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October 2004 Vol. 19, No. 10   RSS Feed for Undercurrent Issues
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Malaria and Divers: Even in Róatán there’s a risk.

from the October, 2004 issue of Undercurrent   Subscribe Now

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 (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. While other products are available, scientific tests continually show that none approaches the effectiveness of 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-totwo 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: www.cdc.gov/tr; International Society of Travel Medicine: www.istm.org; American Society of Tropical Medicine and Hygiene (ASTMH): www.astmh.org/scripts/clinindex.asp.

– Doc Vikingo

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