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 Post subject: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 7:45 am 
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Hi, we are thinking of visiting the park in August/September and by that time my baby would be 3 months old. What is the Malaria risks and would there be any region of the park consider safer? We have been to the park several times before (in all seasons) and have never taken any malaria precautions other than typical repellants i.e. Tabbard.


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 8:04 am 
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Hi MNEL, :D

August/September are still very dry. It is one of the more low risk seasons.

Pretorius Kop, as far as I know, is considered to be the safest area. At that time of the year sightings are frequent at dams and waterholes. There are plenty of those around Pretorius Kop.

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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 10:25 am 
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Hi MNEL
A long read about malaria risk

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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 10:46 am 
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We usually go in August every year... I took my little one to the park for the first time when he was 6 months old.

1. Satara is also a safe place

2. take mosquito nets and stay in a rondawel with aircon

3. I gave my little on Malanil that time, but that was a total disaster! he had fever of 40 degrees at one stage, we take mefliam nowadays and it really does work for us.

4. Buy some of the Mozzi stickers, you can stick it on clothes, camping cots etc and Dischem have a very good baby lotion against mozzies.

I dont take any chances, I had Malaria last year April (not from the Kruger though) and I thought I was going to die. Not something to play with...

If in doubt, wait another year. Prevention is better than cure.


Good luck with the little one! :k


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 10:52 am 
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And use the fan
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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 5:53 pm 
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A three month old is very fragile and if it were me, I would not risk it.

One With Nature has posted in depth on the Malaria thread and he does not recommend taking such a young child.

The thing I remember from my time in South Africa is how easily one can be bitten. At bath time or changing for bed. I suppose if the baby is covered continuously under a net it could be OK but, you would have no chance if it were to be bitten by a malaria carrying mosquito.

Cannot the little one stay with granny and you and SO have some time together?


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 6:08 pm 
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onewithnature wrote:
I have, from time to time, been making fairly comprehensive contributions to malaria and its prevention on other threads on the SANParks forum, so I am not going to give extensive details on everything discussed above today, but would indeed like to add comments where appropriate:

Quote:
Quote:
While the risk of malaria is low in both Kruger National Park and Mapungubwe National Park, the risk is there, so if you go to either park you should know what to do.



Firstly, this statement covers the malaria risk areas amongst the SANParks reserves, but these are not the only malaria risk areas in Southern Africa (I am concentrating on this part of the world because this is the areas that we are dealing most with here on the forums): for example, several areas of Kwazulu-Natal have malarial risk (although mostly low- and medium-risk); parts of Swaziland and some northern parts of Botswana are also seasonal-risk areas, as is Kruger and Mapungubwe; and some countries, like Mozambique, are high-risk areas all year round; while some areas bordering and near Kruger Park and Mapungubwe also contain malaria-infection potential, although generally of a low-risk nature all year round. NOTE: For detailed areas of malaria risk in Southern Africa (and of course anywhere in the world), please consult a competent and up-to-date malaria-risk map!

Secondly, defining a low-risk malarial area depends on the number of reported cases of malaria found in that area. The high-risk season for malaria in both Kruger and Mapungubwe (end of September until end of May) is considered relatively low-risk as compared to all-year-round high-risk areas like Mozambique, most of Tropical Africa, Malawi, and so on. As stated, the risk is lower than many other countries with malaria risk, but it is not wise to ignore that risk.

Thirdly, risk of contracting malaria may rise in some susceptible people, depending on, for example, age, health, how often you get bitten, and when you get bitten.


Quote:
Quote:
Especially pregnant woman should do so [get appropriate and competent professional advice], your baby is at risk!
Also keep in mind that children under 5 kilos can not take antimalarials, so the only protection they have is mosquito repellant soaps and spray..


Because the unborn foetus and young children are particularly at risk of morbidity and mortality from contracted malaria, the first recommendation for pregnant women and young children is NOT to enter a malaria-risk area unless it is absolutely necessary. If the latter, then every suitable non-drug, plus chemoprophylactic (antimalaria medication), measure must be used to prevent contracting malaria; and only after thorough and competent professional advice has been received.


Quote:
Quote:
Malaria is transmitted by the bite of an infected mosquito, these mosquitoes usually bite between dusk and dawn, in the night. To avoid being bitten, remain indoors in a screened or air-conditioned area during the peak biting period.


It is the female anopheles mosquito that may transmit malaria, and she mostly bites between dusk and dawn, with peak biting periods usually closer to midnight, and again in the early hours of the morning prior to dawn. These mosquitoes usually enter human dwellings from around 5 p.m. - 10 p.m., and again in the early hours of the morning, and biting begins anywhere from dusk until dawn. Try to avoid going outside at these times and stay inside a suitably protected dwelling (e.g. intact mosquito nets on the doors and windows, anti-mosquito mats, use of citronella products, and so on).


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You may have heard that taking antimalarial drugs masks the actual malaria. This is not strictly true, but it is harder to diagnose as for instance the parasite count is lower. So if you have malaria-like symptoms have you medic look twice. The malaria itself will not be as severe, and recovery is quicker.


Antimalarial drugs - taken correctly - do significantly reduce the risk of contracting malaria, although they do not prevent the disease a hundred-percent of the time! Hence the necessity of using non-drug measures despite being on chemoprophylaxis. If you are one of the unlucky ones to still contract malaria despite taking antimalarial drugs and suitable non-drug measures, the initial diagnosis of the disease may be more difficult to determine. However, as time goes on, the disease may still progress, until it may indeed become as severe and as dangerous as someone who has not taken any precautions. The advantage in taking antimalarial drugs is that recovery is often quicker when malaria is diagnosed, as the parasite count may be lower than in someone who didn't take these precautions. ALWAYS take all drugs correctly, diligently, and finish the courses as required.

Quote:
Quote:
Malaria is always a serious disease and may be a deadly illness. Travelers who become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after returning home (for up to 1 year) should seek immediate medical attention and should tell the physician their travel history.


Most people who contract Falciparum malaria (generally the most deadly form of the disease) notice malaria symptoms within a few days to a couple of months after entering a malarial area. Chemoprophylaxis, as discussed above, may delay presentation of these symptoms. However, it is indeed safest to adequately test for malaria up to six months, and even one year, after entering a malarial area and presenting with flu-like and other malaria symptoms. People who are in a malaria-risk area (and especially an all-year-round high-risk area) for extended periods of time (weeks, months, or years) should consult a competent medical professional as to what is the best antimalarial measures to use under these circumstances.


Quote:
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For the best protection against malaria, it is important to continue taking your drug as recommended after leaving the malaria-risk area (4 weeks for mefloquine, doxycycline, or chloroquine, 7 days for atovaquone/proguanil or primaquine). Otherwise, you can develop malaria.


Please note that there are only a few places in the world where chloroquine as a preventative antimalarial drug is still recommended, as many places have developed significant chloroquine-resistance; in other words, taking chloroquine will, in all likelihood, have a reduced potential for preventing malaria infection in these places. Because of this, the World Health Organisation and the South African Department of Health do not anymore recommend that chloroquine be used first-line to prevent malaria in malaria-risk areas in Southern Africa, and indeed Africa, and also many other parts of the world. (Again, consult an up-to-date malaria risk-areas map, as well as appropriate preventative information for each area.) Please, therefore, be very wary of using chloroquine as an antimalarial preventative in chloroquine-resistant areas. It has been argued that chloroquine will still provide some protection against acquiring malaria in chloroquine-resistant malarial areas, but there are several other antimalarials that will give significantly better results in this regard, and so are recommended first-line by competent sources. The article above suggests mefloquine, doxycycline, and a proguanil/atovaquone combination, and these are indeed first-line recommended antimalarials in chloroquine-resistant areas like Southern Africa. Always make sure you consult a competent, knowledgeable medical professional for obtaining the antimalarial most suited to your needs because (potential) side-effects, contra-indications, concomitant medical treatment, and other appropriate factors, may mean that you are better off with one of these rather than the others.



Disclaimer: My recommendations here - though based on some experience and some drug, and other, knowledge - are not absolute, and further consultation with suitable health-care professionals is suggested before a final decision is taken on whether to enter a malarial area, what prophylaxis to use, and any general factors and limitations that need to be taken into account. Furthermore, I only advise based on what information is given by the person(s) entering the malarial area, but I have no control on the information given to me, and so such information could possibly be incomplete or misleading. Moreover, people vary subjectively as to how they metabolise, and react to, drugs and other substances, which further accentuates that my suggestions here are only general suggestions, and therefore not to be taken as pertaining to every person alike.


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Tue Jul 24, 2012 9:31 pm 
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MNel, Bert has given you an excellent link to a well-discussed malaria thread. There you will find a lot of information.

However, I will, without hesitation, tell you that, if it was my child that I had to make a decision on, there is absolutely no way I would ever risk taking the child into a malaria-risk area!!!

It is generally the rainy season and increase in average ambient temperature that increases the malaria risk in Kruger from what is considered low-risk (usually end of May until end of September) to high-risk the rest of the year. Officially, high-risk begins the beginning of October, but obviously the mosquitoes don't follow human designations and risk may increase a little before or after this. Low-risk for an infant though is still too much risk, in my opinion.

There is no place within Kruger's borders that is officially considered as a "safe" place in terms of malaria risk!! Regardless of what people tell you, malaria-mosquitoes are found throughout Kruger, and the risk of being bitten by one is everywhere. Some people think that drier areas are safer, but there are enough water sources to allow mosquitoes to breed there.

Regardless, a 3-month-old is not well-positioned to handle malaria if he/she contracts it. Some things in this regard to consider are: Firstly, the disease can progress to a serious state, and so death, usually at a more rapid pace than in adults; so prompt diagnosis and rapid and effective treatment is more critical. Remember that most cases of malaria in Southern Africa are from the Falciparum strain, which is the deadliest. Secondly, the child is unable to tell you how she/he is feeling and so the disease may go unnoticed for a while. Thirdly, the child will begin teething around that time, and so if he/she develops a fever, it may be difficult to decide if it is due to teething or from contraction of malaria.

Amongst other things to take into account are: Firstly, temperatures in the Park can rise rapidly during the day even around that time of year, which may make your baby very uncomfortable. Secondly, if your baby takes a suitable antimalarial drug, the child may suffer from debilitating side-effects, which will make her/his, and so your, holiday a nightmare. Thirdly, you may feel that you can adequately protect you baby from dusk until dawn against all mosquito bites, but experience has shown me that it is not an easy thing to do.

The decision will always lie with you, but, if it was me, I would not even consider taking my infant child to Kruger at any time. I only considered taking my daughter when she was five years old. Many may disagree with me, but I weighed up all the arguments and came to that conclusion, with which I have never had any regrets.



Disclaimer: My recommendations here - though based on some experience and some drug, and other, knowledge - are not absolute, and further consultation with suitable health-care professionals is suggested before a final decision is taken on whether to enter a malarial area, what prophylaxis to use, and any general factors and limitations that need to be taken into account. Furthermore, I only advise based on what information is given by the person(s) entering the malarial area, but I have no control on the information given to me, and so such information could possibly be incomplete or misleading. Moreover, people vary subjectively as to how they metabolise, and react to, drugs and other substances, which further accentuates that my suggestions here are only general suggestions, and therefore not to be taken as pertaining to every person alike.

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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Thu Jul 26, 2012 7:57 am 
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Kruger is my home away from home, its my happy place and my most favourite place on earth.
I have been going for about 30 years.
I'm quite a stickler for rules and doing things the right way, when I started taking my kids I made sure we NEVER went without our tablets, 1 week before, 4 weeks after, never missing one.
I sprayed us with repellent morning, noon and night, instead of sunblock you got a nice cream of Tabard, we slept under our permanent (treated mosquito nets) etc etc.
We never got Malaria, but I think what I got from taking those horrific tablets is even worse.
In December while camping in Pretoriuskop, I started getting ill, really really ill, I would lose consciousness, I would be dizzy but dizzy to a degree that I couldn't hold my head up, I couldnt stay awake, I started having panic attacks, I ended up in hospital 3 times by March this year and eventually after having an MRI, CT scan, and EEG I was diagnosed with Epilepsy, I was having seizures every 1 - 5 minutes - EVERY Doc and Neurologist that I have been too has said the same thing - the malaria tablets "most likely" triggered this.
Obviously they wont say for sure but they have all said the same.
If anyone has every read the pharmaceutical leaflet inside a box of Mefliam or any of the other medications check out the SIDE EFFECTS.
My opinion now is rather take my chances with Malaria than take those tablets.
And to think I gave them to my kids!!!!!!!
I feel ill to think that they could have suffered what I have suffered.
THANK GOODNESS IT HAPPENED TO ME AND NOT TO THEM.

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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Thu Jul 26, 2012 8:54 am 
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Thank you for your post, Blackmamba. Some of the antimalarials are contra-indicated, or should be used with caution, in people who have epilepsy, but I have never heard that antimalarials can cause epilepsy. I have pm'ed you, BM, so we could discuss this further.

I do not agree that most people should take their chances with malaria over the side-effects of the antimalarials. There are indeed some people where antimalarials should not be used, or used with calculated caution, but then a thorough assessment plus adequate alternative professional advice for them is essential; however, these people would constitute by far the minority of the population. Many times, the side-effects for the average person are transient or simply an annoyance rather than a reason to discontinue the drugs; if more severe, then there are often alternative drugs that can be attempted.

Malaria and its risks is not something that people should take lightly or be complacent about! The Falciparum strain of malaria that is prevalent in most of Africa (and many other countries of the world too) can be lethal if not diagnosed early enough and treated aggressively with the correct regimens. The reason that people mostly die from Falciparum malaria is because it moves into the brain - called cerebral malaria - and at that stage it is a very serious disease.

The correct principles to follow are to consult knowledgeable medical professionals and to weigh up the risks of contracting malaria in a particular area at a certain time of the year versus the potential (or actual) side-effects of taking antimalarial drugs. Then, taking into account other significant factors, including diseases that the person may have, a thorough recommendation as to which antimalarial to use should be made. As mentioned earlier, for those where it is felt that antimalarials should not be taken, the risks of entering the malarial area must be comprehensively explained and all preventative measures put into place so that the risk is minimised. Of course, in some circumstances, it may be appropriate not to enter the malarial area in the first place.

Malaria is no joke; never underestimate the damage it can do!



Disclaimer: My recommendations here - though based on some experience and some drug, and other, knowledge - are not absolute, and further consultation with suitable health-care professionals is suggested before a final decision is taken on whether to enter a malarial area, what prophylaxis to use, and any general factors and limitations that need to be taken into account. Furthermore, I only advise based on what information is given by the person(s) entering the malarial area, but I have no control on the information given to me, and so such information could possibly be incomplete or misleading. Moreover, people vary subjectively as to how they metabolise, and react to, drugs and other substances, which further accentuates that my suggestions here are only general suggestions, and therefore not to be taken as pertaining to every person alike.

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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Sat Jul 28, 2012 8:46 pm 
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Hi Bert You are correct in that you should use a fan to keep mozzies away.

You exhale carbon dioxide when breathing and they can accurately locate the source of this CO2 from an astonishing distance. I read about an experiment where they used dry ice as a source of CO3 and they claimed that it attracted Mozzies from 50-60 metres!
When you use a fan you disperse the CO2 in the air and there is no fixed location for the source.


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Fri Aug 03, 2012 3:16 pm 
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I have to agree with OWN it is not worth taking the risk. It could be one that you may regret in later years. Give the matter your most careful consideration.


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Fri Aug 03, 2012 6:16 pm 
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onewithnature wrote:
Malaria and its risks is not something that people should take lightly or be complacent about! The Falciparum strain of malaria that is prevalent in most of Africa (and many other countries of the world too) can be lethal if not diagnosed early enough and treated aggressively with the correct regimens. The reason that people mostly die from Falciparum malaria is because it moves into the brain - called cerebral malaria - and at that stage it is a very serious disease.

The correct principles to follow are to consult knowledgeable medical professionals (....)

Add to that that Malaria is getting more and more resistent against the complete! arsenal of anti-malarials, and you come to the last line I quoted, go to the doctor! Or at least a doctor that knows malaria, and has your medical file at hand. Only that combination can give you the right advice.

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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Sat Aug 04, 2012 12:06 pm 
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Hi there missings.a.! :D

Thanks for your reply. Maybe I confused you by using the "common" word, Doxytabs, but I meant the well-known malaria prophylactic, DOXYCYCLENE. I quote from the webpage, http://www.ecotravel.co.za :

Anti-malaria tablets (prophylactic)
There are a number of different types of anti-malaria tablets available. Choosing one depends both upon the particular area being visited, and the traveller's own medical history. Within south Africa's borders, SAA netcare travel clinics recommend either mefloquine (mefliam) or doxycycline as being the most effective anti-malaria tablets. Both of these drugs require a prescription.

Doxycycline is taken in an adult dosage of 100mg per day, starting a day or two before entering a malarious area. Like mefloquine (mefliam) it should be taken for four weeks after return. The drug should be taken after a meal, and washed down with plenty of liquid. It should be avoided in pregnancy and children.


Another webpage stated that it should not be taken by children under the age of 8. The tablets must be prescribed by a doctor.

I used Mefliam twice and was as sick as a dog afterwards - fortunately not during the visit, but in the weeks after. :cry: Both times I felt like being poisoned until I stopped after 3 weeks and the symptoms disappeared. After that I used the new tablet, MELANIL, which works wonderful, but at that time it was around R80 per tablet and my medical aid does not cover it, so - for the last 4 visits I decided to try DOXYCYCLENE and with great success :dance: I use probiflora tablets with the Doxy's as with any other antibiotics.

With it I use repellents, not only at night, but also during daytime. Also burn some citronella candles at night :D while sitting outside. :thumbs_up:

Leana


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 Post subject: Re: Malaria risk in August/September
Unread postPosted: Sun Aug 05, 2012 3:23 am 
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The general message often is - take no risks! Take absolutely nothing for granted because the second you do, that's when things go wrong.

Take the necessary precautions and you will have a really enjoyable and, most importantly, safe trip.

I remember very nearly refusing rabies jabs before I went to Nepal - injections to the stomach are never pleasant. Grudgingly I accepted the advice of the GP and, wouldn't you know it, I was bitten by a monkey in Kathmandu. I'll never know if that rabies shot made a difference bt I'm sure glad I took it.

Follow the advice of professionals, that's what they're there for.

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