43 replies to this topic

[shadragon]

Okaaaaaay, old South African publications notwithstanding, what was the objection to following CDC suggestions with a physicians approval...?

Was not an objection Don. Just pointing out the CDC makes recommendations for the general public and not divers specifically. When they recommend a med for malaria it MAY cause issues when diving because the CDC assume the person taking it will be at 1 ATA.

Check with the friendly DAN folks to avoid issues is all I am saying.

[DandyDon]

I personally like the natural options. (Thank you Simon!)

Don where have you found that skin so soft etc does not work? Please provide any sources as viable alternatives to DEET are important especially to people who travel a lot and would then get lots of exposure to DEET if used on every international trip.

I suppose that Secretsea18's post should serve as authority enough to answer you, but just in case...
> Here's is a study report from Univ of Florida here showing that DEET worked for 5 hours while Skin So Soft with no additives is listed as good for 10 minutes and other products studies with effective ranges of 4 hours on down to worthless on some products ;
> Also see on that same report the authorities that consider DEET safe as well as their disdain for "Natural Products;"
> And Snopes has an informative article as usual on this here discount natural products and noting that Avon disputed the 2002 article in the New England Journal of Medicine, along with references to 1993 and 2003 Consumer Reports articles that find it ineffective. Avon makes a lot of money on their ineffective products, I think.
> There are additional reports on how worthless Skin So Soft in stopping skeeters if you still want more?

Nicotine is a natural product, but I would not suggest rubbing that on either.

Okaaaaaay, old South African publications notwithstanding, what was the objection to following CDC suggestions with a physicians approval...?

Was not an objection Don. Just pointing out the CDC makes recommendations for the general public and not divers specifically. When they recommend a med for malaria it MAY cause issues when diving because the CDC assume the person taking it will be at 1 ATA.

Check with the friendly DAN folks to avoid issues is all I am saying.

Using the DAN link furnished by Fordan above, you can read there their findings about that...

Specific to Diving:

There is no clinical data that establishes any interactions with antimalarial drugs and diving. Most dive medicine professionals do not expect any complications with the antimalaria drugs and diving. However, the use of Mefloquine (Lariam) by divers is not universally accepted by all dive medicine professionals. Please consult the dive operator at your destination for the local opinon regarding Mefloquine (Lariam).

Altho I would want to avoid any of the cycline meds, I think, as they do make my skin more susceptible to sun burning.

Now in all these postings, we got away from my question to Secretsea18, whose opinion I value greatly, why not use the one of the meds suggested by CDC and DAN for Central America....??

From the DAN article...

chloroquine or hydroxychloroquine sulfate as their antimalarial drug.

Mefloquine (brand name Lariam ®)

Directions for mefloquine use:
# Take on a full stomach: e.g., after dinner.
# Take first dose a week before arrival.
# Take weekly, on the same day each week, while in risk area.
# Take once a week for four weeks after leaving the risk area.

Mefloquine side effects and warnings:

Most travelers who take mefloquine have few, if any, side effects. The most commonly reported minor side effects include nausea, dizziness, difficulty sleeping and vivid dreams. Mefloquine has been reported to cause serious side effects, such as seizures, hallucinations and severe anxiety. Minor side effects usually do not require stopping the drug. Travelers who have serious side effects should see a healthcare provider.

I'll attached the chart from the UofFlorida...

thanks!

Attached Images

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[secretsea18]

Dandy Don,
I will never take Lariam again. I don't care what anything says about the SAs being mild. They are not for me. I will not accept the side affects that I get, and as there are alternatives...

I haven't taken anything in Central America, Caribbean nor Mexico, as the exact areas I go to do not pose actual risks. I also will not take anything for my trips to Philippines, despite general warnings as the regions I go to, do not have malarial mossies, although my Australian friends do take the drugs cause they don't look at their CDC equivilent very closely.

So there you have it. I do bring or buy AND use DEET containing bug lotions and sprays.

Dengue Fever is just as miserable to have as malaria, and there is NO TREATMENT, you just gotta suffer through it.


Robin

Edited by secretsea18, 17 October 2007 - 08:06 PM.

[DandyDon]

Dandy Don,
I will never take Lariam again. I don't care what anything says about the SAs being mild. They are not for me. I will not accept the side affects that I get, and as there are alternatives...

I haven't taken anything in Central America, Caribbean nor Mexico, as the exact areas I go to do not pose actual risks. I also will not take anything for my trips to Philippines, despite general warnings as the regions I go to, do not have malarial mossies, although my Australian friends do take the drugs cause they don't look at their CDC equivilent very closely.

So there you have it. I do bring or buy AND use DEET containing bug lotions and sprays.

Dengue Fever is just as miserable to have as malaria, and there is NO TREATMENT, you just gotta suffer through it.


Robin

Ok, thanks. I never have taken that one, so I don't know what my personal reaction would be. Some people just can't reasonably.

There is little malaria in the Central American destinations I've visited, but the meds that work there don't bother me, so I can take them anyway. As you noted, and from some I've read, Dengue can only be prevented by preventing bite, so sure - that should be the first defense against it and Malaria, but while DEET is the most effective additive, there are places you can't use it and dive. For a recent trip to somewhat higher risk areas that do not allow DEET and diving, I was going to use a biodegradable spray for daytime then follow with DEET spay before sunset, but - H.Dean cut that one short. Still well supplied in all of it.

thanks again!

[scubaski]

Dandy Don,
I will never take Lariam again. I don't care what anything says about the SAs being mild. They are not for me. I will not accept the side affects that I get, and as there are alternatives...

I haven't taken anything in Central America, Caribbean nor Mexico, as the exact areas I go to do not pose actual risks. I also will not take anything for my trips to Philippines, despite general warnings as the regions I go to, do not have malarial mossies, although my Australian friends do take the drugs cause they don't look at their CDC equivilent very closely.

So there you have it. I do bring or buy AND use DEET containing bug lotions and sprays.

Dengue Fever is just as miserable to have as malaria, and there is NO TREATMENT, you just gotta suffer through it.


Robin

Ok, thanks. I never have taken that one, so I don't know what my personal reaction would be. Some people just can't reasonably.

There is little malaria in the Central American destinations I've visited, but the meds that work there don't bother me, so I can take them anyway. As you noted, and from some I've read, Dengue can only be prevented by preventing bite, so sure - that should be the first defense against it and Malaria, but while DEET is the most effective additive, there are places you can't use it and dive. For a recent trip to somewhat higher risk areas that do not allow DEET and diving, I was going to use a biodegradable spray for daytime then follow with DEET spay before sunset, but - H.Dean cut that one short. Still well supplied in all of it.

thanks again!

Hi , Just following this topic for future reference.I have a question. Why are there some places you can dive and NOT USE Deet?? Thanks.

[DandyDon]

Hi , Just following this topic for future reference.I have a question. Why are there some places you can dive and NOT USE Deet?? Thanks.

Mexican parks are publishing some prohibitions, including the Cozumel reefs as they don't want the chemical washing off on the dive, but it doesn't seem to be enforced - and may not be.

Here's one referenced on a Cenote Op's site: here

Mosquitoes are a major problem in the jungle. I would recommend either wearing a lycra dive skin while you are there, or covering up in some other way. DEET works, but shouldn't be worn prior to your dive(s) because of water contamination issues.

Perhaps more important, we shouldn't wear DEET before diving. The worst exposure time is at sundown and after, so I try to dd DEET before then.

[secretsea18]

So there you have it. I do bring or buy AND use DEET containing bug lotions and sprays.

Dengue Fever is just as miserable to have as malaria, and there is NO TREATMENT, you just gotta suffer through it.


Robin

For a recent trip to somewhat higher risk areas that do not allow DEET and diving, I was going to use a biodegradable spray for daytime then follow with DEET spay before sunset, but - H.Dean cut that one short. Still well supplied in all of it.

thanks again!

Hi , Just following this topic for future reference.I have a question. Why are there some places you can dive and NOT USE Deet?? Thanks.

Given the miniscule amount of DEET applied to the body that could possibly get into the water (drop of water in the ocean magnitute) VS the huge amount of unregulated pollution and environmental contaminants that get into the water from even watering ONE golf course on an island in one day, it is stupid in my opinion. We are not talking about spraying the land, just a little bit on a person. So I can't see any scientific basis or ecologic basis for this regulation, say in Mexico, where I am aware of that rule. Perhaps the ecologists here can enlighten me.

[DandyDon]

Yeah well, probly not really - but I've heard that they enforce the prohibition somewhat at least at the Cenotes and with the Whale Sharks. The Cenotes might make sense, since you're swimming in a smaller volume of water, yet it being the aquifer used for drinking water. We didn't make it that far in Auugust, tho - so I can't say.

[DivingDeb]

* When all else fails--get a frog!

And if I kiss it will it turn into a dive buddy?

Please consult a doctor before taking any med-if you decide everytime there might be a threat to areas that normally don't have much of a risk you could be building up an immunity that in the future would render the med useless when you really need it. I was in Georgetown in Feb 2007 & they had a scare in the summer 2006 but it was travellers coming to the island not getting bit there. I think your chances are slim esp as you will be on a boat most of the time.
Good Luck Have Fun

[Latitude Adjustment]

I personally like the natural options. (Thank you Simon!)

Don where have you found that skin so soft etc does not work? Please provide any sources as viable alternatives to DEET are important especially to people who travel a lot and would then get lots of exposure to DEET if used on every international trip.

I know "Skin-so-soft" doesn't work on all mosquitos, I used it one night and the little black ones ate me alive leaving me a bloody mess!
Be aware that there are also some areas where some mosquitos feed during the day and under a tree canopy out of the sun they may all be out.

[shadragon]

I have also noticed that wearing white seems to help. Mossies seem to be attracted to dark colors.

[ScubaDrew]

I have also noticed that wearing white seems to help. Mossies seem to be attracted to dark colors.

OD on garlic pills. You will reek, but it works for my friend, who uses no spray and gets no bites. No dates either but hey, you gotta pick your battles...

[DandyDon]

Please consult a doctor before taking any med-if you decide everytime there might be a threat to areas that normally don't have much of a risk you could be building up an immunity that in the future would render the med useless when you really need it. I was in Georgetown in Feb 2007 & they had a scare in the summer 2006 but it was travellers coming to the island not getting bit there. I think your chances are slim esp as you will be on a boat most of the time.
Good Luck Have Fun

ALWAYS a good idea to consult a physician on personal health care, yes. And mine is an excellent one, originally from Mexico with active visits back to treat there, but in an altitude area not affected I think. Anyway, it's also good to do your own research at CDC and DAN, get yur own info, and while consulting - ensure you have agreed on the best plan.

Georgetown Exuma? That info has been updated...

Outbreak Notice
Malaria in the Bahamas: Recommendations for Travelers
This information is current as of today, October 18, 2007 at 11:44

Updated: August 23, 2007

The Centers for Disease Control and Prevention (CDC) has received official reports of two confirmed malaria cases in Great Exuma, Bahamas. Malaria transmission had not previously been reported from this area, until an outbreak was reported in late spring and summer 2006. One of the confirmed cases occurred in a U.S. citizen who traveled to Great Exuma in late July 2007. This patient’s illness has been confirmed as malaria caused by Plasmodium falciparum. Malaria is not considered endemic on the islands of the Bahamas.
Recommendations for Travelers
Antimalarial Medication

At this time, CDC is recommending chloroquine as an antimalarial medication for travelers to Great Exuma. This recommendation is expected to be temporary and does not apply to other islands of the Bahamas. Chloroquine has a long history of use and safety and is well tolerated by most people, including children. People with an allergy to chloroquine should discuss an alternative antimalarial drug with their health-care provider. To learn more about chloroquine, including dosing information, see Information for the Public: Prescription Drugs for Malaria.

Erring on the side of caution is not my nature at all, but I'm trying...

thank you

Edited by DandyDon, 18 October 2007 - 09:26 AM.

[Divegirl412]

Grew up in Africa. Had malaria several times. My parents thought I was taking prophylaxis (chloroquine back then), but I was an expert at palming pills. At that time, for me, it was just like catching the flu or a cold. Looking back, I realize we pretty much always had subclinical malaria. Now that I have been in the US and lost my innate immunity, I take anti malarial prophylaxis and use DEET whenever I am traveling to a site listed by the CDC (including when I visit home). Don't want to have malaria again. Plus I hate bugs I do use lariam, because I am lazy and like the weekly pills. But I take it at night, before bedtime to minimize possible side effects. I've been lucky and have used it for years without problems.

[TonyL]

I know I took something in Africa. Not sure about India or Panama. I did take doxy in Afghanistan. I know people who caught it in Afghanistan and Africa. I recommend taking the precautions. The side effects from doxy aren't too bad.

Edited by TonyL, 19 October 2007 - 02:02 AM.