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Sources seem to differ on what precautions are required. Is there an authoritative source I can check, or is it better to drug-up anyway (or not to)?

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I found the same differing sources with Central America. I started taking the pills before I went to the affected areas and stopped when the locals told me it was not the season. If the locals are taking pills you should definitely take pills since there is no immunity to malaria. –  hippietrail Jun 27 '11 at 13:01
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The time I was in India did not coincide with the malaria season (I was there in January), however, my doctor recommended I take the pills just to be safe. I wasn't in the deep South (the furthest South I got was Hyderabad), and I didn't see a single mosquito during my time there. I wish I hadn't taken the pills, because the side effects weren't pleasant. –  ESultanik Jun 27 '11 at 13:27
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I have been in traveling around 'malaria areas' a lot. I have never gotten malaria and only took pills for a short time out here. Doxycyclene isn't bad, but some of the pills make you feel horrible. –  Ginamin Jun 28 '11 at 3:48
    
Many friends highly recommend the new "mosquito repellent bracelets" that have appeared over the last couple of years. I wouldn't use them instead of medication but as an additional preventative. They are particularly good because they fit on your wrists and ankles which mozzies love and where the blood supply is just under the skin. –  hippietrail Jul 23 '11 at 12:49

6 Answers 6

up vote 15 down vote accepted

Malaria is transmitted by a specific type of mosquito (female anopheles) that breeds in still / stagnant water that collects after monsoons. If you're travelling during winter or summer in India, you don't have to worry about this too much as the weather conditions are not conducive for these specific mosquitoes to breed. Locals usually don't take malaria pills, instead preferring to sleep in mosquito nets that will prevent you from getting bitten regardless of what type of mosquito it is. Most mosquitoes you'll get bitten by (and you will) are harmless.

While most travellers going to take precautions against malaria, another mosquito vector-borne disease that is common in India is dengue. Compared to malaria, dengue is a bigger threat as it's harder to 'prevent'; there are no pills or vaccinations for it. Like malaria, this is also transmitted by a specific kind of mosquito (aedes aegypti) locally known as 'tiger mosquito' as it has yellow-striped bands on its legs. If you see such a mosquito, then you know to be extra careful.

City and town authorities take disease control seriously and frequent fumigation is carried out during monsoon season; you will be fairly safe when if you're stick mostly to cities when travelling. It helps to keep an eye on local newspapers if you're travelling for longer periods for news about dengue outbreaks. Take extra precaution when you're staying near places with stagnant pools of water, such as the nature reserves, backwater lagoons et al.

Long story short: Sleep in a mosquito net, or burn a 'mosquito coil' (ask for it at any convenience store; it burns slowly and releases smoke fumes that keep mosquitoes away. Handier to carry around than a net, but fragile so no point buying in bulk as they will break when packed in bags). It will keep you safe from malaria/dengue-carrying mosquitoes and every other kind.

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I would also recommend picking up some DEET-based mosquito repellent. I wouldn't recommend using it over long periods of time as there has been numerous reports of long-term health effects, but for a short term trip, it is amazing. –  Ginamin Jun 28 '11 at 3:50
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Also - don't get DEET on your clothes, it melts synthetic fabric... –  fredley Jun 28 '11 at 10:09
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If you intend to do lots of partying or drinking be careful that you close your mosquito net properly. This can be tricky if you have a small net and a large bed. In Mexico I used to sleep in a net and burn a coil. Coils work best in enclosed spaces where the smoke can fill it up. The more open the space the more chance the smoke may be blown away in the wrong direction. I would also sleep with a fan on (not a ceiling fan) since mosquitos can't fly as well or detect my location as accurately in a strong wind. –  hippietrail Jul 7 '11 at 13:24
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+1 - I live in a country where dengue continues to be a serious problem. Always, as in always wear adequate mosquito repellent when out and about, especially on any area of your body where a large vein or artery is near the surface and exposed (ankles, neck, kneepits, etc). –  Tim Post Jul 9 '11 at 15:07
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@Tim: Perhaps you've never been to Kakadu National Park in Australia. There the mosquitos are large, abundant, and love nothing more than splashing around in whatever repellent you were naive enough to apply. And that's in the sun on a 40+C day. Fortunately they don't carry malaria or anything else nasty (-: –  hippietrail Jul 23 '11 at 12:47

Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. The risks to health whilst travelling will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveller. So it is recommended that you consult with your General Practitioner or Practice Nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets.

The risk is highest in north-eastern states including Assam and Orissa. It may be considered for certain groups who may be at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen.

For further information about Malaria precautions and for full list of the highest risk area list, check the official NHS site (Fit for travel).

Please check the following map for further details for areas with high risk:

India Malaria Ma


Please note that Mefloquine (anti-malarial drug) since its introduction, it has been directly linked to serious adverse effects, including depression, anxiety, panic attacks, confusion, hallucinations, bizarre dreams, nausea, vomiting, sores and homicidal and suicidal thoughts. Therefore Malarone has the fewest reported side effects and it's which is much more recommended in preventing and treating malaria.


See also:

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I advise against taking anything. The side-effects can be harsh, in fact I wasn't able to enjoy my trip until I got rid of the medication. Furthermore, especially in India, you're traveling from city to city so the chances for a malaria mosquito finding you are really low. You're much more likely to be hit by a car, suffer from too much heat or get an intoxication by street fumes.

Just use the usual precautions, especially a repellent. Don't buy into anything anyone recommends, find out what reacts well with your own body. When you've found your repellent, you'll realize that the mosquitoes stay away ;).

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Many travellers I know (who went to Africa) do not use profylactic antimalarials (like Lariam) because of the harsh side effects. They have some medicine to take AFTER the get malaria, and usualy travel in dry season only. Moreover, I heard that you can use herbal tea from (I guess) Artemisia annua as a prevention!

If you hate to use chemical repellents like I do, you can use Citronella oil, but you have to apply it more often than chemical repellents.

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Most government health organizations recommend that chemoprophylaxis when traveling to an area where malaria is endemic (which includes South India). However, you should do whatever makes you comfortable - ideally after discussing it with a travel doctor. When I was in Delhi, it was primarily during winter and my travel doctor told me that for that area at that time of year, it really wasn't necessary for me to take anti-malaria pills because there was virtually no risk of contracting malaria then.

Malaria season is whenever there are mosquitos - basically, when it's warm/hot and there is water around. Monsoon season is the highest-risk time for malaria, typically May - October. I was in India from January - May and only took Malarone for about less than half that time (middle of March through the end of my trip in May).

You should also discuss with a doctor with type of anti-malaria pills are best for you; there are pros and cons for the convenience and side of effects of all the varieties available. (The biggest difference convenience-wise is taking a pill once a week is easier than doing it every day, but many people have stronger adverse reactions to the weekly over the daily. Again, discuss with your doctor what is right for you - any travel clinic can help.)

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Another reason to choose between various types of anti-malaria pills is that the mosquitoes (actually the microbes they carry) in different areas have built up different immunity to the various drugs. This also changes over time so think twice before using malria pills left over from a previous trip. –  hippietrail Jul 22 '11 at 19:30
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True! I forgot to include that. Thanks @hippietrail. Yet another reason to talk to a doctor. And regarding the use leftover pills: also make sure they haven't expired. –  Laura Jul 22 '11 at 19:35
    
I am from India. In terms of mosquito-borne diseases, I won't think south India is different from the north. The visibility of mosquitoes depends much more on the locality than the region. For example, it is easy to find lots of mosquitoes in the rural areas. –  phaedrus Jan 31 '12 at 4:37

Depends on where you are planning to go, and when. If you are travelling to cities, you should be safe. In most urban areas, people are at a very low risk due to Malaria. Most cities have some kind of mosquito-control programme. If you are travelling to the hills, forests, natural reserves, and especially during the monsoons, which is when mosquitoes breed the most, it wouldn't hurt to carry a mosquito-repellent cream with you.

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