SimonsMiles

Hi folks,

My wife and I are doing a round the world trip in a couple of weeks, and I wanted to verify something. I've searched around and I *think* I don't need to take Malaria tablets for anywhere we're visiting, but a sanity check would be nice :-) We are going to:

Tokyo, Japan (7 nights)
Hong Kong, China (two nights)
Bangkok, Thailand (three nights)

None of these are places I need Malaria tablets, right?

(Although I did read this and got worried - should I be or is this an isolated incident? Would you take Malaria tablets for Bangkok?

Many thanks,

-simon

msv

jimbo99

I wouldn't and I personally don't. I'm also from London and have spent much of the last 10 years in Saigon and Taipei. Also Hong Kong, Bangkok and Japan. This kind of thing is always at the back of my mind.

Of course people will tell you to seek the advice of a doctor rather than rely on advice from an internet forum - but no harm in doing both, in my opinion.

Bear in mind that whether you do, or whether you don't, there are other risks concerned with mosquitos. Dengue fever is a growing problem in the region and the symptoms can be mistaken for malaria. Also a chap I know almost died following complications following a simple infection from a mosquito bite. So if you do find yourself staying somewhere with mosquitos then try to get a net / take other precautions. Frankly most "nice" hotels seem sufficiently sealed for it not to be an issue.

Its widely assumed mosquitos are not a problem in cities. Well I've had a serious problem with them here in Taipei recently - so there are no guarantees you won't be troubled even if confining yourself to cities.

SimonsMiles

Thanks much Jimbo, that helps. We're staying in nice hotels (the three Conrads, in Tokyo, Hong Kong and Bangkok), and we are only three nights in Bangkok so won't have time to travel out of the city. We have a DEET based insect repellent, and will wear long sleeves and trousers in the evening. Anything else we should think of doing? Or am I being too paranoid? :-)

Cheers,

-simon

jimbo99

Actually my very first experience of Asia was of a limo taking me from BKK to the city centre and it was full of the things! I remember thinking "if this is Asia you can keep it..."

I think avoidance is best - be aware if sitting outside in the evenings near standing water or vegetation.

Frankly I think you have no need to worry at all re malaria for the locations you've given.

From my experience entertaining UK people in SE Asia, the biggest risks are upset stomachs (over indulgence/unfamiliar food), colds/other bugs etc (perhaps lower resistance thanks to tiredness from jetlag or over ambitious travel schedules), alcohol/smoking related problems (cos its cheap), and accident (perhaps from doing stuff you'd never do in your own country - riding on the back of a motorbike).

I don't think you're being paranoid - just try and balance all the risks. I don't take malaria tablets, but I always pop an aspirin and walk around alot on long flights in case DVT gets me. Perhaps that's paranoid...

jfh1107

I usually refer to the U.S. CDC travel advisory page: http://www.cdc.gov/travel/. I would guess the U.K. has something similar.

There is no malaria risk in the areas you list. However, there is Dengue, another serious mosquito-born illness. So preventing bites is still important.

It is important to talk with a doctor, if you haven't already done so, because there are other vaccinations that are recommended before travel to many areas in Southeast Asia.

Have a great trip!

biggestbopper

One other suggestion: do not wear sandals without socks, especially in the evenings. The bugs love to bite at the ankles (where, I am told, the skin is thin).

Dawson

One of the times I most often have had problems is sitting at an outdoor cafe. I have learned to carry repellent in my hand bag and spray my feet. I am a woman, and there's no way I'm going to wear socks with my sandals. Not sure in the heat if a man would really want to either. I can't use DEET, but I found a natural repellent that Consumer Reports said works, and it does. It is called Lemon Eucalyptus and is available at REI.

One thing I learned in my last trip though is that you can ask at any restaurant with outdoor dining, even the homestyle ones, if they have a mosquito coil to put under your or near your table. That helps you to dine in comfort without wondering if the varmints are finding a thin spot on your clothing or just holding their little noses and biting anyway. Unlike American mosquitoes which you can hear whining if they get near your ears, Asian mosquitoes have perfected the art of stealth. They don't whine so you don't know if one is buzzing around your head.

stephem

I'd second this comment from jimbo99. I think the three places you mention are low risk for malaria, but you should try to avoid being bitten by using repellent etc, especially given the dengue fever this year. As for asking your doctor, I went to my travel clinic in the US and talked to them, and they would have me on various malaria meds pretty much every week of my life working over here in Asia. I dont think it's actually possible for me to be 100% covered short of taking the stuff day in and day out (and I'm not comfortable with that based on the lack of long term studies on the meds to do that). So I do what I can to reduce the chance of bites, I think carrying repellent is key, espeicially in the evening hours. Bangkok has seemed wet to me, the mosquitos have been bad in the evenings, so I would watch out there.

SimonsMiles

Okay, we have some boots insect repellent which is 50% DEET (is that strong enough?) and we'll make sure we use it. Long trousers in the evening, no walking in jungles. Hopefully we'll be OK :-)

Thanks for all the advice!

-simon

TTT

I was in BKK last month for 6 days and did not see one mosquito. I was out most evenings and took boats on the river and still did not have a mosquito sighting. That being said avoidance is the best measure to prevent Dengue Fever (as Malaria is not a risk). One thing to keep in mind is that the Dengue Fever mosquito bites both at day and night and is more prevalent in urban areas. So if you notice large bodies of standing water in the gutter or on the sidewalk or after a rain storm be sure to put some repellent on and avoid those areas if you can.

While Dengue Fever is not a pleasant experience, it is rarely fatal (3% case mortality rate). It does require lab tests to diagnose, so knowing where the best English speaking hospital is may be helpful in the event of any emergency. Looking at the CDC website for signs of Dengue Fever may be helpful to give you an idea of what to look out for.

In BKK especially be on the lookout for dehydration as you will constantly be sweating. I did not pay attention to this and actually fainted in my hotel room because I was so dehydrated and consequently lost a day of vacation as I rested. Bottled water is cheap, so make sure you buy and drink plenty (and make sure your kids to as well). If you can, buy some sports drinks (Gatoraid or Poweraid) and make sure to increase your salt intake. Salt is crucial for water retention and as you sweat, you lose a lot of salt.

Lastly, to avoid the Bangkok Belly I took a dose of Pepto Bismol every morning before heading out for the day. If I ate a particularly questionable or greasy food, I took another dose. My 6 days in BKK and the entire 3 week trip in SE Asia went fine with no upset of the stomach.

Enjoy the trip! I am sure it will be a blast!

christep

On the other hand, I wouldn't advise wearing sandals with socks unless you wish to have people pointing and giggling!

jimbo99

I use the same Clarks "comfortable" shoes for walking the streets of Saigon as I do for battling with commuters at Victoria Station in London. Same socks too. Not sure I really want to be walking in sandals with some of the gunk that's around.

Just wear what's comfortable. It amazes me the way I see backpackers walking around Saigon (where there's a cafe on every corner and often airconned too) with a super-large bottle of water hanging off their backside in case they have a sudden dehydration issue. Its a kind of status symbol. Just as having the LP guide with the most ruffled pages....

Simon's sticking to cities which are pretty civilized. I wouldn't worry. I wouldn't swallow tablets in the expectation of being sick either.

I used to carry Imodium with me (not on my person, but back at whereever I was staying) "just in case". But I got fed up with the things forever expiring unused. Have taken 2 of them in the last 14 years. I bought them locally and could have done without them. You can find Boots/Watsons in much of Asia, or their equivalents - and on Simon's OP, I'd suggest it is only BKK where he's facing any risk. Last serious poisoning I had was in the UK a few Christmas's back when I reheated some Turkey on "defrost" instead of "high". Didn't want to miss what was about to start on TV so ate it anyway. Boy didn't I pay a price - took me a week to recover. So mistakes can happen anywhere.

In the end, some stuff just puts me off. If you force yourself to eat food that smells odd or looks strange 'cos its local and part of the tourist experience, it will probably make you sick. No need to feel guilty about fitting in the odd baguette, pizza or Starbucks+chocolate cake if it keeps your system going.

biggestbopper

Perfectly okay--if you are German.

Better a giggle than a bite! @:-)