map of malaria zones in India

FitForTravel's map for Malaria in India

Whilst most precautionary medicines required for far-flung foreign travel are inoculations unfortunately for prevention of Malaria you still have to take oral medicines.

There’s a few questions you need to get answers when researching Malaria:
    - Does Malaria exist where I’m going?
    - Is there enough risk to require tablets?
    - Am I likely to suffer side effects?
    - How high is my price-of-paranoia?

The first two questions are fairly straightforward to answer. Firstly look up one of the many sites available – such as http://www.fitfortravel.nhs.uk/advice/malaria.aspx – which should guide enough. In the UK we have NHS and private travel clinics both of which offer useful, although somewhat conflicting, advice.

The third question is hard to answer as even if you’re taking the same tablets for the n-th time you may have a different reaction this time.

It’s the fourth question that I’ll focus on now.

What exactly is a “price of paranoia”?
It’s a term I’ve come across a few times and it seems to make a fair bit of sense. Basically, it’s about how much you are worried about something happening and the costs involved in minimising your fears about it happening. For example, I store a lot of data on this PC, so I back it up on to a disk that cost me money to buy. But what if that disk went wrong? Okay, I’ll organise a second backup disk. But what if the house burnt down? Okay I’ll buy some online space and keep a backup on that. But what if that online hosting company went bust and I couldn’t connect to my data? Okay I’ll get a second area of online space and keep another backup there. And so on.
If you apply a similar thing to an organisation the costs sky-rocket with each level of paranoia.
(Hey, don’t forget that just because you are paranoid it doesn’t mean it won’t happen.)

What is my malarial-price-of-paranoia?
The background facts:
   - I’m travelling to a country that has many malarial areas, some of which I’ll visit.
   - I’m travelling in monsoon when mosquitoes are active.
   - According to the map above I’m not actually going to hit any high risk areas, apart from Goa where I’m only spend 1.5 days / 2 nights.
   - I’m the one who gets bitten the most. (Grrrrr.)

And the price?
   - 50% deet solution to stop us getting bitten. 1 spray and 3 x 250ml refills – £42 ish.
   - 2 single and 1 double EX8 impregnated mosquito nets – £35 from eBay or £65 in a shop.
   - Jungle Fever electrical mosquito killer – about £8

So that’s about £85 before I start talking about the price of Malaria tablets. If you want to know why I’ve written about nets and sprays before tablets then clearly the answer is that it’s better not to get bitten in the first place.

The cost of tablets
…was something of a shock.
The options seem to be Malarone, Doxycycline or a combination of Chloroquine and Proguanil (more commonly known as Avloclor and Paludrine).
Malarone: Everyone seems to rate Malarone, it’s regarded as the dogs-wotsits as it doesn’t seem to give you any horrible side effects. It also needs to be taken for less time, commonly 2 days before you travel, during travel and one week after. However it’s at least £2.50 a tablet. A course for us would be 37 days which is £92.50, each!!!
Okay so I like the idea of Malarone but £370 seems a bit steep and I’d also need a private prescription for it.
Chloroquine and Proguanil: Right at the other end of the scale is Avloclor and Paludrine, something that I’ve taken many times before. I never suffered too much with it but it tastes foul. You also need to take it for four weeks after returning. However it comes in a pack for about £12 for 7 weeks supply, which is what I need. Total would be £48 for all of us.
Doxycycline: Doxycycline is an antibiotic which, amongst other uses, can be used to prevent malaria. It’s got some odd side-effects, like affecting your skin’s sensitivity to sun – not something we’ll need to worry about this time! Like Avloclor/Paludrine, it’s taken for four weeks afterwards, comes in capsule form (tastes nicer I guess) and you have to take less of them compared to Avloclor/Paludrine. It has the benefit of only costing £14 for a course for a four-week trip, so that’s £56 for all of us. However it looks like Amy may be too young to take it.
It looks like it’ll be Doxy all the way for three of us with Amy taking Avloclor/Paludrin: total cost about £56.

So the final total price-of-paranoia is likely to £141. There’s a lot to be said for travel in non-malarial zones.

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