Q. I am going to Mozambique for a diving holiday. People tell me that because it's winter there, there is no malaria and that, anyway, taking anti-malaria prophylaxis will give me bad dreams and hide the symptoms of the disease should I get it.
Is this correct? Or should I take the pills? - Elizabeth, Johannesburg
A. A doctor lost his cool with me some years ago when I told him I had heard that anti-malaria medication would mask the symptoms of malaria.
"The symptoms ARE what GIVE you malaria," he bellowed across his desk, thereby instilling a solid piece of travel advice that I have never forgotten.
So, the last part of your question first: yes, take the pills.
Dr Leslie Gritzman of The Travel Doc emphasises the folly of not taking prophylaxis.
"It's a total misconception to wait until symptoms appear," he says. "By the time they do you could have cerebral malaria."
Malaria is caused by a parasite called plasmodium, which is spread by female Anopheles mosquitos. One of the strains, Plasmodium falciparum, is deadly. Simply put, if you contract cerebral malaria, you have a good chance of dying from it.Your first step is to visit a travel clinic where you can be assessed for which of the three most popular medicines - Mefloquine (Larium), Atovaquone/Proguanil, or the antibiotic Doxycycline - will work best for you. Larium has earned a bit of a bad reputation for side effects that can include bad dreams, psychosis and seizures.
"It all depends on the person," says Gritzman, who looks at the traveller's medical history before making a recommendation.
As you are going on a diving trip, you should also note that Mefloquine is not an option as it can apparently affect your fine motor skills and balance.
As for the perception that the malaria risk is low in winter, you should behave as you would in summer. Mozambique has a year-round risk of malaria transmission.
The Anopholes mosquito hunts from dusk to dawn. It also makes no sound as it flies, so forget about any early warning.
Along with taking prophylaxis (and please do finish the course after you come back from your travels), the usual cautions apply: sleep in an air-conditioned room if possible. If your room has an overhead fan, use it - air turbulence is your friend where mosquitoes are concerned.
You should also use mosquito coils outdoors and an electric plug-in device inside.
Also use liberal amounts of insect repellent - those that contain Deet work best - and cover up.
That means you should at least wear long pants and a long-sleeved shirt at night.
Because I'm an anxious sort, I also wear socks and shoes - and a buff around my neck.Finally, if you suffer from any flu-like symptoms - nausea, vomiting, a headache, chills, fever and sweats or pain in your muscles - during or shortly after your trip, have a malaria test immediately.
The sooner you catch it, the quicker the cure. Leave it too long and you are playing Russian roulette.
Symptoms usually appear between 10 days and four weeks after infection, although the disease can take hold a few days earlier and may also appear up to a year later.
For more info, contact The Travel Doc on 082-457-0176, e-mail info@traveldoc.co.za or see traveldoc.co.za.
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