Malaria Meds and the Foreign Service
Malaria. Yikes. Scary. Especially when you have kids. And for whatever reason, easy to understand information on the options for prophalxis for FS families can be hard to to find. I got an email a few weeks ago asking my opinion, and since, as my loyal readers know, I am a woman of STRONG opinions, I thought I’d turn the email exchange into a blog post (with my interlocutor’s permission, of course).
Disclaimer: this info is my opinion, definitely not approved by MED, subject to change, and may be wrong. My opinions are strongly influenced by the years I spent in West Africa previous to joining the State Department.
Malaria is dangerous and scary, more so for children. I’ve had it, Bertrand’s had it, and Jasmine’s had it. When Bertrand and I got it, we weren’t on any sort of malaria prophylaxis; when Jasmine got it, at 13 months, her malaria prophylactic was being administered incorrectly. In my family, we are (now) religious about giving our kids their prophylaxis. We will never ever ever leave the administration of medication as important as anti-malarials to the girls’ nanny again.
Malaria can be deadly, and has been for State employees as least recently as 2013. That said, most malaria in adults (with a few notable and DEADLY exceptions) is usually treatable if you have access to modern medical care and can afford the medication. And, the number one preventer of malaria, world-wide, is sleeping under impregnated mosquito nets.
The kicker about malaria prophylaxis is that they all have side effects. Mefloquine can give you bad dreams, insomnia, and is not recommended for those with a history of mental illness or depression (because it can aggravate them). Doxy causes sun sensitivity and can interfere with birth control. Malarone can cause nausea and diarrhea. And it’s not like many medications, where the side effects are minimal. MOST people experience side effects from one or more prophylaxis.
I can’t take mefloquine. I just … stop sleeping. I get *incapacitating* insomnia. No dreams, no hallucinations, just no sleep. I dislike the sun sensitivity that doxy gives me, and switched to malarone. Luckily, it’s now available as a generic, and has become dramatically less expensive over the last few years. My husband takes mefloquine with NO side effects. Each body is different, and it’s important to take the time to figure out what works for YOU.
There also haven’t been a lot of studies done on the long term effects of most prophylaxis. This isn’t a deal breaker for me or Bertrand, we are, after all, adults. However, don’t know what that means for my daughters if I pursue my dreams of a career in AF. I’m not sure what the answer is, yet. I *do* know that for our next tour in a malaria zone, both girls will be on malarone, as will I. The solution may be to do tours in Kenya and southern Africa, where malaria is less prevalent.
Oh, woe is me.
So that’s a lot of information. My two cents is that I feel strongly that kids in malaria countries should sleep under impregnated nets AND take their prophylaxis. Two more cents is that adults are adults, but malaria CAN and DOES kill. Certainly, it’ll keep you out of the office for a week or two while you recover. Currently, the State Department requires all FSOs serving in malaria zones to sign off that they know they’re required to take their prophylactic. I believe that enforcement varies, but it’s important to know about the requirement before bidding on posts where malaria is endemic.
Malaria sucks. Don’t get it.