If you think something small can’t make a difference in life, think of a mosquito. One sleepless night, ruined picnic or one sore arm, a single mosquito can be the cause of so many of life’s displeasure’s. Unfortunately for travelers and many in the developing world, it is a little more serious. Mosquitoes carry two serious vector borne diseases: dengue and malaria. While there’s no vaccine or cure for dengue, there are chemical prophylaxis to help prevent malaria.

We’ve gotten a lot of questions over the last 16 months about malaria medications and we’ve asked plenty ourselves. Here’s how we came to our decision.

To drug or not to drug, that is the question.

The ever growing global discussion on vaccines, use of pharmaceuticals and immunizations is alive and well in the world of travel. We met several long-term backpackers in South America who took no prophylaxis against malaria. On the other hand, we didn’t meet a single traveler in Africa not using a chemical prophylaxis. To put that in perspective consider this: approximately 90% of deaths due to malaria occur in Sub-Saharan Africa.

We began researching our options and speaking with our doctors regarding the different drugs. We wanted to take a chemical prophylaxis for a few reasons: 1) we didn’t want to get malaria, 2) we believe that the potential side effects of the drugs are less damaging than the disease itself and 3) we did not want to contribute to the spread of malaria across regions. Spreading Malaria is no joke, if we were to be infected with a particular strand in one region we risk spreading that strand to another region when we travel there. In some countries malaria accounts for over half of hospital admissions and public health spending. We try to be responsible in our travels and for us we didn’t want to take the chance that we could carry a new strand to a previously unaffected region.

We based our decision on where we would be, the potential side-effects and the convenience of the drugs. We knew we didn’t want to carry a daily drug with us, the storage space aside, its never good to show up at a land border carting around boxes of pills. Also, we wanted to take a drug that’s effective in nearly every region on our itinerary. I wish I could say my regular doctor was helpful in leading the discussion about the options, but she unfortunately was not. Although Danny’s doctor was more willing to educate himself on the possible side-effects and have an informative discussion with him, I think the situation I faced is probably more normal. If your regular doctors is unfamiliar speak with someone at a travel clinic who can guide you through the options.

Besides taking a chemical prophylaxis, we also bought an insecticide treated mosquito net. Although most places we slept in had mosquito nets, it was good to have our own for the few places that didn’t.

The Options

There are several chemical prophylaxis options on the market. You should discuss with your doctor which one is best considering your time frame, travel locations, risk of transmission and medical history. No matter your choice you should always take precautions against mosquito bites, especially dusk to dawn when transmission occurs.

Immunity?

Several promising vaccines are under development around the world, however none has yet been proven to develop immunity to the disease. You cannot build up immunity to malaria by drinking the local water. Seriously. People with sickle-cell disease or carriers of the trait have a substantial protection against malaria. Because the disease causes a deformation of the red blood cell, the malaria causing parasite attached to the red blood cell is destroyed before it has a chance to reproduce.

Now that we’re off to Africa we figured it was about time to get our Latin America summary out there. Epic bus journeys in the south and more than a month of nights sleeping on buses…its been a real adventure.
Here’s a summary of the most “fun” statistics for the last 9 or so months:

8.5 – Months spent on the road

33 – Nights spent on a bus (Jillian’s note: We should have calculated our total hours on the bus!)

23 – Nights spent couchsurfing

20 – Hours of longest single bus ride

4 – Viewings of Transporter 3 on the bus

2 – Bathroom breaks from the bus where there was no bathroom present

15 – Countries visited

41 – Passport Stamps

2 – Hemispheres enjoyed

2 – Gastro-intestinal lab tests

4 – Ferry crossings

1 – Train

11 – Planes

6 – Most consecutive nights in the same bed

6 – Volcanoes hiked

2 – Active volcanoes hiked

6 – Rivers kayaked

4 – Guidebooks

4 – Countries where we bought and paid for a local telephone number

3 – Largest continuous amount of time, in hours, between March 13th and November 30th we spent apart…

It should be no surprise that along with lots of ruins, whitewater and trekking, our tour of the America’s also included beer. Lots and lots of beer. From Mexico to Argentina beer seems to be the local beverage of choice, and almost always its cheaper than soda or sometimes even bottled water. It was not unusual for us to find a liter of beer for less than $3. When it’s that cheap you just have to try it. So we did.

On what is now called our quest for beervana (thanks to our friends for the name), we’ve sampled the local brew in every locale, from ice-cold Salva Vida in Honduras to an amber Beagle down in Ushuaia. There have been some good beers, some beers good for the moment, and even one green coca beer in Peru. Most beers produced in the America’s are lagers or pilsners and it seems the hotter the country the colder the beer. The coldest beer we’ve seen was in Honduras and fortunately at the time we were sweating to death. According to the thermometer on the refrigerator the beer was stored at -9 Celsius (about 15 Fahrenheit). It was perhaps the most refreshing and delicious pilsner in the world, or at least at that moment.

Our quest for beervana has turned into challenge to create a substantial beer label collection. We’ve taken the labels off all sorts of bottles, many of which have been mangled in the process. Just for the record the sticker labels are the hardest to take off. Our quest to build a collection has resulted in choosing our selections by the label not the actual beer, which in some cases has led to mistakes such as the coca beer.  It has also led us to some delicious Colombian micro-brews and copious amounts of Brazilian  chopp (draught beer), err… maybe not the chopp.  That might be our own fault.

Our quest for beervana continues while we’re on “intermission” at home. This week we headed to the Yuengling (my home brew) in Pennsylvania for a factory tour and tasting. Danny and I have been trying to get there for years, but for one reason or another it never worked out. Fortunately the quest for beervana took precedence this time and we finally made it. It was by far the best factory tour ever and not only because it ended in a beer tasting, actually truthfully it was because it ended in beer tastings, two in fact.

Anyway, as we head to Africa have no fear,  the quest for beervana will continue. Fortunately we’ve spent enough evenings at Brickskeller to know which African beers to avoid, but we’re always open to suggestions. Anything out there you think we should try or avoid? Where do you want to share a beer with us?

Salud!