Judging from
the emails I receive and from speaking to guests who stay at our place, most
people are a bit worried about the odds of catching malaria. Google
'malaria' and 'Koh Chang' and you'll find plenty of health related websites
which have Thailand's borders with Cambodia and Burma plus Koh Chang
coloured red. Red meaning, as Guns n' Roses once sang "Welcome to the
jungle, you're gonna die!".
In
boring old reality, there's only a chance of catching malaria
if you plan on spending a few weeks camping out in the jungle during the
rainy season. If you're planning on staying in a beachfront hotel then
I wouldn't worry. Locals don't worry or even give malaria a
second thought nowadays. (The local government launched an eradication
program well over 10 years ago). I've asked a couple of neighbours if they remember
anyone catching it and in the past few years - since the advent of mass tourism
there haven't been any cases that stick in the mind. In the two and a
half years
I've been here I haven't heard of any cases or even rumours of cases.
Take the obvious precautions, wear long
sleeved shirts and light trousers in the evening and bring a good mosquito
repellent, something with a high percentage of DEET in it as mozzies can
sometimes be a nuisance. Natural, citronella based repellents, may make you
feel as though you're saving the ozone layer or whatever, but when it comes
to deterring mozzies; coating yourself with DEET or, any Agent Orange
derivative, is the only way to go.
It's also interesting to note that
whilst I've had loads of emails from people worrying about catching malaria,
not one person has shown any concern about contracting Dengue Fever.
This is odd as Dengue is far more prevalent throughout Thailand, has no cure
and kills a lot more people than Malaria every year in this part of the
world. You'll find that most expats who've lived in Thailand for a
while have either contracted Dengue or have a good friend who has, whereas
none of them will know anyone who caught Malaria.
Below is the state-of-the-art malaria clinic in
Laem Ngop, on the mainland near Koh Chang. If this really was
a dangerous malarial zone you'd have thought that the clinic might
be a little larger or at least staffed or have queues of
people outside.
I caught Dengue when I was living in
the city centre of Bangkok a few years ago - it isn't a fun virus to
have. The main symptoms, of the milder form, are a week of the worst
migraine headache you can imagine combined with all your joints aching at
the slightest movement. The main symptom of the more serious form is
internal bleeding . . . . followed by death.
Thai Red Cross recommends against
tourists to Thailand taking
anti-malarial drugs for several reasons including:
1) Ineffective prevention of an infection
allowing for a sub-symptomatic infection that delays diagnosis and
treatment. Treatment during the early first stages of malaria is very
effective, but it gets more difficult as the infection and life cycle
of the parasite progresses.
2) Contribution to the development of resistance
pools to anti-malarials that are also used for treatment
3) Side effects from the anti-malarials. Rather,
they recommend that you use bite prevention and if you have the
slightest doubt that you might be infected, report to the nearest
clinic or mosquito control office (there's one in every small town in
Thailand) for a diagnostic test, followed by immediate treatment on
the one in a million chance that you have actually contracted malaria.
If you feel that the Thai Red Cross is still a
bit too 'third world' to be a reliable source of accurate
information then feel free to contact the American Center for Disease
Control. If you've ever met Americans when they're travelling you'll
know how paranoid many of them are about catching any foreign bugs, so
you should feel pretty confident that the CDC's advice errs on the
side of caution.
The official comment on the chances of catching
malaria on Koh Chang is as follows. (Note the use of the word
'should' to avoid any possible law suits resulting from following
their advice):
+++
The malaria-risk areas of Thailand are its
borders with Cambodia, Laos, and Burma. Ko Chang should not have
malaria transmission. No antimalarial drug should be required,
although you should wear insect repellent with DEET if you are out of
doors between dusk and dawn for a little extra protection.
Thank you for your inquiry. Please call or write
if you have further questions.
Sincerely,
National Center for Infectious Diseases
Centers for Disease Control and Prevention
amb2@cdc.gov
770-488-7788 (Malaria Hotline, 8am-4:30pm, eastern)
770-488-4206 (fax)
+++
And finally, especially if you're from the UK,
you'll find that your doctor will almost always recommend that you
take anti-malarial medication whenever you visit an area of a country
your GP hasn't already visited personally. Safety first . . . but the
fact that some anti-malarials cost a small fortune and the profits on
sales must be quite high may also be a factor.
The bottom line is that if you are worried at
all then take your pills. No point spending your holiday
wondering if you're going to die every time you see a mozzie.
But, statistically, you will be extremely unlucky if you do catch
anything.
