Lariam. and it's freekin' expensive. Generic cost me $20/pill in 2006

It is transmitted through the bite of the female anopheles mosquito. The symptoms of malaria may occur in as little as 10 days after infection, but sometimes may not occur for several weeks or months after exposure. Malaria resembles the flu, and may in fact mimic many illnesses. The classical symptoms include headache, chills, feeling hot and cold and muscle aches and pains. The most important sign of malaria is FEVER. Classically the fever recurs every 48 hours, but this is not always the case. There is a fair bit of controversy and misinformation regarding both malaria and its prevention. Here are the facts! * There are four strains, and only four strains, of human malaria. * Plasmodium falciparum is the most serious strain, and the only one which may be fatal. This same strain is the one responsible for most of the drug resistance around the world. Drug-resistant malaria is not a new thing. It has been around since the 60's, but its distribution has been expanding. Chloroquine-resistant malaria is now found in all malarious areas of the world with the exception of The Middle East, Haiti and Central America. * Personal measures such as DEET- containing repellents and mosquito nets are extremely important in preventing malaria. * Malaria is often misdiagosed and mistreated in travellers who return home. * Malaria is a treatable infection, as long as it is treated promptly and properly (sort of like a heart attack). * It is a myth that once you have malaria, you have it for life. There are two strains of malaria which may persist in the liver and recur, Plasmodium vivax and Plasmodium ovale. However, this "dormant" stage can be eradicated with the drug primaquine. * Malaria is usually a preventable infection. There are good drugs to prevent malaria. Unfortunately, there are no perfect ones. * Many people say that antimalarials are worse than the disease. Ask someone who has had cerebral malaria! ANTIMALARIAL MEDICATIONS MEFLOQUINE It was first developed in the 60’s during the Vietnam War because of the emergence of chloroquine-resistant falciparum malaria. Mefloquine is taken weekly, also beginning the week before travel, weekly while away, and for foour weeks after travel. It must be taken with food, preferably in the evening, and preferably not with a bucket of alcohol. Minor side effects occur in up to 15% of people. These include stomach upset, dizziness, vivid (good, bad, erotic and otherwise) dreams, insomnia and anxiety. More serious side effects, such as seizures and psychosis, are relatively rare. These side effects are usually transient, and may dissipate with time. Remember, most side effects do not occur in most people most of the time. Many of the same adverse effects are reported with chloroquine. Mefloquine should not be used in those with a history of epilepsy, depression, cardiac rhythm abnormalities, or perhaps those who have had a problem on it in the past. It is safe in children, and may also be used in pregnant women who have no choice but to travel to malarious areas. Mefloquine is a touch expensive ($5.30 in Canada, up to $10.00 in the USA), so some people may chose a cheaper alternative. It may often be purchased for less in tropical countries. DOXYCYLINE (Vibramycin) Doxycycline is an antibiotic, which is quite effective in preventing chloroquine-resistant falciparum malaria. It can be used in those who can not take mefloquine, and those who do not want to take mefloquine. It must be taken on a daily basis, starting the day before entering the malarious area, daily while away, and for four weeks after departure. It must be taken with lots of water, or it may irritate the esophagus. As it can cause photosensitivity, sun precautions must be used. It will also predispose women to yeast infections. It is contraindicated in pregnancy and children under the age of 7, as it can cause staining of the teeth. PROGUANIL (Paludrine) This medication may be used in plaxce of chloroquine in chloroquine-sensitive areas. Most often, it is used in combination with chloroquine in resistant areas. This regimen is slightly less effective than mefloquine. Proguanil must be taken on a daily basis. It is available in Canada (not the USA) and is much more expensive here than in tropical countries. It must be taken on a daily basis, beginning at the time of exposure, daily while away, and for four weeks after departure from the tropics. Its most common side effect is mouth ulcers. It is safe in pregnancy.