Most people contract malaria when they are on holiday, but my brush with the
disease was a little more dramatic. I was 22, and nearing the end of a dream
trip crossing the Amazon basin. Things had been going amazingly well. I was
taking the malaria tablets my GP had prescribed, and I had learnt to adapt
to life in the jungle, with the help of a local Indian tribe. Then I came
across a group of goldminers. It was obvious they didn’t like me, and,
looking back, I think that they were either on the run or they had found a
lot of gold. One night, I overheard them plotting to kill me.
Instinct told me to flee. I ran down to the river and got into my canoe, in
which were all of my supplies and a dog called Cashoe, who had followed me
everywhere. Disaster struck — I capsized, and everything, including Cashoe,
was washed away. I was wearing a survival kit around my waist, and my
emergency malaria pills were in there, but they were a soggy mess and
completely ruined.
Sitting on the riverbank, I was in shock. In that kind of situation, you don’t
want to think about how bad things can get, so I just got up and walked.
Days went by. I was foraging for food as I went along, but hardly ate
anything, and I became weak with hunger. I developed a fever that came and
went. After about a week, I knew that I didn’t just have a bad case of flu —
I had malaria. I suspected I had the Plasmodium vivax strain,
because fever is a classic symptom. I also began to get terrible cramping in
my liver and pains in my spleen and ribs. And then the chills set in. I
started to shake uncontrollably, so much so that I was unable to sit still.
I would feel extremely hot one minute, bitterly cold the next.
Thankfully, I didn’t know that I had the P falciparum strain of
malaria. If I had, I would have tried to sprint out of the forest, rather
than carry on staggering. P falciparum is potentially fatal — it
can turn into cerebral malaria and kill you within 24 hours.
It got to the stage where I thought I was going to die. Then, out of nowhere,
Cashoe came back, which lifted my spirits, but I was so close to starvation
that in the end, I did what I had to do in order to survive. I was so weak
that I hardly even remember killing or eating him. After a month, I made it
out of the jungle and was taken to a local hospital. They took a blood
sample that showed I had both sorts of malaria: the P falciparum and
P vivax strains. I was lucky. After a couple of weeks, I felt like
myself again. You can suffer relapses with P vivax, as the parasite can lie
low in the liver, but I didn’t. And you don’t develop any resistance once
you’ve had it, the way you sometimes do with P falciparum.
A year later, I set off for Papua New Guinea. In the forest, while living
among a remote community, I took part in an initiation ceremony to make me
“a man as strong as a crocodile”. It lasted six weeks, and involved the
cutting of my skin in hundreds of places up and down my chest and back. I
also had to surrender everything I owned, including the malaria tablets my
GP had prescribed. I pleaded to keep them, but the elders said: “Well, if
you take them, everyone else has to.” So they were passed around.
Two weeks later, I returned to England and started to feel flu-like symptoms
again. I was whisked into hospital to have a blood test, which showed I had
the P vivax strain again. I was treated orally, and stayed in
hospital for three days. I was told to drink lots of fluids and to avoid
stress and strenuous exercise. I recovered in a few weeks, with no long-term
effects.
People from high-risk countries who emigrate to the UK are especially
vulnerable to malaria. They settle here and lose any immunity they once had.
When they go back to visit, they don’t take medication, because they assume
they will be okay.
More and more people in the UK are contracting malaria, because travel to
far-flung places is no longer a big deal. Some of the most popular
destinations are in malarial zones. I could go on the internet, book a
flight and be back in the Amazon tomorrow. Some people don’t bother to take
the pills: they are lulled into a false sense of security and think they
won’t be at risk in a tourist resort, or they are afraid of the side
effects. But the pills do work well when taken properly, and the malaria
medicines that have bad side effects are a thing of the past. It is a
question of getting the right medication for the right place. Go to your GP
and ask for the latest advice, because things do change.
You should also use an insect repellent that includes Deet. The malaria
mosquito only bites between dusk and dawn, so cover up during these hours.
Malaria can take weeks, or even months, to develop, so if you have been back
a while and are feeling unwell, go and see your doctor — it could save your
life.
Benedict Allen talked to Jini Reddy
BEFORE TRAVELLING
1. Find out if you are visiting a malarial region. Ask your
GP, visit www.fitfortravel.scot.nhs.uk,
or call the Nomad Travel Clinic on 0906 863 3414.
2. Find the antimalarial medicine that is right for you. The
drug you are prescribed will depend on where you are going, the time of year
you are travelling and your medical history. Some drugs are more effective
in some parts of the world than others. For example, the oldest antimalarial
drugs, chloroquine and proguanil, are no longer effective in many areas.
3. Consider the side effects. There are three main types of
antimalarial medicine. The side effects of mefloquine (Lariam) can include
hallucinations, dizziness and depression and, in extreme cases, psychotic
episodes. However, the number of people who suffer from such episodes is low
(about 1 in 10,000). Doxycycline can cause thrush in women, while the
combination drug proguanil with atovaquone (Malarone) has not been known to
cause serious side effects.
4. If you are planning to take Lariam, take a test dose for
2-3 weeks before travelling. This will enable you to establish if there are
any problem side effects. If there are, there is time to switch to a
different medicine.
5. Complete your course of medicine. Contracting malaria
could be far worse than any side effects.
THE SYMPTOMS
Initially, these can include: headache, vomiting, fatigue, muscular pains,
diarrhoea and fever. Patients can rapidly progress to delirium, impaired
consciousness and generalised convulsions, followed by coma and death. The
symptoms of the most life-threatening type of malaria usually occur between
one week and two months after infection.
