We have read on some PCV listservs that some volunteers stop taking their anti-malarial medication because of the side-effects. These volunteers are putting themselves at risk for a terrible disease. Read and comment on this story from the London Evening Standard on an overseas traveler who stopped taking her anti-malarial medication and the consequences. Read the story at:
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I was so seduced by my dream trip that I felt I was invincible
Aug 5, 2003 - Evening Standard; London
Author(s): Bonnie Estridge
THE expression on my mother's face when she met me in the isolation unit at Heathrow said it all. I weighed only a little over six stone [84 pounds], my skin was yellow, and I was so delirious and dehydrated that I'd been taken from the plane in a wheelchair. My dream holiday had turned into a nightmare - and it was my fault.
Five years ago, just before I turned 30, my friend Mark and I decided to go backpacking in India, which we had always longed to do. We had saved enough money to go for six months and when we left, in June, we'd had every injection possible to guard against tropical diseases, and started our anti-malarial pills, as instructed, two weeks before leaving.
We had been given two types of pills; proguanil, to take weekly, and chloroquine, to take daily. Yet, by our second day in Delhi, both of us were feeling ill. Like most backpackers, we suffered from the "runs", but it was the nausea - a side-effect of anti-malarial drugs - that took the edge off our thrill at being in India.
Mark stopped taking his pills soon after we arrived because he felt so sick, but I was determined to keep going. I didn't want to get malaria.
After four weeks, however, I felt differently. We met other travellers and it seemed that I was the only one taking her pills like a good girl.
Everyone kept telling me that they were fine and I would be, too. Did I want to spoil my holiday by feeling sick all the time? In the end, I was convinced, and felt so much better for giving them up. The fact that we all had loads of mosquito bites didn't bother us; we were having such a great time, we felt invincible.
By October, we had been from Rajasthan to Bombay, Calcutta and Goa, ending up in Kerala - the southernmost point of India.
Although I'd stopped feeling sick I had become very weak; it had happened so gradually, I hardly noticed.
But by the time we reached Kerala I was exhausted, freezing - even when temperatures reached more than 100 degrees - and vomiting a lot. Having loved the local food, it now repulsed me - just the thought of eating made me throw up. I craved something plain such as toast and Marmite.
We were staying in a lovely beach hut in a heavenly place, yet all I could do was drag myself a few yards down the sand and lie there shivering. This caused friction between Mark and me because he wanted to explore while I refused to do anything.
After two weeks I suddenly felt desperate to get back to Delhi. I had lost more than two stone [28 pounds] in weight (I normally weigh nine-and-a- half stone [133 pounds]), I had no energy, felt sick all the time and wanted my mother.
Everything seemed hazy.
Eventually we agreed to travel to Delhi by bus and train - it took six days and was horrific. The transport was crowded, every smell made me vomit and there were no public lavatories. When at last we reached Delhi we treated ourselves to a smart hotel.
I started having uncontrollable fits of shivering and sweating, so violent that they made my body go rigid. I had a raging thirst but couldn't even sip a glass of water because my teeth were chattering so much my mouth wouldn't open. We saw various doctors, none of whom mentioned malaria. They simply handed out pills or medicine which they said would "cure" me.
Mark was now anxious to get me home, but in my delirious state I kept saying that I couldn't leave until I'd brought presents for my family and friends.
After a couple of days and yet another episode of me refusing to leave without presents, Mark stormed out. I was scared because I felt so ill, and rang the hotel reception babbling incoherently.
I have no recollection of how I ended up on a table in a shabby back room of a shop - I think I was taken there by a hotel receptionist - but when I saw medical instruments in a Fairy liquid bottle with the top chopped off and a doctor coming towards me with a syringe saying "you need an injection", I screamed.
Suddenly the door burst open and Mark came in like Superman, scooped me up and carried me back to the hotel. He had booked the plane tickets, but couldn't get us on the same flight. The next day he saw me on to the plane.
By now I weighed little more than six stone [84 pounds]. I was terrified I would have another of the shaking fits and wouldn't be allowed to board. I was frantic to see my mum.
I sent a fax saying: "Please meet me - don't worry, I have a bit of a cold."
On the flight I had a horrifying shaking bout. I came round and the three seats next to me had been cleared. I was lying across them, desperate for water. A woman passenger sat down, put my head on her lap and stroked my hair.
She seemed like an angel. As we landed, I heard an announcement asking for the person in seat 17b to make themselves known. I remember thinking, "I wonder what they've done?"
Slowly I realised they meant me. I was carried from the cabin. When my mother saw me, all she could say was "Look at you, you're yellow". She looked terribly distraught.
At the Hospital for Tropical Diseases, close to Heathrow my red blood cells were so depleted that it was almost impossible for the nurses to take enough blood for tests. But, eventually, it was confirmed: I had malaria. Strange though it may sound, it hadn't even occurred to me.
I was asked whether I had taken anti-malaria drugs; I felt so stupid and naive. No one reprimanded me, but I got the impression that they were used to seeing backpackers in similar circumstances. Over the next week, I started to recover; the less hazy I became, the more foolish I felt. It took me three months at home in Buckinghamshire to recover fully. I was very, very lucky as I had no kidney or liver damage.
I still cannot believe that I took such a risk. My message is: don't listen to anyone who tells you not to bother taking anti- malaria drugs. I did, and I nearly paid for it with my life.
Interview by Bonnie Estridge
The doctor's orders you can't afford to ignore YOU can contract malaria by being bitten by an infected mosquito.
Depending on where you are travelling to, your doctor may prescribe anti-malarial drugs such as chloroquine, proguanil, chloroquine plus proguanil, mefloquine, maloprim plus chloroquine and doxycycline.
There is controversy over mefloquine, tradename Lariam. A study by the London School of Hygiene and Tropical Medicine showed that one in 140 people will experience psychological side-effects; it should not be taken by those who suffer from depression, fits or seizures.
The Lariam Files Read about the anti-malarial drug thousands of volunteers have taken - and its potential side effects.
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This story has been posted in the following forums: : Headlines; Malaria; Infectious Diseases