You might find this helpful. It's an updated edited version of my "Ask RSD" column in the Oct '99 issue of "Rodale's Scuba Diving."
"Sand fleas & mosquitoes can be a real bother, not to mention that they are sources of some serious tropical diseases.
The danger & bother of insects can be substantially reduced by these precautions: (1) Wear long sleeves and pants, avoiding dark or bright colors, especially at dawn and dusk. Protective clothing such as the "Buzz Off" brand can be useful. As an extra precaution, you may treat clothing with permethrin (As in the easy to use Sawyer Products
http://www.permethrin-repellent.com ) ; (2) Try to stay indoors at dawn and dusk when many flying insects are most active, and avoid sandy areas as much as possible at any time of day, especially when there is no breeze. When making reservations, make sure the resort has screened windows; (3) Wear insect repellent. The best protection against these and other insects is full strength DEET. Some divers like things such as Avon's Skin-So-Soft & Cactus Juice, less toxic products than DEET, by the science is solidly behind DEET for lasting effectiveness. Most DEET containing repellents are the 15-30% range of concentration. The testing of various strengths of DEET has shown that after about 30% little additional effectiveness is to be had by upping the strength, and even less after about 50%. As such, there is simply no point in exposing oneself to more potent brews. UltraThon at 32%
http://www.3m.com/us/home_leisure/ultrathon/ appears to be a good product. Used as directed over relatively brief periods of time, say a week, DEET has been shown to pose no significant risk when applied to exposed skin. If you wear lightweight, loose fitting clothes, it generally is safe to use DEET underneath. Doing so with heavy, snug fitting clothes can result in dermatological problems & worse. Be aware that DEET can dissolve synthetics like plastics, rayon & nylon, so it's best to wear natural fibers & keep it off of your gear; (4) Avoid scented toiletries and perfumes; (5) Upon arrival, treat your room with a bug bomb such as Shelltox or Fish (stay outside while this is being done). Touch up with spray after that as needed."
As for malaria, there are reported cases of malaria on Roatan, although to the best of my knowledge not at a high incidence rate. The majority of divers I know who frequent Roatan do not take malaria medication prophylactically if they are not planning to go over to the mainland for touring.
As with many things in scuba & foreign travel, the level of risk one is willing assume is a personal decision. However, malaria is a nasty disease, and the conservative CDC guidelines would be appropriate for those wishing to reduce risks to a very low level. These can be found by clicking here----> CDC Travelers' Health--Health Information for Travelers to Mexico and Central America
http://www.cdc.gov/travel/camerica.htm .
If one decides to take an anti-malarial prophylactically, care must be taken in choosing the drug as some may not mix well with scuba, e.g.,----> Concerns About Lariam
http://dive.scubadiving.com/talk/read.php?f=1&i=204092&t=203844 . At present, chloroquine (e.g., Aralen) is largely recommended for the Honduras, and it tends to be tolerated well & to pose little threat to scuba.
If you decide that malaria chemoprophylaxis may be for you, contact your nearest tropical diseases/travel medicine clinic. They'll get you squared away. And, don't wait until the last minute. The following websites may be of assistance in locating such a facility:
International Society of Travel Medicine
http://www.istm.org
American Society of Tropical Medicine and Hygiene (ASTMH)
http://www.astmh.org/scripts/clinindex.asp
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.
Best regards.
DocVikingo
