Wednesday, August 17, 2011

Lucky With My Bad Luck

Trying not to get malaria is like playing Russian Roulette with about 10 gazillion mosquitoes.  Thing is, the odds are actually in your favor NOT to get malaria.  Only Anopheles females carry it.  A mosquito has to bite a person infected with malaria, wait about a week while the parasite makes its rounds ending up in the mosquito’s saliva, then that mosquito has to feast on you. Once you are bitten, the parasite travels to your liver where it grows and multiplies, then it enters your bloodstream and gets into your red blood cells where it continues to grow, and once it matures it causes your red blood cells to burst.  This usually takes about 48 hours and that is when you get a massive fever.  Malaria-related fevers tend to be cyclical and they occur when these red blood cells burst.  I looked this up online yesterday.

I’ve heard from many other travelers here that along with its gorgeous coastline, Mozambique is a bit notorious for its malaria infections.  I’ve also heard a number of horror stories from locals and others about their bouts with malaria – a two-day drive with a high fever to the nearest doctor, raging diarrhea and vomiting, six months of deafness, getting malaria three times within six weeks.  All this being said, while I was unlucky to get malaria, I am so lucky about where I was and who I was with.

The prophylactics you can take are only up to 95% effective.  There are three different ones: malarone, lariam, and doxycycline.  Malarone has the least amount of side effects, but costs $10/pill and is simply not feasible for a trip of this duration.  Lariam has a crazy amount of awful side effects including that it can actually make you crazy, and neither of us wanted to risk that.  So we took doxycycline.  For about two weeks.  Side effects included severe sun sensitivity, headaches, tingling nose and digits, and yeast infections.  We were both unhappy on it and couldn’t bear the thought of nine months worth of these side effects, so we got off it.  I had to get back on doxy for about a week when I got sick in Lesotho (it’s an antibiotic) and for that week the sunburns, headaches, tingling were a good reminder that I was glad I was off it.  So we’ve been doing what many other expats or overlanders do, take other precautions – long pants, bug spray, and mosquito nets.  I’ve been diligent about all of these, opting to use 100% DEET instead of the all natural stuff and painstakingly tucking in the mosquito net no matter how many times I get up in the middle of the night to pee.  It just takes one unlucky bite though.

On our return trip from the Quirimbas Archipelago with Laura, Pete, and Lucas I felt like I was coming down with something.  The boat ride was about three hours long, during which my lower back hurt, my throat ached, I was tired, and I was cold.  Once in the car I started feeling slightly nauseas and achy and I made Anne feel my forehead – no fever.  By the time we reached Pemba 2 ½ hours later I was burning up.  All I wanted to do was get to camp and lie down.  Anne asked Laura and Pete if they had any Panado (fever reducer) handy and they did not.  However, Laura – just the previous week – also had malaria (and she is even on prophylactics), and she and Pete both said ‘we’re going to the hospital – it’s fast and cheap to get tested.’  I was lucky to be in a place where there was a doctor and a pharmacy.  If it wasn’t for them I would have waited at least a day, but instead within a few hours of coming down with a fever I was tested and got the medication.  

The hospital was a bit of an experience. We walked in and, once we found someone who spoke Swahili, we paid $1.30 and were seen right away. The “doctor” spoke mostly to Anne, despite the fact that he also spoke English, and never bothered to take my temperature. He asked me twice what I was “doing” and how I found Mozambique and the people.  Anne says he was also implying that we would have to pay extra to get everything done because we were “strangers.” Luckily, that didn’t happen. The hospital was large and clean and fairly empty. The guy who drew my blood took three tries to get the needle in my vein and that hurt, but the blood test was quickly returned with a note saying “positive.”

I was lucky Pete and Laura were so insistent I get tested right away and I was lucky to catch it early.  They came back to pick us up, then drove us to a pharmacy to get the rest of the medication, then on to a guest house where we could get an en suite room in case I got raging diarrhea, which luckily, I did not.  I completely owe my mild case to these two – thanks for everything.

Laura and Pete - my malaria angels.
 That first day was one of the worst days of my life.  Raging fever, terrible headache, muscle aches, lower back pain – all the classic flu-like symptoms.  I had a difficult time sleeping that afternoon and just laid in bed wallowing in my misery.  I finally took some Benadryl to help me sleep and in the morning, or rather 14 hours later when I woke up, my fever was gone.  I spent about 40 hours in bed getting up only to use the bathroom.  I was weak and utterly exhausted.  Anne made sure I took a shower and drank water and ate and took my meds (three different ones: 1) malaria treatment 2) antibiotics 3) fever reducer) and she did the laundry and ran the errands and got attacked by a monkey (seriously, sort of) and found us a cheaper place to stay.  By the third day I was much better.  Still exhausted with an occasional headache and tired muscles, but nothing like that first day.  This is day four and I’ve been sitting almost all day, which is actually a big deal.  I think one more day of rest and then on to Tanzania.

So far I have had a fever above 102°F twice and we’ve been to the doctor three times for me.  Anne?  Well, she’s had a bad cold.  What gives?  Is her body accustomed to the germs and bug bites here from her time in Tanzania?  Do I have a horrible immune system?  Is this because I’m pushing 35?

Speaking of painful tropical diseases, this reminds me that we met a med student in Malawi who said he met someone at the clinic where he was working who got schistosomiasis after swimming in Lake Malawi in Nkhata Bay where we stayed three weeks ago.  So, I think we’re going to get the treatment for that as well, just to be on the safe side.

P.S. Don’t let Jeanette mislead you. I was definitely attacked by a monkey. At around dusk I took a short break from my vigil by Jeanette’s bedside to seek out some food. As I walked down the busy street that went by the beach I felt something on the back of my leg. My first thought was that I was being pick-pocketed, but there are definitely no pockets on the back of my bare calf. Then I thought, maybe a dog is down there, but dogs don’t grasp things. I look down and there was a sneaky little vervet monkey grabbing onto my leg! I tried to get away from it, and it kept following me. I think he confused me with palm tree – pale color with darker lines, just like my hairy legs. Everyone else on the street was in hysterics. The monkey and I were just confused. I quickly moved away, and he quickly climbed a real tree. No blood was shed during the incident, which is good. Monkeys carry a lot of diseases that are even worse than malaria.    

1 comment:

  1. Oh, poor Jeanette! I feel for you but I am happy for your good malaria luck (if there can be such a thing). Thankful you got treated right away. I hope you are soon feeling much better. I have to say that you two have confirmed my opinion that I would never do such a trip. I know I am a wimp but I could not deal with all your "adventures." :) I will just live vicariously through you. And I had to laugh about the monkey attack, sorry, Anne. xoxox