Chloroquine and Malaria, just visited Honuduras

[JenCK]

I am a 30 year old female and have a question concerning Malaria.  I just returned last Sunday (3/23) from a week in Honduras where I spent most of my time on the Bay Island of Roatan with my husband who is 33.  We did not take an anti-malarial pill before going, but began taking Chloroquine given to us by another traveler.  (We began to be a bit paranoid about contracting malaria after talking with these fellow travelers)  We did not take the recommended dose one week before we left for Honduras and have since taken 2; one on the first Monday of our trip and one on the Monday since our return.  I am wondering if we need to continue to take the Chloroquine if we did not take it the week prior to arriving in Honduras?  Is it still doing something?  Also, I have developed a dry sore throat and productive cough with no fever in the last day and am concerned.  Do I need to see a physician for a sore throat as a possible symptom of malaria?  Thank you so much for your help.

[JenCK]

Thank you so much for your advice.  To answer your questions about our exposure to mosquito bites, it is difficult to say.  We were bitten by a number of sand flies and it seems as though the majority of our bites came from those.  I may have had 2-3 mosquito bites and it seems they came an hour or two after sundown.  As for my cough, it has developed into a typical cold: stuffy head, runny nose, sore throat and swollen glands.  I have been mindful of my temperature and have not experienced a fever unless it was during the night.  Is it safe to assume that I just caught a cold (I am a high school teacher) upon my return?  I am unable to contact my health care provider currently, so thank you again for your advice.

- Jen

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

The usual guidance on chloroquine is to begin taking the medication 1-2 weeks prior to travel and for 4 weeks after returning. So, yes, the medication is still definitely "doing something" after you leave the area with malaria.

It is unlikely that a dry, non-productive cough without a fever is representative of  malaria.

Because you did not begin taking chloroquine prior to your arrival in Honduras, you were probably not protected the week you were there. It is difficult for me to precisely quantify your risk--the risk depends on a number of factors: were you bitten by mosquitos, when were you bitten (mid-day, morning, dusk?), and the risk of malaria in the particular area that you were traveling/trekking. Mosquitos that carry malaria bite mostly at dusk and dawn.

My recommendations would be for you to discuss your current symptoms with your health care provider and for you to continue the chloroquine for 4 weeks after your return.

Links:
1. http://www.mdtravelhealth.com/destinations/mamerica_carib/honduras.html
2. http://www.webmd.com/a-to-z-guides/chloroquine-for-malaria

Also, be mindful of any fever that you experience because of your incomplete prophylaxis against malaria.

I hope that this is helpful to you.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.