Defence Force Accused Of 'Massive Cover-up' Over Anti-malarial Drug

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Mefloquine Or Lariam - Is It A Safe Antimalarial Prophylaxis?

During my own search for the safest antimalarial prophylaxis that I'll consider taking on my upcoming safari, I have found the following article related to the effects that Mefloquine had on some people. I thought I should share it with all of you, in case some of you are interested and/or have not seen it yet.


http://mobile.abc.net.au/news/2015-...p-over-anti-malarial-drug/7001142?pfmredir=sm

"Defence Force accused of 'massive cover-up' over anti-malarial drug
THE WORLD TODAY BY MANDIE SAMIUPDATED FRI DEC 04 19:24:02 EST 2015

The Australian Defence Force (ADF) has acknowledged for the first time that a number of its past and present members have suffered severe side-effects from the use of an anti-malarial drug known as mefloquine or Lariam.

Key points:
  • Mefloquine or lariam is one of three anti-malarial medications approved by the Therapeutic Goods Administration
  • Estimates up to 1,250 current and former ADF members have brain injuries from the medication
  • ADF maintains less than 1 per cent of members receiving mefloquine
The medication has led to permanent psychological damage, anxiety attacks, nightmares, suicidal thoughts and hallucinations in some people.

Defence personnel have previously complained that their concerns about the drug were not taken seriously by the ADF.

Major Stuart McCarthy started experiencing things that included major depression, suicidal thoughts, vertigo and tinnitus after he started taking the drug in 2001.

"That's when I started saying up through the chain of command, and I'm not the only one here, there are many other veterans who are affected, and for the efforts that I made to do that, I was threatened with disciplinary action, repeatedly threatened and gagged about approaching the media," Major McCarthy said.

"And anybody like me who has dared to stand up and ask for proper help has just been threatened."

Mefloquine or Lariam is one of three anti-malarial medications approved by the Therapeutic Goods Administration for malaria prevention.

It is the ADF's third line agent, meaning it is only used when one of the other two medications does not work.

'More than 1,000 ADF members with brain injuries'
Major McCarthy estimates there are up to 1,250 current and former ADF members who now have permanent brain injuries as a result of taking mefloquine or tafenoquine.

Tafenoquine is another anti-malarial medication Defence has given to personnel, but it was not approved by the TGA.

Major McCarthy alleges the ADF has systematically downplayed the number of people who have been affected by the drugs.

"Personally I can't trust anybody in the ADF medical system," he said.

"They're not worthy of trust.

"I mean, they will provide people with drugs that are known to be neurotoxic, and when they get caught out, they'll cover it up."

The Australian Defence Force maintains that less than 1 per cent of members currently deployed and receiving anti-malarials are taking mefloquine.

"While in the majority of cases the side-effects associated with mefloquine disappear after ceasing the medication, Defence accepts that some people do continue to experience ongoing issues," a Defence spokesperson said.

"Those who claim to have ongoing problems linked to side-effects from the use of mefloquine are provided with appropriate medical treatment including specialist referral, assessment and treatment.

"Further to this, ADF members who are diagnosed as suffering longer-term or permanent side-effects from mefloquine use can also claim compensation through the Department of Veterans' Affairs (DVA) if the mefloquine was prescribed for service reasons."

Calls for judicial inquiry
Major McCarthy is not satisfied with the response, but acknowledges it contains a major concession from the ADF.

"The one positive thing about it is it's the first time that Defence has conceded that mefloquine can cause long-term side-effects ... but the surprising thing is just the deceit that they continue on with," Major McCarthy said.

"So all of the claims about 'they're supporting veterans in seeking support for health problems' — they're just a massive lie.

"It's a kick in the guts. There needs to be a judicial inquiry that can prosecute crimes."

Major McCarthy has made complaints against senior officials within the Defence Force, which are currently being investigated.

A spokesperson for the ADF has confirmed to the ABC that the Inspector General is currently inquiring into certain allegations, made by one Defence member, into the use of the drug mefloquine in the ADF to determine whether any failures in military justice may have occurred.

As it remains ongoing, Defence has said it will not make any further comment.

POSTED FRI DEC 04 12:32:36 EST 2015"

Screen Shot 2017-04-22 at 7.37.05 PM.png
 
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https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/doxycycline.pdf

Many places around the world are considered areas that CDC recommends malaria medication. I've been to guatemala, Belize, and Haiti where it was recommended while on medical/dental missions trips. I had teams of between 15 and 48 members. I never saw a mosquito. Took mosquito nets and larium with us. Took larium on one of those trips. I had none of the major side effects but I didn't like it. Stopped taking it!! If I were going into a malaria area personally I would take doxycycline. My family with young children in tow is heading into the Limpopo region of RSA in June. They had more than normal malaria concerns due to heavy rains and flooding in March 2017. I'm taking doxycycline with me but not preventatively. Ultimately, we pick our poisons. We are treating shoes and clothes with insect repellent and hopefully making good decisions related to exposure to mosquitoes. My .02 cents...
 

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I have been prescribed....and never taken lariam based on the intel I received. Wanted to punch the GP for prescribing after what I learned on this site of the effects. Doxy is safe & regularly taken.

There is a lot of first handers her that have taken lariam and will tell you to avoid at all cost. I do not have that experience thank goodness
 
My wife had some unpleasant reactions to larium on our first trip to Africa in 2004. (Some hallucinations, vivid dreams; she knew she was hallucinating and was calm about it, but of course she immediately stopped taking the drug, and so did I. We had been warned of "possible side effects.") On our trip to Zimbabwe in 2015, our son, who is a flight surgeon with the USAF, advised doxycycline instead. No problems. Doxy is good stuff.
 
I've taken both Melfoquine and Doxy, while Melfoquine didn't really have any really bad side effects on me Doxy was easier on me
 
I have decided to go with Doxy as well. Like any broad spectrum antibiotic, it can destroy the intestinal flora, but that can be fixed. The side effects of the alternate prophylaxis are not always reversible.
Like slam8031, I'm heading to (Western) Limpopo mid May.
 
I have decided to go with Doxy as well.

surely this taking of antibiotics as a preventative is one of the reasons for the major cause of resistance to antibiotics that a growing number of bacteria etc are acquiring, and becoming very difficult to kill or totally untreatable with deadly results?...........
 
surely this taking of antibiotics as a preventative is one of the reasons for the major cause of resistance to antibiotics that a growing number of bacteria etc are acquiring, and becoming very difficult to kill or totally untreatable with deadly results?...........

Could be. I usually avoid them as much as I can, since all medications have effects. The negative ones or the undesirable are called "side effects ". But I'm sure the simple fact that all animals raised for consumption are kept on "healthy" doses of antibiotics to prevent lost revenue has a much greater influence on the resistance issue than taking Doxycycline as antimalarial prophylaxis has. From what I've seen Doxy is used for both: treatment and prophylaxis. By the way, I'm not an expert on this subject, just have my own opinion and I don't want to start an argument.
 
Malaria is nothing to mess with - particularly in the age range of most of the contributors here. Can't speak for the parts of Central/South America where others visited, but Panama and Brazil were alive with mosquitos. In the Caprivi and coastal Mozambique they'll carry off small children if not staked to the ground (rather like South Louisiana). ;) I have used atovaquone/malorone when in harms way most of my whole professional life. When deployed, troops under my command used it. Like all of you, I have read of these side effects, but in all of those thousands of users, never saw a case or had a soldier treated for such issues. Given a choice of running around in bright sunlight loaded up on an anti-biotic or using a once a day parasite preventative, I have no problem opting for the latter.

I would also note, these things tend to be a post deployment trend these days. Something catches on, now usually fueled by the internet, and soon everyone believes governments are conspiring to hide the truth about _______. PTSD, agent orange, chemical exposure in the Gulf War, and malarial treatments. In the civilian world it is black mold, asbestos, etc. There are real unfortunate cases among all of these, but also whole industries built up around VA benefits, treatment, legal contingency fees, political leverage, and the speculative attention they generate in the press. It does make me wonder how anyone survived in the post WWII world.

I am not a Doctor and I am not making a recommendation what any individual should do w/regard to themselves or their family. I would simply suggest that you really do not want malaria. I would urge that everyone going into an area where malaria is endemic consult with a professional with the right credentials on the wall, and adopt a risk reduction/prevention plan.
 
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I have always heard that some of the drugs could make one sick. I had two different. Drs and a relative say that Malarone had not made them feel bad at all. So that's what I have taken with no ill effect.
This situation of cover up sounds bad!
 
I worked in Cabinda, Angola for 5-1/2 years and took Larium with no issues. I would normally quit taking it for about 2-3 months during the dry season, just to get off of it for awhile. Larium is a weekly pill, as opposed to Malorone which is a daily pill. Lots of people I worked with did have issues with Larium (vivid dreams, couldn't sleep, etc) so they would switched to Malorone. The tropical disease specialist that I talked with during this time recommended Malorone as the best available treatment. When Malorone was new to the market (2000) it was very expensive ($20/pill) so companies and the military preferred Larium from a cost standpoint. Malorone generic is now available and cheap.

Since living in Nigeria for 5 plus years, I don't take anything. I do however travel at all times with a dozen Malorone pills and our medical staff here advises if you come down with malaria symptoms, get tested ASAP and start a course of 4 pills per day for 3 days.

When I went hunting in Zim, I actually took the Malorone and had no issues.
 
doxy was the medicine of choice for my wife and i on our 5 trips to africa.be sure to keep taking it when you get back as the instructions state until your ammt is gone.
 
I have used doxy, and feel cheated. Most that use it had weird dreams they could remember, I never did. Side effects of doxy is your skin is more sensitive to sunlight so you will sunburn quicker and easier.

Worked with a bloke who had bad side effects from Doxy, couldn't sleep, so put him on larium, no side effects. Yet others I worked with had been on larium and had mild to server side effects. It sent 2 diggers in East Timor tropo and they shot others. For me I will stay with doxy.
 
My wife and I used Malorone on our trips to Zimbabwe 2011 and Mozambique 2016. Neither of us had any side affects.
 
CDC recommendations below--
Table 3-09. Considerations when choosing a drug for malaria prophylaxis
DRUG REASONS TO CONSIDER USE OF THIS DRUG REASONS TO CONSIDER AVOIDING USE OF THIS DRUG
Atovaquone-proguanil
  • Good for last-minute travelers because the drug is started 1–2 days before travel.
  • Some people prefer to take a daily medicine.
  • Good choice for shorter trips because the traveler takes the medicine for only 7 days after traveling rather than 4 weeks.
  • Well tolerated—side effects uncommon.
  • Pediatric tablets are available and may be more convenient.
  • Cannot be used by women who are pregnant or breastfeeding a child that weighs <5 kg.
  • Cannot be taken by people with severe renal impairment.
  • Tends to be more expensive than some of the other options (especially for long trips).
  • Some people (including children) would rather not take a medicine every day.
Chloroquine
  • Some people would rather take medicine weekly.
  • Good choice for long trips because it is taken only weekly.
  • Some people are already taking hydroxychloroquine chronically for rheumatologic conditions; in those instances, they may not have to take an additional medicine.
  • Can be used in all trimesters of pregnancy.
  • Cannot be used in areas with chloroquine or mefloquine resistance.
  • May exacerbate psoriasis.
  • Some people would rather not take a weekly medication.
  • For short trips, some people would rather not take medication for 4 weeks after travel.
  • Not a good choice for last-minute travelers, because drug needs to be started 1–2 weeks before travel.
Doxycycline
  • Some people prefer to take a daily medicine.
  • Good for last-minute travelers because the drug is started 1–2 days before travel.
  • Tends to be the least expensive antimalarial.
  • People who are already taking doxycycline chronically to prevent acne do not have to take an additional medicine.
  • Doxycycline also can prevent some additional infections (such as rickettsial infections and leptospirosis), so it may be preferred by people planning to hike, camp, and swim in fresh water.
  • Cannot be used by pregnant women and children aged <8 years.
  • Some people would rather not take a medicine every day.
  • For short trips, some people would rather not take medication for 4 weeks after travel.
  • Women prone to getting vaginal yeast infections when taking antibiotics may prefer taking a different medicine.
  • People may want to avoid the increased risk of sun sensitivity.
  • Some people are concerned about the potential of getting an upset stomach from doxycycline.
Mefloquine
  • Some people would rather take medicine weekly
  • Good choice for long trips because it is taken only weekly
  • Can be used in all trimesters of pregnancy
  • Cannot be used in areas with mefloquine resistance.
  • Cannot be used in patients with certain psychiatric conditions.
  • Cannot be used in patients with a seizure disorder.
  • Not recommended for people with cardiac conduction abnormalities.
  • Not a good choice for last-minute travelers because drug needs to be started ≥2 weeks before travel.
  • Some people would rather not take a weekly medication.
  • For short trips, some people would rather not take medication for 4 weeks after travel.
Primaquine
  • It is the most effective medicine for preventing P. vivax, so it is a good choice for travel to places with >90% P. vivax.
  • Good choice for shorter trips because you only have to take the medicine for 7 days after traveling rather than 4 weeks.
  • Good for last-minute travelers because the drug is started 1–2 days before travel.
  • Some people prefer to take a daily medicine.
  • Cannot be used in patients with G6PD deficiency.
  • Cannot be used in patients who have not been tested for G6PD deficiency.
  • There are costs and delays associated with getting a G6PD test; however, it only has to be done once. Once a normal G6PD level is verified and documented, the test does not have to be repeated the next time primaquine is considered.
  • Cannot be used by pregnant women.
  • Cannot be used by women who are breastfeeding, unless the infant has also been tested for G6PD deficiency.
  • Some people (including children) would rather not take a medicine every day.
  • Some people are concerned about the potential of getting an upset stomach from primaquine.
Abbreviation: G6PD, glucose-6-phosphate dehydrogenase.
 
Could be. I usually avoid them as much as I can, since all medications have effects. The negative ones or the undesirable are called "side effects ". But I'm sure the simple fact that all animals raised for consumption are kept on "healthy" doses of antibiotics to prevent lost revenue has a much greater influence on the resistance issue than taking Doxycycline as antimalarial prophylaxis has. From what I've seen Doxy is used for both: treatment and prophylaxis. By the way, I'm not an expert on this subject, just have my own opinion and I don't want to start an argument.
Well sir you did start an argument! I am a rancher and raise livestock and they do not stay on a constant diet of antibiotics. They get antibiotics when needed and that's it. Animals raised indoors are another subject but please do not lump all livestock into the medicated category!
Fake news needs to be disregarded.
Regards,
Philip
 
I spent a couple years in West Africa, malaria was allays present, I had it twice its no fun. Just remember no prophylaxis is 100% effective on malaria. Both times I contracted the parasite I was on an prophylaxis. Melfoquine didn't & does not agree with me, I can attest to its side effects. Again not a good time. Malrone seem to work for just about everybody I was with in varying degrees, as most of us got ill to some extent. You just cant spend month after month in the jungle with getting something. Ciprofloxacian was the broad spectrum antibiotic we used from time to time to fight the wee beasties.

Regards
Pat
 
https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/doxycycline.pdf

Many places around the world are considered areas that CDC recommends malaria medication. I've been to guatemala, Belize, and Haiti where it was recommended while on medical/dental missions trips. I had teams of between 15 and 48 members. I never saw a mosquito. Took mosquito nets and larium with us. Took larium on one of those trips. I had none of the major side effects but I didn't like it. Stopped taking it!! If I were going into a malaria area personally I would take doxycycline. My family with young children in tow is heading into the Limpopo region of RSA in June. They had more than normal malaria concerns due to heavy rains and flooding in March 2017. I'm taking doxycycline with me but not preventatively. Ultimately, we pick our poisonsou feel . We are treating shoes and clothes with insect repellent and hopefully making good decisions related to exposure to mosquitoes. My .02 cents...
The trick with malaria, and I have had it many times living in Africa, is to REACT as soon as ANY flu like symptoms are felt. DONT wait... take the prophylactics that you have with you. It can't harm you if actually don't have malaria but it will CERTAINLY help you if do have it.
Headaches, sore joints, tiredness, sore neck, runny stomach etc. COMPLETE the course!!!!!
I worked in heavy malaria areas for years and as such would not take the pills continuously, but I kept up to date meds with me all the time and even when traveling overseas, as the symptoms strike up to 14 x days after being infected.

In my case, I immediately feel sore in the neck. I take the pills immediately and as such I'm sick for max 2x days.
People who wait can be sick for weeks and even worse!
 

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