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August 6, 2006

Jason down with Fever - Malaria Again?

Click on image to play video (high speed connection advised).

LOCATION: Mengyuan, Yunnan Province, China
SEE WHERE WE ARE!
Longitude: N: 21.65541°
Latitude: E: 101.67260°
Miles from Singapore: 2472

After contracting Malaria (P. vivax) earlier this year following the Indonesian leg I had no interest in having a repeat performance on this leg through SE Asia, especially as we'd be traveling through some very remote regions with little access to medical facilities. So, with the advice of various of medical friends a formidable arsenal was put together for both field diagnosis and treatments that included both western and eastern medicines. I would take Doxycycline for prophylaxis, seeing as the route would take the expedition through the increasingly drug-restistant areas of Northern Laos and Southern China (i.e. where we are now!), and if this didn't work 'then let the little blighters do their worst!' These were my thoughts as I trundled out of Singapore weighed down by what seemed (at the time) to be an excessively heavy first aid kit.

Since reaching the malaria belt I've been super-careful to not get bitten, wearing long trousers and shirts in the evening as much as practically possible, and lathering 100% deet on all other exposed regions of flesh. It seems however that I have not been careful enough.

My joints were feeling slightly achy during the two steep 13km climbs out of Mengla yesterday, but nothing too serious. Melissa then had to backtrack on a bus to retrieve her mobile phone left at the guesthouse in Mengla by mistake, so the rest of the day was a wash and we checked into a little guesthouse here in Mengyuan. By the time she arrived back at 5pm I was just starting a 3-stage fever cycle, with a 2 hour cold stage (during which I was wearing ALL my Himalaya cold weather gear under the duvet/comforter and still freezing), following by a hot stage and a third sweating stage, with a fluctuating temperature of between 38-39 degrees (controlled by ibuprofen), that's been the story for the last 20 hours. Although things have stabilized at the time of writing.

We used a field test kit (thanks Alex from Austria for putting me on this!) to test for Malaria. Even though kits like these are reported to contain a 15-20% error factor, when you're 16 hours drive along mountain roads from the nearest decent hospital, as we are now, they're certainly better than a poke in the eye with a sharp stick. A fever in this part of the world means malaria unless proven otherwise. So if we could at least reduce or eliminate the likelihood of malaria, this might make decision-making easier as to what best to do.

Plasmodia falciparum attacking red blood cells

Even though we didn't get quite the full amount of blood recommended (Melissa is afraid of too much blood), a faint trace on the test cassette indicated the presence of P. falciparum. While the most dangerous of the four plasmodia in terms of leading to cerebral compications and over one million deaths each year worldwide, the good news is that we have the ammunition to deal with it! Currently I'm taking a concentrated course of Malarone combined with a herbal treatment called artemisinin used by Chinese practitoners since A.D. 341 where it has proved to be the best-ever anti-malarial drug (and I'm quoting an excerpt from an article in a medical journal my friend Dr Sharon Kessler in the US sent me!). However, it is not yet currently available in the west (no surprises there). For anyone interested you may be able to order it from this website (keyword 'malaria' for Artesunate Tablets).

Melissa has been looking after me wonderfully, badgering me constantly to drink more water and other healthy things I normally try to avoid to much overindulgence of. The most unexpected surprise of the whole recovery plan has been the revelation that the guesthouse is located directly above a raging Chinese Karaoke Bar. And it's Friday night. They have bass speakers. Ohhhh joy. Praying for a power cut right now....

jason

Melissa's blog

Posted on August 6, 2006 10:06 AM

Comments

Posted by: tagami at August 6, 2006 8:09 PM