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Malaria Risk and Travel Vaccine Information for Myanmar (Burma)

Myanmar (formerly Burma) Overview

Travel and tourism around Myanmar is becoming more and more accessible since the freely contested 2015 government elections, the first since 1990.  Travel to Myanmar is still problematic but rewarding for those willing to make the journey, with highlights like; the cities of Yangon and Mandalay, religious sites like Pindaya, beautiful scenery like Lake Inle, the ancient city of Bagan and serene white sand beaches of Ngapale.  

 

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

Myanmar (Burma) - Malaria Risk

What is the risk of malaria in Myanmar (Burma)? 

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

  • Areas below 1000m, including Bagan
  • Kachin
  • Kayah
  • Kayin
  • Shan
  • Tanintharyi

In other regions of Myanmar anti malaria medicine is not usually advised but could be considered in the following groups of patients who suffer the following conditions:

  • long term medical conditions
  • the elderley
  • 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 1000m.

Fitfortravel have an excellent map highlighting nalaria risk areas in Myanmar.

The 2017 World Health Organisation report in to Malaria transmission in Myanmar (Burma) showed that 8.4m people live din high risk transmission zones.  This led to an estimated 116,000 cases of malaria with deaths estimated to be approximately 200.  Myanmar nationals have had access to malaria treatments free of charge since 2003 and nets have been distributed free of charge since 2003.  Ongoing studies have shown a decline in the number of laboratory confirmed cases since 2005 with a similar decline seen for hospital  admissions and deaths also.

 

What malaria tablets should I take?

The following antimalarial tablets are suitable when travelling to Myanmar:

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

› Malarone Tablets 

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

› Doxycycline Capsules

Unfortunately due to resistance Travelpharm do not recommend Mefloquine (Lariam) in this region.

Vaccinations for Myanmar (Burma)

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

 

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 Myanmar (Burma)

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

  • Hkakabo Razi (5881m)
  • Other high altitude areas are typically found in the east and north of mainland Myanmar due to the wider Himalayan mountain range.

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 Myanmar (Burma)

Myanmar (Burma) 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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