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Malaria Risk and Travel Vaccine Information for India

 

India (Asia) - Travel and Malaria Risk 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.  Risks include malaria (in some parts of the country) which may require malaria prevention tablets, but there are other risks that may require travel vaccines or good avoidance measures to prevent. 

Popular destinations for travellers in India include Goa, Kerala, Mumbai, Punjab, Delhi, Agra, and Kashmir, but India has so much more to offer than these highlights.    

Have you considered the risks you might face?  Even travel to 5-star hotels and resorts present risk.

Do you want to be one of the statistics?

If not then read on as the following sections contain information on the risk of malaria in India, what vaccines are recommended, and other important issues that you may face on your trip of a lifetime to India.

India - Malaria Risk and Vaccine Requirements

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 in order to reduce the risk of malaria transmission by mosquitoes. 

Officialy risk for UK travellers (according to UK sources) is considered to be Low but it is the opinion of Travelpharm based on CDC and UK sources 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.

and those who have the following conditions::

  • long term medical conditions
  • the elderly
  • immunocompromised
  • travellers without a spleen

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 take?

The following anti malaria tablets are suitable when travelling to India:

› Atovaquone and Proguanil 250mg/100mg- Generic Alternative to Malarone

› Maloff Protect Tablets

› Malarone Tablets 

› Malarone Children's Tablets (for Children under 40kg weight)

› Doxycycline Capsules

› Lariam Tablets (Mefloquine 250mg)


How many malaria tablets should I order?

To help you fathom this impossible conundrum our clever pharmacist created a great calculator to help you work out how many tablets you need.  We have a calculator that will help you calculate the numbers of tablets required for:

Simply fill in the blanks with the details of your trip, and it will tell you how many tablets you need to order. Easy! 

 

What Vaccinations do I need for India?

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 an area with risk of transmission

Areas of High Altitude in India and Altitude Sickness Prevention

India has areas of high altitude because of the Himalayas.  You'll be glad to know that Malaria is not present at high altitudes so no malaria prevention tablets are required if all your time is spent above 2000m.  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 an accent 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 has 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 offers a free online consultation service should you wish to purchase this.  

 

Travellers Diarrhoea in India - Treatment and Prevention

India has a high prevalence of reported cases of travellers diarrhoea with expected risk of suffering illness including stomach cramps, diarrhoea, fever and potentially vomiting at greater than 20%. It is important to ensure you observe strict hygiene and to be careful of what food and drink are 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.  

Travelpharm also sells a great product called Xifaxanta.  Xifaxanta contains Rifamixin, which is an antibiotic treatment for travellers diarrhoea.  Rifamixin is totally non-absorbable, so has few side effects, and can be used for travellers diarrhoea where there are approximately 6 watery stools over 24 hours and mild to moderate cramping without blood in the stools.  

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