Chloroquine

[deepstop]

As mentioned previously the cdc is the expert on travel meds and they do advise of malaria in honduras including the Bay islands.
I was in roatan and utila for 3 months last year and took cloraquin the entire time with no ill affects aside from slight sensitivity to the sun which is a known side effect.
I would definatly think that a few slight side effects are a lot better than contracting a disease that there is no cure for only treatment ( which by the way is also cloraquin)
Malaria stays with you for life and can lie dormant for years....
Not worth the risk in my opinion But then my opinion does not mean much...talk to a travel medicine specialist if you are still unsure ...

 

[DocVikingo]

Hi gangrel441,

"Chloroquine" usually is pretty innocuous stuff, so it's unusual that you both had significant adverse reactions, but it appears that was the case.

Here's a brief article I wrote for the Aug '05 issue of Undercurrent regarding malaria prophylaxis in the Bay Islands:

"Malaria and Divers: Even in Róatán there’s a risk.

Malaria kills more people worldwide than any other communicable disease, except tuberculosis. A parasitic disease transmitted by infected female Anopheles mosquitoes, malaria’s symptoms include extreme exhaustion, high fever, shaking chills, muscle aches, diarrhea, and vomiting.

Make no mistake, it can be a nasty disease. And, while savvy divers traveling to Southeast Asia, Indonesia, Malaysia, and the Solomon Islands take a prophylaxis, malaria is closer to home than you think, e.g., Central America, even the Bay Islands of Honduras.

Lorin Zaret, originally from Long Island, New York, and now a massage therapist on Róatán, was bitten by mosquitoes on the island during Christmas week last year. Two weeks later she thought she had food poisoning, with chills and a fever of 104 degrees. She told Undercurrent, “I became very sick. I hallucinated, threw up repeatedly and had diarrhea. I could hardly raise my head off the pillow to go to the bathroom. Every bone hurt me. I lost my appetite completely and lost 15 pounds.” Despite malaria treatment, she indicates that, “I have not quite felt myself since.”

In Honduras, the Center for Disease Control says there is risk in rural regions, including resort areas, on Róatán and the other Bay Islands. Mdtravelheath http://www.mdtravelhealth.com/ says that historically the incidence has been greatest in swampy regions of the east end, but that the number of cases reported from the north has risen dramatically over the last several years.

Recent studies suggest that components of perspiration, especially those described as “smelling like a horse barn,” rank high among cues that attract mosquitoes. If true, keeping a low odor profile may help prevent malaria. This means showering and changing clothes often, using unscented soap, shampoo and antiperspirant and wearing no fragrances. Most important, regularly apply full strength DEET.

The CDC also recommends antimalarial medication in known risk areas. Contact your primary physician or nearest tropical diseases/travel medicine clinic well ahead of your trip. State and local health departments may be of assistance in finding a center.

Happily there are effective medicines, including chloroquine and doxycycline. Lariam (mefloquine) should be taken by divers only after weighing the potential risks and benefits. It can cause hallucinations, anxiety, depression, confusion, forgetfulness, seizures and balance disturbance that may both threaten a dive and mimic DCI. A newer drug, Malarone (atovaquone & proguanil), provides similar coverage to Lariam, and in some locations superior protection, and has a more benign side effects profile.

For Honduran and other Central American risk areas, which include inland Belize, chloroquine works. It’s user-friendly, taken weekly, starting one-to-two weeks before arrival and continuing for four weeks after departing the risk area.

Do your research, tell the prescribing physician you are a diver, and whenever possible allow for an adequate topside trial to assess for adverse reactions, because all these drugs have side effects. Some useful web sites are: CDC Travelers’ Health-Health Information: http://www.cdc.gov/travel/camerica.htm ; International Society of Travel Medicine: http://www.istm.org ; American Society of Tropical Medicine and Hygiene (ASTMH):
http://www.astmh.org/scripts/clinindex.asp. – Doc Vikingo"


As you've been prescribed "Malarone," here are some possible side effects for which to be on the alert: abdominal pain, nausea, vomiting, headache, diarrhea, weakness, loss of appetite, and dizziness.


The first step on malaria prevention is to avoid getting bitten by an infected mosquito. In this regard, the following should prove informative:


Avoiding Insect Bites
http://www.awoosh.com/Doc Vikingo's Resource Page/Avoiding_ Insect_Bites.htm


Helpful?

Have a great trip.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

DocVikingo

 

[gangrel441]

Thanks Doc!

The wife has been on Malarone twice with no ill effects. My perceived incident happened towards the end of my most recent dive trip, the Belize Aggressor in 2005. Where her reaction included loss of appetite, abdominal cramps and nausea, mine seemed to mainly manifest in the form of anxiety and paranoia. I even managed to convince myself that I was bent, which logically I knew was highly, HIGHLY unlikely. As I haven't been on any antimalarials since, I have neither been able to confirm that this was indeed a side effect (though I am fairly certain it was), nor test myself on Malarone, as this incident happened on Chloroquine. I guess I will find out one way or another, as we plan to go to Roatan in May 2008.

 

[Lloyd]

I go to Honduras every 6 months with a group of 25 to 30 people for the last 4 years. No one has ever had a serious reaction to chloroquine so far. You do want to take some form of anti-malarial med. You don't want malaria. We do have patients die from malaria every so often here in Houston.

This is general educational material. It is not specific medical advice and does not imply a Dr. Patient relationship.

 

[nivla80]

Probably best if you check with a doctor...

 

[lil_wings]

I did Chloroquin for about four months, and had the experience of something not unlike four months of stomach flu. It has also been known to contribute to mild depression. Be prepared... nothing can ruin a dive trip like the runs!

 

[Diver Lori]

My buddy and I have both taken chloroquine twice....for Belize and Roatan. He had no side effects whatsoever. I on the otherhand, had some very vivid dreams....but nothing bizarre or bothersome. But hey, melatonin gives me vivid dreams.

Would I take chloroquine again? Yes, without a doubt.

I have to wonder if some of the responses to chloroquine in this thread have it confused with some of the other malarial drugs now available. Chloroquine has been around, tested and true for many years....with very few side effects as the CDC states.

 

[gangrel441]

The reactions (or percieved reactions) I described above in my wife and myself were most certainly on choroquine. When my wife changed meds to Malarone, she had no perceived reaction whatsoever. I have not been on anything but Choroquine so far, once with a reaction and once without.

My buddy and I have both taken chloroquine twice....for Belize and Roatan. He had no side effects whatsoever. I on the otherhand, had some very vivid dreams....but nothing bizarre or bothersome. But hey, melatonin gives me vivid dreams.

Would I take chloroquine again? Yes, without a doubt.

I have to wonder if some of the responses to chloroquine in this thread have it confused with some of the other malarial drugs now available. Chloroquine has been around, tested and true for many years....with very few side effects as the CDC states.

 

[DocVikingo]

Hi gangrel441,

As is stated by the CDC, and was earlier remarked upon by myself and Lloyd, both doctors, adverse reactions to chloroquine are not frequent. However, they certainly do occur in some individuals and what you describe in your wife and yourself could be consistent with such.

While not especially common, GI complaints like diarrhea, nausea, stomach discomfort, vomiting and loss of appetite in response to chloroquine indeed are reported. Frank psychiatric symptoms are unusual, but anxiety, depression and psychosis also have been reported. I can provide references for these assertions if you like.

While it is true that certain other antimalarials may have more alarming side effect profiles than chloroquine, such as mefloquine (e.g., Lariam), surely you would know which drug you were prescribed and not be confused in this regard.

It is good that you have identified a malaria chemoprophylaxis that doesn't cause either of you distress.

In closing, don't be paranoid--we believe you ; )

Regards,

DocVikingo

 

[DandyDon]

Are you triple sure you need it where you're going?

That is some of the foulest, nastiest stuff on the planet. I'm not saying it's worse than malaria but I had to quit taking it while I was living in the jungle in Belize. I was willing to risk it.

Everyone I knew that was taking any malaria meds had freaky lucid dreams, a nasty sour stomach, a bad taste in their mouths for a couple days and generally felt crappy.

After every dose I took I felt awful for 2 full days. I only managed three doses out of what should have been an 8 dose course. I didn't get malaria, luckily, but IMO it's bad nasty stuff.

YMMV

Rachel

P.S. Not a doctor, don't play one on tv, didn't stay at a Holiday Inn Express last night. In other words my opinion is pretty useless.

Are you sure you were taking this med? Your description sounds more like the one used for Asia and Indo Pacific.

I got very upset with the new pharmicist at my regular drug store when he switched me to the bad med for Asia, since my script was for chloroquine - cuz I'd showed my doc the page on the CDC site where they suggested it.

The CDC does suggest different meds for "Travelers to Darién Province and San Blas Province in Panama (including the San Blas Islands) should take one of" see this site