Travel health

Question 1

Which malaria prophylaxis medication is associated with a neuropsychiatric reaction (hallucinations & erratic behaviour?)

Answer 1

Mefloquine

Question 2

For how long does mefloquine need to be taken pre and post trip for malaria prophylaxis?

Answer 2

For 2-3 weeks ideally (min 1-2 days) pre-trip and for 4 weeks post trip

Question 3

Which travel vaccinations are normally available free of charge from the NHS?

Answer 3

Cholera
Hep A
Diptheria, Polio and Tetanus booster
Typhoid

Question 4

Which antimalarial medication is contraindicated in those with a past history of psychiatric disorders (including depression) or seizures?

Answer 4

Mefloquine

Question 5

Which antimalarial prophylaxis medication is available over the counter?

Answer 5

Chloroquine/Proguanil

Question 6

What are the different malaria prophylaxis options and for what duration of time should they be taken before and after the trip?

Answer 6

Chloroquine - start 1 week before travel & for 4 weeks after leaving the area - the preferred choice for very long term prophylaxis over a couple of years however concerns re resistance.
Safe in pregnancy however concerns re resistance.

Mefloquine - start 2-3 weeks before travel & for 4 weeks after - can be used for upto 1 year. Can be used in pregnancy in 2nd and 3rd trimesters

Atovaquone with Proguanil (Malarone) - start 1-2 days before travel and for 1 week after - can be used for upto 1 year. Avoid if possible in pregnancy but can be used in 2nd and 3rd trimester if no alternatives.

Doxycycline - start 1-2 days before travel and for 4 weeks after - can be used for upto 2 years.
Contraindicated in pregnancy but if no other option can be used so long as course completed by 15 weeks gestation