7 ms·

As someone who doctors once put "12 hours from coma" due to malaria (and I was in rural Tanzania, so coma == death out there), this is straight up the best news

by cguess 6y ago

As someone who doctors once put "12 hours from coma" due to malaria (and I was in rural Tanzania, so coma == death out there), this is straight up the best news I've heard in a very long time. Seriously, don't get malaria if you can help it. Your bones hurt from the inside out while you lay in a pool of your own sweat, crawling to the toilet every hour or two because of oscillating vomiting and diarrhea. Since you're most likely in a developing country, air conditioning is usually out of the question (you're shivering in the 100F+/35C+ temps anyways from the fever). The drugs, if you're lucky, only give you the most vivid and disconcerting dreams you've ever had (if you're unlucky, which 50% of people are, they're the most horrifying night terrors you can imagine). The good news is it's highly treatable. The bad news is that at ~$3 for a round of treatment it's prohibitively expensive if you're only making $2/day and have a family to support. We only got rid of it here in the US because of DDT. Malaria was endemic in the South (and parts of the North in the summer) until the mid-20th century.

deleted 6y ago
[deleted]
pfortuny 6y ago
It also used to kill thousands in Italy until the mid XX Century: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340992/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340992/
- Talanes 6y ago
  It took me entirely too long to realize XX was Roman Numerals. I was very perplexed why you had written a placeholder for the century.
  - taurath 6y ago
    I thought it was megaman, which is set in the year 20XX
    - Talanes 6y ago
      Fun Fact: The first two games actually give the date as 200X.
grecy 6y ago
Ditto. I had it in Mali (not so bad) and Angola which was 5 days of not eating, sleeping, walking talking eating or drinking. I lost 20lbs. I sincerely hope the end is in sight!
AriseAndPass 6y ago
I grew up in Tanzania! Can I ask where you were, and what you were doing? BTW - I had malaria about 5-6 times while growing up. What you describe sounds like a particularly bad case (1-2 of mine were like that). My experience, and that of my peer group (lower-middle class by western standards, top 0.1% by Tanzanian standards) was that if you got an early diagnosis and had access to drugs it was usually akin to a severe flu unless you got unlucky with the strain/severity. It was culturally very normalised to get two malaria tests any time anyone felt sick, because the commonly accepted belief was that anything could be malaria, and false negatives were too common. I always thought the main problem with malaria in Tanzania was that 99.9% of the country (especially rural areas) does not have access to quick testing and easy drugs, and for them it's a death sentence. That's not to downplay it, but more to emphasise the socioeconomic dimension.
- cguess 6y ago
  I caught it in Arusha (back in 2008, when Arusha was much less built up than it is now). Got sick about two weeks later outside of Dar. At the time I was a journalist working on some freelance stories. I've actually gone back and worked with local duka la dawas (sorry about the spelling, my Kiswahili is really out of practice) in figuring out ways we can help rural populations get easier access to the medication. It's often not that it's not there, it's that the medicine is too expensive. It's still such a horror show of a disease (among the many many other horror show diseases). My heart broke for every mother I saw with their feverish infants in the same waiting room I was in.
  - AriseAndPass 6y ago
    Very cool story. Thank you for whatever you've done to help :) (and your spelling looks perfect to me).
Vysero 6y ago
How amazing would it be to see a story like this premier on one of the main stream media outlets nightly broadcast for 1 or 2 months in a row?
derefr 6y ago
> The drugs, if you're lucky, only give you the most vivid and disconcerting dreams you've ever had Now I'm intrigued. What do anti-malarials do to healthy people? Does anyone take them recreationally to experience this effect, the way they do other "weird downers" like mescaline/DMT/salvinorin/etc? Or is the psychotropic effect of the drug predicated on actually having malaria?
- joshvm 6y ago
  The prophylaxis medication is typically a broad spectrum antibiotic like doxycycline. There are other more expensive options which you take for a shorter period afterwards vs doxy which you have to take every day plus a month after. However.. Some of the alternative drugs have very serious warnings that if you have any history of mental illness you probably shouldn't take them. Mefloquine is particularly prone to this I think and the symptoms sound like what the OP described (insomnia, vivid dreams, etc). You shouldn't have that with doxycycline, but it can make you photosensitive which isn't ideal in Africa.
  - KMag 6y ago
    See my other post here about my friend getting paranoid on mefloquine, leading to my discovering that mefloqine is suspected in playing a role in several instances of peacekeepers attacking unarmed civilians. Search [mefloqine "freaky Friday"].
- tonyarkles 6y ago
  I took Chloroquine as a prophylactic anti-malarial before and during a trip to Central America. You can get the crazy dreams whether or not you’re infected. Mine were, fortunately, quite vivid (and sometimes lucid) but not disturbing. The scenarios were pretty wild though. Other friends of mine had less pleasant experiences. For example, one had a recurring dream that his abdomen got ripped open, a load of pebbles fell out (instead of viscera), and a flock of ravens came and eat the pebbles while he watched in agony. Every night, over and over, for about two months. During your waking hours, nothing feels amiss at all. Keep in mind too that the dosing is once a week. It took a week or two for the effects to start for me, and they persisted for almost a month after I was home. Unlike reports from the various psychedelics you listed, I felt absolutely no euphoria or “spiritual awakening” from any of it; I just woke up every morning and thought “wow, that was fucked up!”
Ductapemaster 6y ago
Is there a reputable non-profit I can donate to that provides this treatment? The idea that $3 is unaffordable for so many is so sad. I would gladly provide for a number of people to be treated if I could trust the money goes to them.
- jlebar 6y ago
  https://www.givewell.org/charities/top-charities https://www.givewell.org/charities/top-charities
  - Ductapemaster 6y ago
    I realize now I could have googled that myself, but it is nice sometimes for the things you thought of to be validated by others. Thank you! Adding this to my yearly donations list.
  - wizzwizz4 6y ago
    https://app.effectivealtruism.org/funds/global-development https://app.effectivealtruism.org/funds/global-development This fund goes to GiveWell's top charities, unless there's something that the fund managers think could do better in expectation. (For context, the EA Meta fund went towards founding GiveWell and https://80000hours.org/; https://80000hours.org/; they know what they're doing.) If you're too lazy to keep track of GiveWell's top charities at any given time, or want to contribute to medium-risk high-reward causes too, that's a good place to put your money.
rawoke083600 6y ago
Yup those dreams are real on the medicine ! Damnn ! I SAW aliens like the little grays, they were in my bedroom when I woke up. Till this day I'm not sure if it was the pills and a dream or if there were real grays visiting me... Maybe they needed a specimen that took malaria-pills ? Never taking malaria pills again. And I live in South Africa.
- softwarejosh 6y ago
  it was a dream unfortunately :(
jcampbell1 6y ago
What drug did you take? I got malaria and a friend mixed up a white powder with bottled water and I injected it in my leg. I was better in 24 hours and don’t recall any side effects. My guess is the drug was chloroquine, but not sure. Based on other’s experiences, I am glad I was young and dumb enough to opt for a questionably sterile injection. I was fortunate to have made a friend that worked in oil services in Nigeria, and he had “malaria training” from Schlumberger, and the bottled water injection sounds crazy, but was the recommended treatment.
- cguess 6y ago
  I was on cholorquine. It was four pills, twice a day, for three days. They do have one-and-done pills that are MASSIVE, but they, from my friends' advice really screw with you even more than the normal stuff. Note: DON'T drink while being treated for malaria. The parasites hide out in your liver, and the drugs shut it down further. 1/3 of a pint and you're spinning like a freshman during welcome week.
giardini 6y ago
Here's a lengthier but fascinating description and personal history of someone who caught malaria and treated it with quinine derivatives (and then caught it again...): "Of Quinine And Chloroquine" by Willis Eschenbach / https://wattsupwiththat.com/2020/04/11/of-quinine-and-chloroquine/ https://wattsupwiththat.com/2020/04/11/of-quinine-and-chloro...
tsuyoshi 6y ago
In Cambodia, I got what I assume must have been a less serious case, because I didn't have any vomiting or diarrhea, only the worst headache I've ever had in my life. Luckily the lack of air conditioning wasn't a big problem, because it was close to the coldest part of the year. It permanently reset my pain scale. When I later had a pulmonary embolism and appendicitis, the doctors were confused that I said my pain was only 7 on a scale of 1 to 10. The drug I took for it (mefloquine) didn't give me any unusual dreams, but it permanently altered something in my brain. I don't agree that DDT is necessary to eradicate malaria. See for example that malaria has been eradicated in Thailand (except for border areas), but not (yet) in Cambodia, Laos, or Myanmar, despite having the same climate. A combination of regular pesticides and flood control are sufficient - if the government is competent and dedicated. It's a political problem, not a technical problem.
- cguess 6y ago
  I feel you with the pain. It was horrifying. RE: DDT, I didn't mean to imply it's the only way these days, just that there was a very good reason it was so popular in the former part of the 20th century. I love the tune to "Big Yellow Taxi" but it was never about "spots on my apples." It still is used in very rare and specific circumstances, but we have a lot better understanding of how to stop mosquito. Which is why they're really only a problem in poor countries, mitigation is unfortunately not cheap and convenient.
- tandr 6y ago
  > but it permanently altered something in my brain Sorry to ask and if it is not too much to share - What kind of changes are you talking about?
- tim333 6y ago
  >I assume must have been a less serious case Wikipedia has: >Cerebral malaria is the form of severe and complicated malaria with the worst neurological symptoms. Glancing at this it may be more likely your brain was altered by the malaria than the mefloquine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056312/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056312/
KMag 6y ago
The anti-malarial drugs are not all the same. I've taken hydrochloroqine a few times without much side effect. Mefloquine is on a completely other level, at least for some people. One of my closest friends from university was also a work colleague at the time he went on a recruiting trip to India and his travel doctor prescribed mefloquine for him. It's standard practice to keep taking the drugs for some time (2 weeks, IIRC) after leaving a malarial area, and he was noticeably mentally altered when he returned. He seemed uneasy with his eyes darting around, and he wasn't his normal outgoing self. He seemed a bit paranoid. The incident that brought it all into sharp focus involved a couple of colleagues that were your garden variety gossipy braggarts and I had a minor disagreement with one of them that we resolved quickly, but which prompted my friend to whisper to me "You don't get it. They're not good people." He gave me a look like I was the crazy one for believing the minor argument was resolved. (On the one hand, he was right. I would never trust the one any further than I could throw a fully loaded server rack. However, I still smiled, remained social, and watched my back.) I googled [mefloquine paranoia] and went down a deep rabbit hole. I found out that mefloquine has been suspected in several incidents of peace-keeping troops getting paranoid and attacking unarmed civilians. [mefloquine "freaky Friday"] or [mefloquine "wacky Wednesday"] may be a better search. Also, at least at that time, several sites said that if you had ever taken mefloquine in your life, you were ineligible for one of the front-line malarial treatments should you ever contract the disease. Due to his mood changes / paranoia, I strongly suggested he talk to his doctor about coming off of his medication after just one week back in the U.S. > 100F+/35C+ temps Note that 35 C is below normal body temperature. 100F ~= 37.8 C. I used to donate plasma once a month back when I lived in the U.S. (I'm fortunate enough to not have cytomegalo virus, so newborns, chemo patients, HIV patients, etc. can receive my blood.) My body temperature for my pre-donation check-up was typically 35.8C/96.4F.
vixen99 6y ago
And malaria reemerged elsewhere after DDT was banned around 1973 thanks to Rachel Carson's book. A professor of pediatrics summarizes how millions died as a result and how WHO reinstated DDT in 2006. https://www.thedailybeast.com/how-rachel-carson-cost-millions-of-people-their-lives?ref=scroll https://www.thedailybeast.com/how-rachel-carson-cost-million...
- restalis 6y ago
  That's not quite right to cast the blame on her. She was right, DDT indeed accumulated in soil and caused bad effects. Blame the people that actually made the call to ban DDT without a plan to prevent the bad consequences. That move could have been handled better.
- msla 6y ago
  DDT is still used in the Third World, and mosquitoes are becoming resistant: https://www.sciencemag.org/news/2016/10/after-40-years-most-important-weapon-against-mosquitoes-may-be-failing https://www.sciencemag.org/news/2016/10/after-40-years-most-... https://mosquitoreviews.com/insecticides/ddt-resistant-mosquitoes https://mosquitoreviews.com/insecticides/ddt-resistant-mosqu... > Several serious human health problems, including diabetes and hormonal disruptions, have been linked to DDT, and it is suspected to be carcinogenic. So, no, it wasn't just the eagles.

by cguess 6y ago

deleted 6y ago

[deleted]

pfortuny 6y ago

It also used to kill thousands in Italy until the mid XX Century: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340992/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340992/

Talanes 6y ago
It took me entirely too long to realize XX was Roman Numerals. I was very perplexed why you had written a placeholder for the century.
- taurath 6y ago
  I thought it was megaman, which is set in the year 20XX
  - Talanes 6y ago
    Fun Fact: The first two games actually give the date as 200X.

grecy 6y ago

Ditto. I had it in Mali (not so bad) and Angola which was 5 days of not eating, sleeping, walking talking eating or drinking. I lost 20lbs. I sincerely hope the end is in sight!

AriseAndPass 6y ago

I grew up in Tanzania! Can I ask where you were, and what you were doing? BTW - I had malaria about 5-6 times while growing up. What you describe sounds like a particularly bad case (1-2 of mine were like that). My experience, and that of my peer group (lower-middle class by western standards, top 0.1% by Tanzanian standards) was that if you got an early diagnosis and had access to drugs it was usually akin to a severe flu unless you got unlucky with the strain/severity. It was culturally very normalised to get two malaria tests any time anyone felt sick, because the commonly accepted belief was that anything could be malaria, and false negatives were too common. I always thought the main problem with malaria in Tanzania was that 99.9% of the country (especially rural areas) does not have access to quick testing and easy drugs, and for them it's a death sentence. That's not to downplay it, but more to emphasise the socioeconomic dimension.

cguess 6y ago
I caught it in Arusha (back in 2008, when Arusha was much less built up than it is now). Got sick about two weeks later outside of Dar. At the time I was a journalist working on some freelance stories. I've actually gone back and worked with local duka la dawas (sorry about the spelling, my Kiswahili is really out of practice) in figuring out ways we can help rural populations get easier access to the medication. It's often not that it's not there, it's that the medicine is too expensive. It's still such a horror show of a disease (among the many many other horror show diseases). My heart broke for every mother I saw with their feverish infants in the same waiting room I was in.
- AriseAndPass 6y ago
  Very cool story. Thank you for whatever you've done to help :) (and your spelling looks perfect to me).

Vysero 6y ago

How amazing would it be to see a story like this premier on one of the main stream media outlets nightly broadcast for 1 or 2 months in a row?

derefr 6y ago

> The drugs, if you're lucky, only give you the most vivid and disconcerting dreams you've ever had Now I'm intrigued. What do anti-malarials do to healthy people? Does anyone take them recreationally to experience this effect, the way they do other "weird downers" like mescaline/DMT/salvinorin/etc? Or is the psychotropic effect of the drug predicated on actually having malaria?

joshvm 6y ago
The prophylaxis medication is typically a broad spectrum antibiotic like doxycycline. There are other more expensive options which you take for a shorter period afterwards vs doxy which you have to take every day plus a month after. However.. Some of the alternative drugs have very serious warnings that if you have any history of mental illness you probably shouldn't take them. Mefloquine is particularly prone to this I think and the symptoms sound like what the OP described (insomnia, vivid dreams, etc). You shouldn't have that with doxycycline, but it can make you photosensitive which isn't ideal in Africa.
- KMag 6y ago
  See my other post here about my friend getting paranoid on mefloquine, leading to my discovering that mefloqine is suspected in playing a role in several instances of peacekeepers attacking unarmed civilians. Search [mefloqine "freaky Friday"].
tonyarkles 6y ago
I took Chloroquine as a prophylactic anti-malarial before and during a trip to Central America. You can get the crazy dreams whether or not you’re infected. Mine were, fortunately, quite vivid (and sometimes lucid) but not disturbing. The scenarios were pretty wild though. Other friends of mine had less pleasant experiences. For example, one had a recurring dream that his abdomen got ripped open, a load of pebbles fell out (instead of viscera), and a flock of ravens came and eat the pebbles while he watched in agony. Every night, over and over, for about two months. During your waking hours, nothing feels amiss at all. Keep in mind too that the dosing is once a week. It took a week or two for the effects to start for me, and they persisted for almost a month after I was home. Unlike reports from the various psychedelics you listed, I felt absolutely no euphoria or “spiritual awakening” from any of it; I just woke up every morning and thought “wow, that was fucked up!”

Ductapemaster 6y ago

Is there a reputable non-profit I can donate to that provides this treatment? The idea that $3 is unaffordable for so many is so sad. I would gladly provide for a number of people to be treated if I could trust the money goes to them.

jlebar 6y ago
https://www.givewell.org/charities/top-charities https://www.givewell.org/charities/top-charities
- Ductapemaster 6y ago
  I realize now I could have googled that myself, but it is nice sometimes for the things you thought of to be validated by others. Thank you! Adding this to my yearly donations list.
- wizzwizz4 6y ago
  https://app.effectivealtruism.org/funds/global-development https://app.effectivealtruism.org/funds/global-development This fund goes to GiveWell's top charities, unless there's something that the fund managers think could do better in expectation. (For context, the EA Meta fund went towards founding GiveWell and https://80000hours.org/; https://80000hours.org/; they know what they're doing.) If you're too lazy to keep track of GiveWell's top charities at any given time, or want to contribute to medium-risk high-reward causes too, that's a good place to put your money.

rawoke083600 6y ago

Yup those dreams are real on the medicine ! Damnn ! I SAW aliens like the little grays, they were in my bedroom when I woke up. Till this day I'm not sure if it was the pills and a dream or if there were real grays visiting me... Maybe they needed a specimen that took malaria-pills ? Never taking malaria pills again. And I live in South Africa.

softwarejosh 6y ago
it was a dream unfortunately :(

jcampbell1 6y ago

What drug did you take? I got malaria and a friend mixed up a white powder with bottled water and I injected it in my leg. I was better in 24 hours and don’t recall any side effects. My guess is the drug was chloroquine, but not sure. Based on other’s experiences, I am glad I was young and dumb enough to opt for a questionably sterile injection. I was fortunate to have made a friend that worked in oil services in Nigeria, and he had “malaria training” from Schlumberger, and the bottled water injection sounds crazy, but was the recommended treatment.

cguess 6y ago
I was on cholorquine. It was four pills, twice a day, for three days. They do have one-and-done pills that are MASSIVE, but they, from my friends' advice really screw with you even more than the normal stuff. Note: DON'T drink while being treated for malaria. The parasites hide out in your liver, and the drugs shut it down further. 1/3 of a pint and you're spinning like a freshman during welcome week.

giardini 6y ago

Here's a lengthier but fascinating description and personal history of someone who caught malaria and treated it with quinine derivatives (and then caught it again...): "Of Quinine And Chloroquine" by Willis Eschenbach / https://wattsupwiththat.com/2020/04/11/of-quinine-and-chloroquine/ https://wattsupwiththat.com/2020/04/11/of-quinine-and-chloro...

tsuyoshi 6y ago

In Cambodia, I got what I assume must have been a less serious case, because I didn't have any vomiting or diarrhea, only the worst headache I've ever had in my life. Luckily the lack of air conditioning wasn't a big problem, because it was close to the coldest part of the year. It permanently reset my pain scale. When I later had a pulmonary embolism and appendicitis, the doctors were confused that I said my pain was only 7 on a scale of 1 to 10. The drug I took for it (mefloquine) didn't give me any unusual dreams, but it permanently altered something in my brain. I don't agree that DDT is necessary to eradicate malaria. See for example that malaria has been eradicated in Thailand (except for border areas), but not (yet) in Cambodia, Laos, or Myanmar, despite having the same climate. A combination of regular pesticides and flood control are sufficient - if the government is competent and dedicated. It's a political problem, not a technical problem.

cguess 6y ago
I feel you with the pain. It was horrifying. RE: DDT, I didn't mean to imply it's the only way these days, just that there was a very good reason it was so popular in the former part of the 20th century. I love the tune to "Big Yellow Taxi" but it was never about "spots on my apples." It still is used in very rare and specific circumstances, but we have a lot better understanding of how to stop mosquito. Which is why they're really only a problem in poor countries, mitigation is unfortunately not cheap and convenient.
tandr 6y ago
> but it permanently altered something in my brain Sorry to ask and if it is not too much to share - What kind of changes are you talking about?
tim333 6y ago
>I assume must have been a less serious case Wikipedia has: >Cerebral malaria is the form of severe and complicated malaria with the worst neurological symptoms. Glancing at this it may be more likely your brain was altered by the malaria than the mefloquine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056312/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056312/

KMag 6y ago

The anti-malarial drugs are not all the same. I've taken hydrochloroqine a few times without much side effect. Mefloquine is on a completely other level, at least for some people. One of my closest friends from university was also a work colleague at the time he went on a recruiting trip to India and his travel doctor prescribed mefloquine for him. It's standard practice to keep taking the drugs for some time (2 weeks, IIRC) after leaving a malarial area, and he was noticeably mentally altered when he returned. He seemed uneasy with his eyes darting around, and he wasn't his normal outgoing self. He seemed a bit paranoid. The incident that brought it all into sharp focus involved a couple of colleagues that were your garden variety gossipy braggarts and I had a minor disagreement with one of them that we resolved quickly, but which prompted my friend to whisper to me "You don't get it. They're not good people." He gave me a look like I was the crazy one for believing the minor argument was resolved. (On the one hand, he was right. I would never trust the one any further than I could throw a fully loaded server rack. However, I still smiled, remained social, and watched my back.) I googled [mefloquine paranoia] and went down a deep rabbit hole. I found out that mefloquine has been suspected in several incidents of peace-keeping troops getting paranoid and attacking unarmed civilians. [mefloquine "freaky Friday"] or [mefloquine "wacky Wednesday"] may be a better search. Also, at least at that time, several sites said that if you had ever taken mefloquine in your life, you were ineligible for one of the front-line malarial treatments should you ever contract the disease. Due to his mood changes / paranoia, I strongly suggested he talk to his doctor about coming off of his medication after just one week back in the U.S. > 100F+/35C+ temps Note that 35 C is below normal body temperature. 100F ~= 37.8 C. I used to donate plasma once a month back when I lived in the U.S. (I'm fortunate enough to not have cytomegalo virus, so newborns, chemo patients, HIV patients, etc. can receive my blood.) My body temperature for my pre-donation check-up was typically 35.8C/96.4F.

vixen99 6y ago

And malaria reemerged elsewhere after DDT was banned around 1973 thanks to Rachel Carson's book. A professor of pediatrics summarizes how millions died as a result and how WHO reinstated DDT in 2006. https://www.thedailybeast.com/how-rachel-carson-cost-millions-of-people-their-lives?ref=scroll https://www.thedailybeast.com/how-rachel-carson-cost-million...

restalis 6y ago
That's not quite right to cast the blame on her. She was right, DDT indeed accumulated in soil and caused bad effects. Blame the people that actually made the call to ban DDT without a plan to prevent the bad consequences. That move could have been handled better.
msla 6y ago
DDT is still used in the Third World, and mosquitoes are becoming resistant: https://www.sciencemag.org/news/2016/10/after-40-years-most-important-weapon-against-mosquitoes-may-be-failing https://www.sciencemag.org/news/2016/10/after-40-years-most-... https://mosquitoreviews.com/insecticides/ddt-resistant-mosquitoes https://mosquitoreviews.com/insecticides/ddt-resistant-mosqu... > Several serious human health problems, including diabetes and hormonal disruptions, have been linked to DDT, and it is suspected to be carcinogenic. So, no, it wasn't just the eagles.