Malaria kills more people worldwide than any
other communicable disease, except tuberculosis. A
parasitic disease transmitted by infected female
Anopheles mosquitoes, malaria’s symptoms include
extreme exhaustion, high fever, shaking chills, muscle
aches, diarrhea, and vomiting.
Make no mistake, it can be a nasty disease. And,
while savvy divers traveling to Southeast Asia,
Indonesia, Malaysia, and the Solomon Islands take a
prophylaxis, malaria is closer to home than you
think, e.g., Central America, even the Bay Islands of
Honduras. Lorin Zaret, originally from Long Island,
New York, and now a massage therapist on Róatán,
was bitten by mosquitoes on the island during
Christmas week last year. Two weeks later she
thought she had food poisoning, with chills and a
fever of 104 degrees. She told Undercurrent, “I
became very sick. I hallucinated, threw up repeatedly
and had diarrhea. I could hardly raise my head off
the pillow to go to the bathroom. Every bone hurt
me. I lost my appetite completely and lost 15
pounds.” Despite malaria treatment, she indicates
that, “I have not quite felt myself since.”
In Honduras, the Center for Disease Control
says there is risk in rural regions, including resort
areas, on Róatán and the other Bay Islands.
Mdtravelheath (www.MDtravelhealth.com) says that
historically the incidence has been greatest in
swampy regions of the east end, but that the number
of cases reported from the north has risen dramatically
over the last several years.
Recent studies suggest that components of perspiration,
especially those described as “smelling like
a horse barn,” rank high among cues that attract
mosquitoes. If true, keeping a low odor profile may help prevent malaria. This means showering and
changing clothes often, using unscented soap, shampoo
and antiperspirant and wearing no fragrances.
Most important, regularly apply full strength DEET.
While other products are available, scientific tests
continually show that none approaches the effectiveness
of DEET.
The CDC also recommends antimalarial medication
in known risk areas. Contact your primary
physician or nearest tropical diseases/travel
medicine clinic well ahead of your trip. State and
local health departments may be of assistance in
finding a center.
Happily there are effective medicines, including
chloroquine and doxycycline. Lariam (mefloquine)
should be taken by divers only after weighing the
potential risks and benefits. It can cause hallucinations,
anxiety, depression, confusion, forgetfulness,
seizures and balance disturbance that may both
threaten a dive and mimic DCI. A newer drug,
Malarone (atovaquone & proguanil), provides similar
coverage to Lariam, and in some locations superior
protection, and has a more benign side effects
profile. For Honduran and other Central American
risk areas, which include inland Belize, chloroquine
works. It’s user-friendly, taken weekly, starting one-totwo
weeks before arrival and continuing for four
weeks after departing the risk area.
Do your research, tell the prescribing physician
you are a diver, and whenever possible allow for an
adequate topside trial to assess for adverse reactions,
because all these drugs have side effects. Some useful
web sites are: CDC Travelers’ Health-Health
Information: www.cdc.gov/tr; International Society
of Travel Medicine: www.istm.org; American Society
of Tropical Medicine and Hygiene (ASTMH):
www.astmh.org/scripts/clinindex.asp.
– Doc Vikingo