Austinrunner

You would rely on advice from South African officials instead of the US Centers for Disease Control? Wow.

iahphx

Honestly, the US gov't knows NOTHING about the real risk of malaria in Kruger. Nothing. To the extent that there is knowledge, it is in South Africa. There is a sophisticated medical community in South Africa. They are definitely the experts on tropical diseases in southern Africa.

The problem is that nobody has spent much money studying the risks. It's not a high priority item because nobody is getting sick from malaria at Kruger. Everybody knows the risk is very low, but no one is prepared to say it's zero. So folks are generally told to take the meds, at least during the wet season.

I'm pretty sure this advice will change at some point in the next ten years as further research is done, but in the meantime, it's probably best to take the drugs "just to be safe." That's what we did, even though I knew it was probably unnecessary.

stimpy

You should rely on the US CDC as much as you should rely on the US State Dept when it comes to travel. Both agencies are required to give the most dire warnings imaginable about a place, even if there is almost no chance of something happening. That's because there are people out there who either have the worst luck in the world or put themselves in a position to have bad things happen. And if they complain to the US Govt "No one told me Country X was dangerous", then the US Govt can point to the CDC and State Dept websites where you are advised about all the bad things possible, even for countries like the United Kingdom. Go to travel.state.gov and read up on how dangerous the UK is. If you believed all that, and you were a worry-wart, you would never travel to the UK. And European governments equally have dire warnings about visiting the US.

So no, I wouldn't rely at all on the CDC. And really I wouldn't rely on the SA govt either. I know intelligent people who live in Africa who tell me where I can safely travel without concern about Malaria. Johan is one of those people and he is right that it is foolish to take Malaria meds for a safari in Kruger.

If Malaria meds had no consequences, I might take them myself. Sort of like how I might take a One-A-Day vitamin. But Malaria meds do have serious consequences and you should NOT take them unless you are sure you are going to a place where the risk is high.

Austinrunner

That's uninformed advice. I take malaria meds all the time when I go to Africa and never have had problems, as do millions of others. And your assumptions about the Centers for Disease Control and the Department of State are also uninformed.

Austinrunner

Right. They're the experts but haven't done any research. That inspires lots of confidence.

Both the CDC and the South African Department of Health recommend malaria prevention meds in Kruger. I'd take that advice over a lay person's anonymous Internet advice anyday.

stimpy

OK, you think I'm uninformed and I think you are uninformed. Let's move on. People can make their own choice.

DavidAL

As I stated before.....no meds for me at the advice of my friends who live there. Yes, some of their children have gotten malaria, but the right treatment and they're good again after a couple days. They live there, so it's much more likely they would get malaria.

To each his own though....

Austinrunner

They have been very fortunate so far. Local advice is not necessarily better advice, especially when the issue relates to health or science

kimwhits

Omg. So many posts. I am both a doctor and avid Africa traveler. I lived in SouthAfrica 3 years and practiced at a huge KZN hospital. I saw the grand total of one child with malaria from Mozambique. No one else. Been to Kruger multiple times as well as Zambia, Zim and the Namibia/ Angolan border and the SA/Mozambique border. Never taken anything. I'm much more afraid of viral diseases I can't treat like dengue. Malaria is easy to treat. South Africans never take anything when they travel.

The worse advice comes from USA docs. I snicker when the advice is to consult your own physician. Trust me, they know absolutely nothing and just read the CDC website. I have traveled to many nasty places. Maybe I am just lucky but I never get sick.

Austinrunner

What is your specialty? You advise patients based on your own anecdotal experiences? Seriously? I would not choose a doctor who does that to treat myself or anyone I care about. That borders on malpractice.

jannis

I am a doctor as well (GP and infectious diseases) currently based in NBO. I have seen, local, tourists, adults and children with malaria. Some with severe malaria aquired in different regions of Kenya.

I don't know anything about the physicians perspective in SA, but for Kenya I feel confident to say, there are quite a number of places where malaria is present and transmitted.

I do know and understand people that don't tolerate the different prophylactic meds and therefore don't take them, however I'd never advise against chemoprophylaxis; especially as in my experience Malarone/Malanil or Doxy are well tolerated.

What I really like to point out, that there is not only chemo-prophylaxis but also mosquito nets, repellents, long sleeves. This is an essential part of prophylaxis and if you take these measures it greatly reduces the risk of malaria (and also e.g. for dengue if you do it also during daytime).

In the end, I think that one should consult with a physician that they trust and discuss their individual risk.

stimpy

Thanks for participating. Can I ask you if you would advise anyone to take meds for a trip to Nairobi?

jannis

Sure. In the city of Nairobi there is no need for malaria prophylaxis.

stimpy

Good answer! That was my little test to see if you were a maniac. Sorry, but there are some crazy posts in this thread. Some people will actually insist that we all take meds when going to large relatively well run capital cities in Africa.

Austinrunner

Malaria does not exist in Nairobi because of the altitude, certainly not because it is (not) well run or a large capital city. Geez.