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INTERNATIONAL MEDICAL INSURANCE AND HEALTH INSURANCE FOR OVERSEAS |
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INTERNATIONAL MEDICAL INSURANCE AND HEALTH INSURANCE FOR OVERSEAS |
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- add to favoritesGLOBAL COVERAGE, INTERNATIONAL HEALTH INSURANCE |
Although international medical insurance is important it is also important to be so prepared in order to avoid health problems overseas.
EXPATRIATE HEALTH
Diseases
| Malaria and Prevention | Tuberculosis | Sun Protection | |
| Leishmaniasis | Deep Vein Thrombosis | ||
| Hepatitis | Leptospirosis | Altitude Sickness | Diabetes |
| Influenza A & B | Lyme Disease | AIDS |
Malaria is still a great killer. Over 30,000 American and European travelers are infected each year. It has a 4 – 20% mortality rate. There are many areas with chloroquine resistance, covered later.
Three types:
Plasmodium Vivax, which is 50% of the world’s malaria It has some chloroquine resistance, especially in Indonesia
Plasmodium Falciparun is 40%, the most dangerous and often most resistant to chloroquine and has caused the most deaths. It is seen especially in Central Asia and the Middle East
Plasmodium ovale is the most mild. It rarely causes death.
Insect Bite Prevention – the best malaria offensive
Deet, the common insect repellent ingredient, varies from 17 - 35% Found in brands like Off, etc. Should be sprayed directly on the skin, never on clothes or gear Permethrin-impregnated mosquito netting, can often be obtained overseas. This liquid can also be used to cover the lower ends of the mosquito netting or window screens. Avoiding or reducing activity after dusk helps. If one lives in a malaria-free city and goes into the country during the day and returns to the city by day, very few cases of malaria have been contacted. Anti-malarials may not be indicated.
Mosquito coils are effective and ought to be considered.
Spraying the room an hour before bedtime when children are not in the bedrooms is worthwhile.
Long-sleeved shirts and pants, light in color are also somewhat protective. Contrary to many expatriates’ opinions, Avon “Skin-so-Soft” is not effective in preventing mosquito bites.
It should be kept in mind that IN VIRAL-BORNE DISEASES like dengue fever, Japanese encephalitis and yellow fever, prophylaxis and AVOIDANCE of mosquito bites is important.
Malaria Drug Prophylaxis (drugs taken for prevention)
Chloroquine, trade name Arlen, manufactured by Sandoz 300 mg. base tablet taken once weekly. Continue taking till 4 weeks after return from exposure.
Mefloquine, trade name Lariam by Roche 250 mg. weekly, most often prescribed by American doctors and CDC, some mild resistance. Should not be given in the first 12 weeks of pregnancy Some psychotic and mood changes, panic insomnia, depression, 1 in 500 users Contraindicated in people who need to rely on spatial judgment (airline pilots, etc.)
Doxycycline, trade name Vibramycin by Pfizer, 100 mg. daily Used common by U.S. military Start when leaving for exposure zone, MUST have 100 mg. daily Less likely to upset stomach if taken with food; Milk inhibits absorption. Contraindicated in pregnancy and in children under 8 years of age. Least expensive Probably worth taking when one goes to highly infested areaContinue dosage until 4 weeks after exposure period Malaria parasite resides in the red cells of the blood, having a 14-21 day cycle. Hence, the 4-week advice covers the time when the parasite opens into red cells. WHO and CDC tend not to recommend because of LACK OF COMPLIANCE for 4 weeks after exposure period Military has sergeant ORDERING troops to take their pill for the prescribed time. Women on oral contraceptives should be on at least a 35-microgram monophasic pill. In lower dose pills the doxycycline may cause the liver to metabolize the pill. Pregnancies have occurred in these cases. Malarone Available in Europe, Canada, Mexico- Combination pill of atovaquone and progouanil 250 mg. per week with two weeks prior to exposure & one week post exposure. Expense greater than $5, Canadian per pill
Fansidar, Used for self treatment when symptoms of headache, fever, malaise occur. 3 tablets for presumptive malarial symptoms. Contraindicated in pregnancy or with sulfa allergic patients. Azithromycin (Zithromax) has been used as prophylaxis and side treatment. Not recommended by any agencies
Malaria vaccine is not yet available but is being worked on.
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