Amazon cruise with P&O-anti malaria

[moonshine17]

We are doing an Amazon cruise With P&O IN January. We are sailing the Orinocho then the Amazon with only one stop at Santerem. We have to have the Yellow fever jab but will we need anti malaria, my doctors don't give travel advice they have told me to find a clinic, so I thought I'd see if anyone has done this cruise before.

Thankyou

[John Bull]

Hmmm - I'd be inclined to change surgeries, though I've heard of others getting a similar response.

Advice depends on your medical history, age, etc as well as your itinerary and you need to be sure your other jabs such as Hep are up-to-date, so it's perhaps foolish to rely too much on advice from us helpful amateurs.

That said:

 

A yellow fever innoculation certificate or certificate of dispensation (due to age or medical history) may be mandatory for countries or other areas of Brazil after sailing the Amazon.

Don't rely on ship's doctor for it - it needs a few days incubation before effective, & ship's doctor will charge an arm & a leg. Cost in the UK is around £40.

 

Malaria precautions aren't mandatory but are advisory on the Nat Health website

https://www.nathnac.org/ds/c_pages/country_page_br.htm

though it's a bit vague about those precautions & the use of anti-malaria tabs.

I do know that altho' some anti-malaria tabs can be bought without prescription there are at least two main strains of malaria in the world & if you choose to use tabs (I'd be incline to play safe) you need to be sure you get the right ones for the Amazon. Some have side-effects for some people, the more expensive ones are less likely to give side-effects.

There are other precautions, including where you go & when, clothing to cover legs, ankles & arms, and anti-mosquito sprays & your clinic should include that advice. Most important if you take a trekking excursion into the rain-forest.

 

If you seek advice from a clinic, take along your itinerary, make sure they're aware you'll be on a cruise ship & over-niting on board, whether you plan to spend an evening ashore (the place really isn't worth it), and that you'll be going as far as Santarem. Some ships go further, to Manaus.

 

The risk on the ship is very low, mosquitos don't like air-conditioning. But you will see some amazing huge bugs on deck :cool:

 

IMHO Santarem is pretty grubby & uninteresting but options from there include

- a riverboat trip past the wedding of the waters & up a creek - great fun, & easy to share a boat with fellow-cruisers on-the-fly (needs about 8 to 16)

- a trek thro' a bit of rainforest followed by a swim at an attractive sandy beach, again cheap & easy to fix on-the-fly with a minibus-load.

 

First & last days we found disappointing due to the size of the Amazon. Those day "cruising the Amazon" were like sea-days but the water was brown & you could see the shore in the distance.

Otherwise a great itinerary. :)

 

JB :)

[Fattony]

You want to find a travel medicine clinic if your doc's facility won't prescribe anti-malarial prophylaxis, so you want to know who else has taken this cruise?? Are you asking whether the prophylaxis are necessary? This is medical advice. There are many travel medicine clinics that give such medications and you should be able to find one with an Internet search and/or by calling local hospitals. Which medications are best depends on where you're going (i.e., the strain of malaria found there), as well as your personal medical history (e.g., allergies, sensitivities). You should definitely get the prophylaxis. Some people (non-doctors) might say better to do without due to possible reactions, but malaria is life-threatening and isn't to be trifled with.

 

One other mosquito-borne illness, dengue fever, is carried by specific types of mosquitoes. There is no vaccination (just avoid getting bit), but the most common strain is usually easily treated if treatment begins soon after symptoms appear. Good idea to educate yourself on both diseases (e.g., http://www.cdc.gov).

 

Be careful, and enjoy your trip.

Edited August 5, 2014 by Fattony

[KirkNC]

We are traveling up the Amazon in Feb. and the travel doctor we have visited told us we should take the pills. I forget the exact timing, seems like we start a little before we arrive.

[mathladyca]

Anti - malaria are taken 3 days before you go into an infected area and follow through to 3 days post area.( from my travel clinic doc) Some people on our trip took started taking it 3 days before they left the US and then they did not have enough left.

I would also take dukoral or something similar before trip and cipro with you.

Bugs can be picked up anywhere, even on star ships.

[Loreto]

Our travel advisor for our HMO prescribed malarone...not sure of the spelling...a tablet we started taking several days before entering the Amazon and continued after we left the Amazon. We experienced the side effects of a constant slight headache and continual upper respiratory symptoms ( all listed side effects.) A travel advisor should be able to prescribe something based on your age and health history.

 

As previously stated, use insect repellant liberally, bring sunscreen and take a prescription of cipro. Dengue Fever is something you don't want, so use the insect repellant. The Amazon is an amazing experience and worth the extra precautions!

[cruising cockroach]

Doxycyclone, which is similar to the antibiotic tetracyclone, is another malaria prophylaxis without the side effects of Malarone. However, there are dietary restrictions around when you take it (no dairy before & after 1-2 hours of eating) and it may make your teeth yellow and make you sensitive to sun so maybe not a good thing if you want to sun bathe.

 

This is my anti-malarial of choice. It's also a generic and cheap. You need to start 1-2 days before you get to the malaria zone, take it (once or twice) daily while you are there, and 2 weeks after or some such.

 

FWIW, a disturbing number of British travellers think they can develop resistance to malaria. Maybe if you carry the sickle cell anemia gene or some other genetic resistance that few northern European carry....

Edited August 7, 2014 by cruising cockroach

[Fattony]

You should consult a physician before choosing an anti-malarial prophylaxis. What medication to take depends not only on where you're going, but your own personal medical history and characteristics. You can get anecdotal "evidence" here, but side effects, etc. vary by individual. A physician may not be able to predict with complete certainty, but could give you useful advice.

 

Still use mosquito repellent, wear long sleeves when possible, etc.

[Fattony]

You should consult a physician before choosing an anti-malarial prophylaxis. What medication to take depends not only on where you're going, but your own personal medical history and characteristics. You can get anecdotal "evidence" here, but side effects, etc. vary by individual. A physician may not be able to predict with complete certainty, but could give you useful advice.

 

Still use mosquito repellent, wear long sleeves when possible, etc. Remember, there is no vaccine for dengue.

 

I worked in Mozambique for two years and switched prophylaxis due to side effects, but did so in consultation with a physician.

[Keith1010]

We have sailed the Amazon River most recently in 2013.

 

In the end, you have to figure out what is best for you.

 

I will tell you that unless you plan to go deep into the jungle at any of your port stops, and we did none of that, there is absolutely no need to take malaria pills during the cruise. And I am one who the bugs love and am very cautious.

 

If you do decide to go the route of the medication then discuss with your physician. When we have needed it we have taken Malarone for Malaria based on our physicians recommendation. It costs more than some of the others that are available but has less side effects and you just take it a few days before, during the stay and a few days afterwards.

 

Again, look closely at where you are going in port. In our case, there were no jungles and we did tours closer to the ports. Some of the ports are cities like anywhere else you may travel.

 

I encountered very few people on our cruise who used the medication.

 

And I am extremely cautious when we travel.

 

Keith

[moonshine17]

Thankyou for all your replies they were very helpful. I will seek medical advice , as we are in our early fifties and fit and we wont be going on any tours into the jungle just sailing through I hope we wont need them, but if we do I will be sensible and take them.

[Keith1010]

moonshine17, good luck with all of this.

 

If you are not taking tours that go into the Jungle you really don't need the malaria pills. Some physicians will push them just because that's what some do. Do some reading on all of this and then speak with the physician.

 

Keith

[sugarbird]

We did Buenos Aires to Manaus on Seabourn a few years ago. We did not take any malaria medication--no one we met from USA did--but a lot of Canadians did. Check with you doctor.

[sammiedawg]

The Brazilian expert on board our ship said anti malarial is absolutely not necessary unless you Are going very deep into the primary forest. Tourist do not get anywhere close.

[Tothesunset]

I hope the anopheles mosquito will cooperate with those who believe that they are safe as long as they stay away from the deeper jungle!

 

Playing Russian roulette with malaria has always struck me as a step too far in medical bravado. It's a nasty disease and one bite from an infected mozzie is all it takes. The prophylaxis is cheap, effective (as long as the correct medication is taken - take advice from a travel specialist) and has minimal side-effects.

 

However, if you have syphilis then a good trek, unprotected, through the jungle is a good idea as your malaria will induce a fever that, if it doesn't kill you, will at least kill the Treponema spirochaete that causes syphilis. (n.b there are eaiser treatments for syphilis available.)