Q: I am thinking of travelling to Mexico this winter. I like to explore so I may not stay in the major resort areas. Is there any risk of malaria in the interior parts of Mexico? Will I need to take antimalarial drugs if I go there?
A: About half the world is affected by malaria to some extent or other. Included is most of the southern hemisphere with the exception of Australia and New Zealand. Mexico is on the list, although most travellers to popular resort towns do not bother to take malaria prevention therapy. There is also a toll-free information service at 877-FYI-TRIP.
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Travellers should check with their doctor or local health unit six weeks before making the trip in case shots are required for such diseases as hepatitis A or B, yellow fever or typhoid.
Malaria is still a significant cause of sickness and mortality in the world, especially in places where there are chloroquine-resistant strains of the parasite. Symptoms of malaria are fever, chills, headache, muscle aches and fatigue, and occasionally vomiting and diarrhea. The illness will begin a week after being bitten by the infected mosquito, so it may not be apparent until the traveller returns home.
Chloroquine, brand name Aralen, is the commonly prescribed antimalarial drug. A 500 milligram tablet is taken one week before arrival in the risk area and once a week after that. The most common side effect is nausea, so it is best to take it on a full stomach.
Mefloquine, trade name Lariam, is a related medication that is also taken once a week. It is taken as a 250 mg tablet, but should be avoided if you have history of epilepsy or schizophrenia, as rare side effects include seizures or
hallucinations.
Doxycycline, a form of tetracycline, may also be used at a dosage of 100 mg once a day, starting two days before arrival. However, in warm countries it can cause a light-sensitive rash if you are exposed to hot sun. It should also not be given to children under the age of eight or pregnant women.
Malarone is a new antimalarial drug that is a combination of Doxycycline or Mefloquine.
The only way to contract malaria is through a mosquito bite, so it is also a good idea to prevent bites by using mosquito repellents such as DEET, particularly after sunset.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
