Malaria Risk and Travel Vaccine Information for India

India - Travel Overview

Travel to India is very popular and rewarding with stunning scenery and fantastic culture but India is a very large country and has potentially many risks that need preparing for.  Popular destinations include Goa, Kerala, Mumbai, Punjab, Delhi, Agra, and Kashmir, but India has so much more to offer than these highlights.    

 

The following sections contain information on the risk of malaria, what vaccines are recommended and other important issues you may face.

India - Malaria Risk

What is the risk of malaria in India? 

It is the opinion of Travelpharm that customers to India are at moderate risk of contracting malaria and therefore they should observe strict bite avoidance measures.  The risk for UK travellers is considered to be Low but it is the opinion of Travelpharm that travellers visiting the following areas take anti-malaria medicines: 

  • Assam
  • East Godavari, Srikakulam, Vishakhapatnam and Vizianagaram in the state of Andhra Pradesh
  • Orissa
  • the districts of Balaghat, Dindori, Mandla and Seoni in the state of Madhya Pradesh
  • the district of Amini in Arunachal Pradesh
  • north-eastern states of Meghalaya
  • Mangalore.

those who have the following conditions::

  • long term medical conditions
  • the elderly
  • immunocompromised

and also long term travellers or those visiting rural remote locations.  CDC states that risk to US travellers is moderate and transmission is known to occur in all areas of the country below 2000m including cities.

 

Information made available by the WHO shows that in 2017 162.5 million people in India lived in high risk transmission zones, with an estimated 9.6 million cases of malaria leading to nearly 17,000 unnecessary deaths. The positive is that confirmed cases are decreasing year on year due to investment in preventative measures.  

 

What malaria tablets should I use?

Vaccination Requirements

Below is a table designed to show you what vaccines are mandatory, recommended or ones to consider when visiting India:

 

Cholera

Hepatitis A

Hepatitis B

Japanese Encephalitis

Meningitis

Rabies

Con

Rec

Con

          Con

 

Con

 

Tetanus

Tick Borne Encephalitis

 

Typhoid

 

Yellow Fever Vaccine

Rec

  

Rec

 

A certificate is needed if arriving from transmission risk country.

 
Man = Mandatory
 
Con = Consider
 
Rec = Recommended
 
Req = Required if visiting from area with risk of transmission

Areas of High Altitude in India

India has areas of high altitude because of the Himalayas.  High altitude is defined as being over 2500m.  Some notable examples in India include:

  • Darjeeling (2127m)
  • Leh (3514m)
  • Dugri-La Pass, 5,608m.  The worlds highest motorable mountain pass

Travel to high altitude can cause several conditions which include Acute Mountain Sickness (Altitude Sickness) and the more severe High Altitude Pulmonary Oedema (HAPE) and High Altitude Cerebral Oedema (HACE).

Symptoms of Acute Mountain Sickness include headache, fatigue, loss of appetite, nausea and sleep disturbance  Improvement will only occur by descending to lower altitudes.  Complications can occur for persisting with ascent that can lead to swelling around the brain or fluid collecting in the lungs.  Ultimately HAPE and HACE can prove fatal.  

Prevention is by slow ascent (no more than 500m per day once over 3000m) and by ensuring travel to high altitude areas from low altitude areas is not done in a single day. 

Travel Health Pro have an excellent resource for helping to determine a patients risk based on previous experience and elevation.  The information is available here  

Patients potentially at risk due to unavoidably rapid ascents, or those with previous experience of Acute Mountain Sickness may benefit from taking Acetazolamide (Diamox).  Travelpharm offer a free online consultation service should you wish to purchase this.  

Travellers Diarrhoea in India

India has a high prevalence of reported cases of travellers diarrhoea with an expected risk of suffering illness greater than 20%. It is important to ensure you observe strict hygiene and to be careful of what food and drink is being consumed.  We have a handy guide available in our travel blog and we also stock a large selection of medicines to help ease your symptoms in our stomach and bowel section.  

 

How to order?

Travelpharm offer an Online Consultation service to make it simple and convenient for you to get hold of your anti malaria tablets without having to book a visit with your doctor. Our online consultation service means that we are able to ask you a number of questions during the ordering process, and when we receive your order it is reviewed by one of our pharmacists who will then dispense your items from our UK registered pharmacy.

How it works:

Ordering products with an online consultation service is simple:

1. Select Tablets

2. Complete Questions

3. Checkout

  1. When ordering a product that has the option for an online consultation, simply select the 'Online Consultation' option and click the 'Add to Basket' button.
  2. Next, you will be prompted to answer a series of medical questions that are related to that particular product, for example, the number of people requiring the tablets, your GP's information, the length of stay in the risk area, any medicine you are currently using and if you suffer from any other health issues. When you have answered the short questionnaire, your tablets will be added to the basket ready for you to checkout. 
  3. When we receive your order, our pharmacist reviews the information given in the consultation, and if we don't need to contact you for any more information, the item is dispensed from our UK registered pharmacy and sent out in the post to you. The item is sent out as requested during the order process, items sent 2nd class are sent free of charge, and will be with you in 3 - 5 working days.

 

Online Anti-Malaria Consultations:

If you are visiting a country that has risk of malaria, then it is important to take the necessary precautions so you do not pick up the disease when travelling.  There are a range of anti malaria tablets available, and the type of tablet you require will depend on factors such as the area you are visiting, the length of stay, your medical history and drugs you may already be taking. All our medicine are legallysourced and dispensed in the UK, our credentials can be checked against the General Pharmaceutical Councils register.

Travelpharm supply popular anti malaria tablets, such as Malarone, Maloff, Doxycycline, Lariam, Atovaquone & Proguanil, which are generic Malarone tablets. These tablets are designed to provide protection from malaria, however certain tablets are designed to be taken at different stages, the table below shows how and when the tablets should be take. Always read the product leaflet before taking any tablets:

 

 Malarone
(Atovaquone & Proguanil)
DoxycyclineLariam
 How often should tablets be taken? 1 tablet each day when in the risk area 1 tablet each day 
in risk area
 1 tablet each week 
 When should I start treatment? 2 days before entering 
the risk area
 2 days before entering the risk area 10 days before entering the risk area
 How often when leaving risk area? 7 days when leaving 
the risk area
 4 weeks after leaving the risk area 4 weeks after leaving the risk area

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