Advice: Malaria

Malaria is still a major health problem in India. One figure: 1,863,303 malaria cases were reported in 2003.

Good news… It seems that Malaria can only be inoculated by the bite of a female anopheles mosquito only from around 6 pm to 7am with peak activity after midnight. I knew it… Girls at night are the most dangerous ones ;o)

But what is exactly Malaria? In short, the parasites “enter the host's bloodstream when bitten by an infected mosquito and then migrate to the liver where they multiply before returning back into the bloodstream to invade the red blood cells. The parasites continue to multiply inside the red cells until they burst releasing large numbers of free parasites into the blood plasma causing the characteristic fever associated with the disease. This phase of the disease occurs in cycles of approximately 48 hours”.

As far as the prevention is concerned, follow the ABCD rule:

-Awareness of risk.
-Bite avoidance.
-Chemoprophylaxis (taking preventive medicines).
-Diagnosis made promptly with early treatment of an infected case.

Mosquito bites can easily be avoided by using insecticide-treated mosquito nets, insecticide sprays and repellent creams containing diethyl toluamide. Regarding the preventive medicines, check with your doctor. I am not in a position to advise you the best treatment. But… I would prevent you to use the Lariam. It was given to American soldiers in Iraq and has bad records in terms of murder and suicide attempts. Roche, the drug's manufacturer, issues warnings about Lariam, including anxiety, panic attacks, paranoia, hallucinations, psychotic behavior, and, possibly, suicide.

The ABCD rule seems simple but a bit constraining… The mosquito net gave me a feeling of claustrophobia and I quit taking the mix Nivaquine/Paludrine two weeks after reaching India. The reason? The bulk of malaria cases are found in the flood plains of northern India and coastal plains of the east and west coasts. The north-eastern region, and the forests and forest fringes on the hill ranges of peninsular India occupied by minority ethnic groups are also highly endemic to malaria. Fortunately, I was in Bangalore where malaria cases are infrequent. While traveling, I barely used repellent creams. So far, no symptom (atypical fever, headache, body ache, back ache and joint pains, vertigo, hallucinosis, delirium, altered sensorium, neck stiffness, convulsions, coma, cough, breathlessness, chest pain, acute abdomen, weakness, vomiting and diarrhea, jaundice, puffiness of lids…) but it doesn’t mean that I was not infected during my journey in India. Some sporozoites may go into hibernation. They can lie dormant for months or years and on reactivation they cause clinical relapse.

Update (June 27th 2006):

A new strain of malaria has killed 55 people and affected more than 18,000 others in India’s eastern state of West Bengal since January, the World Health Organisation and the state government said on Monday.