting the disease ! Seriously. The man is no doctor but he sounded like he knew what he was talking about to me. Maybe research this theory to see if it has any credence .

Personally I attempt to avoid exposure by covering up with clothes , spraying repellent like its water and don't be where the mossies are when they come out to play.

And nightly gin and tonics. The quinine in the tonic water is anti malarial, the only side effects I suffered from this treatment was a tendency to talk shit and laugh like a drain at stupid jokes. The occasional headache the next day also.

I take doxycycline as a 100mg dose, once a day every time i go to Nias , i have used this for years . It can make some people more sensitive to sunburn, but it is an antibiotic so it wont mess with your head like larium will . Believe me you dont want to get a bad dose of malaria , some strains are fatal and you might have other strains for the rest of your life. Use a good repellent and cover up ....

The day after you stop taking doxi, get some yoghurt or yakult into your system to get some bacteria back into your gut cause its a very powerfull antibiotic and kills some good germs and any females taking doxi expect a hell dose of thrush

Had a similar experience Redbeard , but in my hallucination i saw a Nias warrior with a spear come into my losmen , i came at him swinging and in the process totally trashed my mosquito net , i was spun out by how real that dream had seemed , i then spent half the night trying to fix the net in a sweating daze , in the morning i told one of the old Indo ladys what happened and she told me i had seen a ghost as they were sometimes seen on Lagundri point , i didnt know what to think after that ..

Read somewhere that sun sensitivity to doxy affects 1in 80 or 1in 100 people.

That might be what the drug companies say udo. I think it's more common.
I stopped taking it halfway through last trip, feet and ankles came up with weird blotchy reaction to sun from riding bike around, although the tropical sun is pretty brutal. I used extra sunblock in that area when I started to notice it, but it got worse so I stopped taking the Doxy.

My two cents... I got malaria in 2001, when I was about 17 years old. I believe I picked it up in Sumbawa.
I can't remember which medicine I was taking , but it was the standard one at the time and I dutifully took my tablet everyday. I also remember, strange, vivid dreams but that might have something to do with all the ephedrine I was munching or simply being a teenager in an exotic country, or other recreations that a silly teenager might pursue when not riding waves.

Anyway, the malaria hit after I had been back in Australia for over a month, maybe even two. I was misdiagnosed three times and got worse and worse. There were a couple of weeks that I have very little memory of but I can remember how shit I felt during the earlier stages and how long it took to get my strength back. Luckily, I only had vivax (?) malaria, a non cerebral strain that doesn't go into the brain. I was told that if it was the other kind I probably would have died.

The tropical disease specialist who came to observe me told me that at the time, a lot of the Australian soldiers who were in East Timor were taking the same medicine as me and came back with the same strain of malaria that had somehow got resistant to it.

Still, I am glad I took the medicine as apparently it held the parasites at bay, forcing them to hide in my liver or something until I got home and the medicine got out of my blood. My trip wasn't cut short and I got treatment (eventually) in an Australian hospital rather than an Indonesian one.

I will say there are some good point to having malaria. I was given immune boosting medicine to take for a while as part of the recovery. That stuff was amazing... after the malaria, I didn't even catch a mild cold for a long time. I reckon I could have made love to a leper and got away infection free. Also, I lost about 10kg over 2 months so if you want to get rid of that spare tire...

It also makes a good yarn to tell.

The trip I took doxy I got sunburned to the point of being covered in blisters. (Which were eventually ripped off brushing reef - ouch)
I've recently taken Larium for 6 weeks and wouldn't have known I took a thing. Zero side affects, though my wife experienced weird dreams.

Good stories there about larium. A lot seem to get crazy dreams, a guy next door to me at bobbies said he had a dream he had amachibe gun machine gun massacring everyone.
Blowin,i have heard that too about taking it all after you get it.
Also a few veterans swear by taking doxy if anything, then malerone if you do get it as malerone is effective on different strains and stronger too.
I havent taken anything for the several last trips.long trips toi. But always have two bottles of doxy in bag in case. Often youll find a full or half full box of antimalarials in your room from the last guest.

Yes that doxy can turn u into a beetroot . When i was in g-land for 4 yrs i became knowledgable about malaria meds . Would see bright red guys and pick them for using doxy . After having copped both vivax and p-falciparum ( cerebral ) strains repeatedly during a five yr period i had used larium (mefloquine) a few times , it did cure the fever but was also brutally poisonous . The stuff does cause hallucinations / audio as well . Horror dreams and even caused wipe outs while surfing because it messed with balance . One time some guests said they were doctors and gave me 5 larium at once ! Near killed me but also cured malaria for a while . Later i learnt that was not the way to use larium . I was really tripping almost dead for a day or two . Few yrs later learnt about chinese medicine named quing hao that possibly was good and healthier .eventually after a close call dying then coming back to the living an alkaline diet for 18 months whilst recovering in australia was likely the best cure/ preventative .

Yes the good stuff was primaquine that cured me a cupla times . Not very poisonous stuff but difficult to get in fact it had to come from canberra the first time when i was in a perth hospital . Was at the time anyway about 1998 but a few yrs later in bali i was dying again so called a extra good doctor in bali and he supplied some for me .not sure if you can get it nowdays easily or not but that was decent cure .majority of gps in aust dont know a great deal about the medicine i noticed .

Chloroquine and quinine are not poisonous either but the mozzies may have become resistant to that stuff by now could be worth enquiring about

Caml, your liver has worked very hard over the years dealing with malaria and the medication do you have yearly liver function tests ?

When I went through Indo 1982, Fansidar had just been phased out in favour of Maloprim because of resistance. No side effects from Maloprim and only to take once or twice a week from memory. Probably not effective now.
Here's a link to a good explanation of what's available and related info.
http://www.familydoctor.co.nz/index.asp?U=conditions&A=32780

I just went to the doctor for malaria advice for a trip to Indo, I'm guessing he was Indian or Pakistani. Which is good I thought because Aussie docs don't seem to have a clue. I basically had a good conversation about some of the things in this thread like bombing a heap after you get sick, He said it was not a good idea, but did not rule it out, saying in Oz doctors wont tell you about this stuff because they may be held responsible. He said that Doxy is the best thing they can recommend "in Australia" which lead me to believe there are better things overseas, but he would not confirm.

I told him about sunburn and how most people stop the medication because of the side effects, and he said "Isn't it better to get sunburn than die or get cerebral malaria? I kind of agreed while telling him I had also stopped with the medication in the past. I took a bottle of doxy to Mentawais last time and brought it back without opening it. I did get quite sick just before coming home and thought I had got malaria but it just turned out to be a really nasty throat infection. I am wondering, if I was taking doxy as a prophylactic would it have prevented this infection too? because my understanding is that doxy is not specifically for malaria, it is just an antibiotic to prevent many infections.

Come on there must be a doctor out there in swellnet land that can tell us about this stuff anonymously?

sypkan wrote:

Come on there must be a doctor out there in swellnet land that can tell us about this stuff anonymously?

Maybe post the question in the recent 'Surf travel goes viral' article and see if the good doctor answers it?

Some strains are resistant to some drugs. Some areas of the globe are known to have resistant strains. So some drugs are not effective in some areas. Some drugs can be mildly effective at "bombing". There are resistant strains to those bombing drugs, making prevention & the "bombing" cure redundant. Most drugs come with side effects.

So in short it's not a one size fits all.

Your doctor will give you the most accurate and up to date info relevant for your area of travel.

Yes its true doxy is an antibiotic . Therefore good and bad side effects ie killing your gut flora

Oh yeah i have had a few tests udo

I once had a southern coral reef cut that got infected a week or so BEFORE i went to Indo for an extended stay . And it was " tracking " up my leg . Doc's gave me Doxy's for that here along with the prescription for the trip .
So i reckon doxy's are the go , especially if you are going somewhere remote in Indo , and will be treating any potential reef scrapes on longer stays . And it goes without saying if your going to be targeting some of the shallower reefs , and even more so , the more Northern Isles . Again nightmares received with doxies , but sometimes even with rigoress treatment of cuts with lime , peroxide , chinese medecine , betadine , gauze , waterproof tape and golden seal root . Its nice to know if you lose control of self nursing of particularly bad cuts that the doxies will keep you good till you get home .... ontop of any added value of some Malaria protection .

I'm not trying to blow smoke up your arse Southey, but that is the best advice I've read. Do you go with doxy as a preventative from day one? And are thy l they pills?

And while I'm at it, I've got a sub continental doc and he's a legend. Straight up just gives you the most practical advice and will actually physically examine me and refer to text books

The first Malaria vaccine 'Mosquirix' has just been given the go ahead .

udo wrote:

The first Malaria vaccine 'Mosquirix' has just been given the go ahead .

http://www.abc.net.au/news/2015-07-25/malaria-vaccine-mosquirix-gets-go-...

BTW. You can buy Doxycycline in Indo for a fraction of the cost you can in Oz, even in the main ports towns of Mentawai's, Telos, Nias.

Salt ,Bit of info above.

6 years ago I did some "internet" research beforeheading off to Sumatera ( took no malarial meds ), basically I read that if you dosed daily on a high potency vit B tab a week before leaving, during and a week after your trip it helped. The theory is vitB like vit C is passed through your system via sweating and urinating, and the smell of vitB in your sweat is a deterant to the mozzies. I've done it on every trip since, got my wife and mate to take em as well and have had no probs. I'm interested to hear if others do the same.
The other 3 musts are 1. Bushmans applied around 5pm, be carefull not to put it on your lips or other "sensitive" areas that don't see the light of day, as the bushies is potent gear. 2. a can of fly spray and 3. the old mozzie coils. These methods work well on short 2week trips in and around busy to semi remote spots.

Very much depends where you are going. Malaria can exist in one swamp but be non-existent 2 kilometers up the road. A good travel doctor will know how to check on things like this and be able to answer your questions confidently without having to hit Google. Most GPs have probably never been to the part of Indo you are going to, and in my experience they get pretty excited recommending all the drugs they can due to the novelty of exotic travel versus the common cold.

I've never taken any meds. I've either been in a place for such a short period of time that I'd be home before I realized I was sick, or for so long that prolonged use of the drug might not be worth the benefits. What I do is take every possible precaution not to get bittin by mosquitoes. Yes, I am that bloke you see in Indo surf towns with jeans, a jumper, shoes and socks on at night sitting next to a mosquito coil covered in Soffell. It saves the worry. I can't help but say I told you so to the blokes who get stung with dengue when they are floating around known dengue hot spots in boardies and nothing else, sitting up drinking beers during the peak mozzie hours...

Just take the doxys, why risk it......what is it a 2-3 week holiday, its likely at some time in Aust you will be prescribed them for an infection or whatever and probably for a longer duration.
Cerebral Malaria no thanks.

Danadan, with the chosen evening attire and next to the mozzie coil, couldn't mistake you for GaryG ; )

yep cerebral malaria nasty I've had it before and you definitely don't want to get it.

Vit b is worthwhile

agree caml.

vit b is a great asset.

ive said this before on this site but I always take barocca to indo.
its not the only precaution a bloke should take but it definitely discourages mozzies from biting , and there are a hell of a lot more diseases than just malaria that are spread by mozzies. dengue and many ross river type viruses. and those mozzies arnt always the ones that bite at dusk / early evening.
it works quite well.
helps with hang overs too.
mozzie nets are a must outside bali too.

Spray the walls, ceilings etc of your room with surface spray. This prevents the Mosquitos hiding out in there during the day. Hit it with the aerosol half an hour before you go to bed, with your net, and leave the can handy to deal with any buzzing you hear. Best preventative is not to get bitten.

Blowin wrote:

G'day Rosso

I don't take the anti malarial drugs anymore after bad experiences. On Larium both myself and my lady were having the most fucked up fever - like dreams and endured a depressive state that , whilst not suicidal or anything that drastic ,certainly did not improve what was meant to be a good time.

Just went on a trip to Sumatra that a bad rep for malaria with a few guys that have contracted malaria previously. None of them used prophylactics either, saying they weren't always effective anyway .One fella with a fair bit of knowledge on the subject reckoned the drugs were more effectively used as a treatment by bombing the entire course after contracting the disease ! Seriously. The man is no doctor but he sounded like he knew what he was talking about to me. Maybe research this theory to see if it has any credence .

Personally I attempt to avoid exposure by covering up with clothes , spraying repellent like its water and don't be where the mossies are when they come out to play.

And nightly gin and tonics. The quinine in the tonic water is anti malarial, the only side effects I suffered from this treatment was a tendency to talk shit and laugh like a drain at stupid jokes. The occasional headache the next day also.

ABC online have a story on larium and its side effects and the ADF personnel who were prescribed it.

If anyone is keen to find out morecthere is a product on the market made from refined tea tree It has been tested as 97% effective in all 4strains of dengue Within 3 days. It was tested and n airlines university in Jakarta .., it is effective as a preventative To malaria. Dengue. Basically all viruses.. and has nothing side effects. It actually make Yiu more alert and stronger with more energy .., I have s website link if anyone wants to email me .. freemecdt@gmail.com

Sounds like nonsense to me but anything is possible, post the link and let's see the evidence.

I thought malaria was a parasite not a virus.

Im with Blindboy sounds way to good to be true, and i couldn't find anything with a google search.

Please post a link here.

Great thread, and some good info.
I have a couple questions for you guys.

Is the risk of malaria still considered the same if (if any) if you were on a boat charter as opposed to land based accommodation?

Is it necessary to start dosing doxycycline prior to potential exposure or do you start on the first day.

TIA, just doing some research before I start planning a trip. I usually go to Bali most years but also going to to add on a week to somewhere a little more remote this time.

Risk is lower on a boat, but its still there, the mosquitoes that carry malaria are active between dusk to dawn and that is when boats anchor in protectives area that are often not far from villages and you need people or higher primates to carry malaria, a remote swamp full of mozzies with no people or higher primates wont have malaria even if that is the common perception.

Risk of malaria in Indo is pretty rare these days especially in Sumatra, only are id personally take anything is up some eastern ends of Indo, especially the Papua/West Papua region.

IMHO much higher chance of picking up dengue fever especially in heavily populated areas including areas of Bali Java and Lombok

Good malaria risk map of indo in this article http://wrclinic.com.au/travel-vaccines-indonesia/

Great thread, and some good info.
I have a couple questions for you guys.

Is the risk of malaria still considered the same if (if any) if you were on a boat charter as opposed to land based accommodation?

Is it necessary to start dosing doxycycline prior to potential exposure or do you start on the first day.

TIA, just doing some research before I start planning a trip. I usually go to Bali most years but also going to to add on a week to somewhere a little more remote this time.

Cheers @indo-dreaming for the quick reply. Might look a bit further into where I go after Bali, was going to head to Sumbawa but it definitely seems like I’m going to need doxys there, so maybe that’s better on a trip of its own. it’s not going to be much fun in Bali if I can’t sit by the pool between surfs

I took anti-malarial drugs for Sumbawa last year based on that area being a low/moderate risk spot at the time. As ID said above, the risk seems to get higher as you head to the east.