Malaria, mobs and other travel buzz-kills

Randi is on a brief leave. This column was originally published Sept. 4-10, 2014.

I have begun to worry about malaria, and I’m taking malaria prophylaxis, even though I’m not about to leave for a safari or the wilds of Myanmar anytime soon.
I’ll wager, right now, that I am the only non-traveling person in our entire reading area who is taking malaria prophylaxis. The disease is not endemic to the U.S., so why take a preventive? (Explanation to follow.)
Even those who don’t venture beyond the bridges and tunnels, and don’t fancy foreign travel, know there are places in this world where the Anopheles mosquito carries malaria. It threatens 3.4 billion people, half the world’s population, almost all of whom live in developing countries. The disease killed some 650,000 people last year. You get a bite, a few days later your fever spikes and you begin to shake with bone-rattling chills. In many countries, there is no treatment available; people suffer and die.
Here on Long Island, we have relatively benign mosquitoes that crash our backyard barbecues, tormenting those who forget to use repellent. For decades they have been no more than a nuisance. But recently (and this is what got me thinking), there has been serious concern about the mosquitoes that carry West Nile virus, a disease the bugs contract from infected birds.

Last week, in an effort to mitigate that threat, Nassau County sprayed vast tracts of the South Shore during the overnight hours. Go, big government!
In the past, there have actually been small, isolated outbreaks of malaria in the U.S., caused by healthy mosquitoes biting sick people who carried the malaria parasites from their travels. The mosquitoes then bit other humans, spreading the disease. Those outbreaks were all easily contained, because we have a relatively efficient public health system.
While West Nile is a homegrown problem and our government is effectively addressing the threat, malaria is out of control in many areas of India, Southeast Asia and Africa.
We’re planning a trip to India and Africa later this year. Our doctor is adamant about requiring malaria prophylaxis. The best choice is Malarone, he says. Unfortunately, Malarone and I have a history. Several years ago, I took it when I traveled to Cambodia. On the fifth day of taking the pill, I got really sick. I figured it was the pill, and stopped taking it. I felt better within hours, and I didn’t get malaria, although I traveled for two more weeks through India. This led me to the logically flawed conclusion that I don’t need protection from malaria.
The doctor believes I may have gotten sick from something other than the medication. So he suggested I take Malarone for 10 days while I’m home and safe in my own neighborhood. Thus, the malaria prophylaxis. So far, so good. If the test goes well, I’ll take the pills every day during the trip. According to the Centers for Disease Control and Prevention, even the prophylaxis is only 90 percent effective, and travelers who visit African game parks are advised to wear cover-up clothing and to use repellent with DEET.
All this anticipatory medication has made me rethink the entire enterprise of foreign travel these days, especially to places like India and Africa. Fear of mosquitoes, I realize, is a metaphor for all the dangers of such travel. When I read the newspaper, I realize that malaria is probably the least-worst thing that might happen on a trip to sub-Saharan Africa. Is there a vaccine against al-Shabaab?
It’s easy to make the argument for staying stateside. And some of our friends and family are urging us to reconsider our plans. Here at home we have clean food, pure water and relatively safe streets. There is good oversight of public services and infrastructure and transportation. Our doctors are well trained and available. There’s no Ebola.
On the other hand, you probably won’t see a rhino in the wild unless you travel, and you definitely won’t see Cape Horn or the lemurs of Madagascar.
I think the desire to travel beyond the I-95 corridor, the willingness to put up with inconvenience and risk and cost and medications, has to do with one’s basic philosophy of life. Or perhaps it’s just foolishness; I’m not sure which. Maybe it even has to do with one’s sense of mortality. We can play it safe, or we can seek out new experiences. I find myself thinking about people who live in Mumbai or Mombasa, and I want to see what their lives look like up close. I want to see the colors of another culture. I want to see the children’s faces.
After all, you and I won’t get to do this dance again. While we’re out on the floor, shouldn’t we kick up our heels?

Copyright 2023 Randi Kreiss. Randi can be reached at randik3@aol.com.