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Most of Myanmar is a malarial risk area. All areas other than the cities of Yangon and Mandalay and areas over 1000 meters in altitude are considered malarial risk.
Burma has more deaths from malaria than any other Asian country. That’s a pretty shocking statistic for such a small country. One of the reasons for this is that medical care in Myanmar is quite poor. In addition, the treatment of choice for malaria, an artemisinin drug, is both manufactured in China and is counterfeited in China. Approximately one-third of the malaria treatment drugs sold in Burma are counterfeit.
If you’ve been to SE Asia, you are no doubt aware of fakes. The Hanoi airport is famous for it’s “Scotch” that reads “Made in Scotchland.” So the way people discern fakes is typically to examine the packaging. The best packaging must be the real thing, right? It turns out not to be true when we are discussing the malarial treatment drug, artemisinin. The drug is manufactured in China and the packaging photo looks grainy and is often printed slightly out of register, making it blurry. The counterfeiters, also working in China make better looking packaging for the counterfeit drug. To make matters worse, the counterfeit drug actually contains some artemisinin, just not an adequate dose to fully treat malaria. As a result, strains of malaria resistant to artemisinin are developing in Burma as well as along the Thai/Cambodian border.
At the very least, you want to do what you can to prevent mosquito bites while in Burma. The mosquito that spreads malaria is most active at dawn and at dusk. But the mosquito that spreads dengue is active throughout the day. The mosquito that spreads dengue is prevalent in urban areas, while the mosquito that spreads malaria is most prevalent in rural areas.
So take plenty of your preferred mosquito repellant along. If you choose to take malaria prophylaxis, there are two effective alternatives: Malarone and doxycycline. We take Malarone, as we have often used it and have no side effects from it. We also like that you only have to take it for a week after leaving the malarial risk area, while doxycycline must be taken for a month after leaving the malarial risk area. Discuss your options with a travel medicine professional.
