An aid worker friend returned home last Christmas, to Montana. Mild fever and chills started within a week, becoming the state’s first malaria case since something like 1921. The hospital freaked out, making panicked calls to the national Center for Disease Control.
We Canadians are no better: the same thing happened to a Toronto friend. The hospital quarantined him, immune to his insistence that malaria is not a contagious disease, at least in the absence of mosquitoes. It was minus twelve outside.
All this has made me wary of Western hospitals in the face of tropical disease. I keep a med bag with every manner of drug and test, and have more than a few tropical medicine friends on speed dial.
This weekend, however, the medical system impressed. A week back from Liberia, Jeannie came down with a heavy fever that didn’t break during the night. We broke out our Plasmodium falciparum rapid test. There are 1200 malaria cases a year in the U.S. Make that 1201.
Our initial instinct was to avoid the hospital and trust our stack of malaria meds. But 12 hours and a 104 fever later, it was time for the Yale clinic.
No panics. No quarantine. They barely batted an eyelash. Frankly, we were even a bit disappointed. Surely we deserve a little development street cred. One yelp if surprise? A raised eyebrow? Alas, no.
Turns out our test kit and meds still came in handy. It’s taking two days to get the blood work back on the actual malaria strain, and they couldn’t round up Coartem (or alternatives) at night or on a weekend.
My advice to the world travelers who read the blog (inexpert, but echoed by my tropical med pals):
1. Carry malaria meds home with you, ideally a cocktail like Coartem that has low resistance in the field.
2. Buy quick test kits when you arrive in country. Developing country, that is–your American pharmacist won’t have heard of them. Why wonder all night whether what you’ve got is street food revenge or a malarial fever?
3. Get to a hospital, and on a drip. Even in Montana. No heroics. Fear not the quarantine. Make sure they call an infectious disease sepcialist if one is not around. Give them the 24-hour CDC malaria hotline if they need it. With your meds you’d be fine 98 cases in a 100. I wouldn’t want you to be one of the two.
Update: Fever down, and checked out of the hospital in less than 24 hours.
3 Responses
Yikes! Glad to hear that Jeannie is recovering nicely. Please give her some healing hugs from us. :-)
Phillip + Melanie
Hilarious – somebody else has experienced my similar disappointment when I was diagnosed with malaria in Columbus, Ohio. (I rushed to the ER upon landing, after a hellish plane journey from Indonesia) I too was surprised with the lack of a raised eyebrow! But that disappointment was tempered by the quick lab work and immediate treatment. (However, the first two treatments failed to knock it out completely and so I had two relapses – I hope Jeannie’s treatment is better)
Can you write out a description of the contents of your med bag? I’d like to put one together myself. Thank you.