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Getting a good view of the main crater of the Santiago volcano while visiting Masaya national park in Nicaragua. (OSWALDO RIVAS/REUTERS)
Getting a good view of the main crater of the Santiago volcano while visiting Masaya national park in Nicaragua. (OSWALDO RIVAS/REUTERS)

Our kids are 6 and 2 and we're travelling to Nicaragua. Are anti-malarials safe for kids? Add to ...

TRAVEL CONCIERGE: Malaria is a little bit different in Central America as the parasite is still sensitive to the drug chloroquine, physician Mark Wise says.

"Chloroquine is usually well tolerated and can be given in kid doses," says Dr. Wise, who wrote Travel Health Guide and runs the Travel Clinic in Toronto. "It's not generally associated with the side effects that people associate with mefloquine."

Mefloquine is the anti-malarial drug whose secondary effects can include vivid dreams, insomnia and anxiety (and on rare occasions seizures and psychosis) - not what you want on a family holiday.

Malarone, which combines proguanil and atovoquone, is also well tolerated and comes in pediatric doses, Dr. Wise says. Potential side effects for both these drugs are limited, generally, to upset stomach.

Malaria is present in some areas of Nicaragua, so first, figure out where you're going to be in the country. The U.S. Centers for Disease Control, which describes the estimated risk for travellers as "low," provides a useful map at www.cdc.gov/malaria.

There are other precautions you can take against this mosquito-spread illness, including reducing exposure at dusk and dawn, using insect repellant containing DEET and sleeping with mosquito nets.

DEET is safe for kids, says Dr. Wise, who recommends a10-per-cent concentration for children aged six months to 12 years. Adults should apply it, and keep it away from kids' eyes, mouth and hands. "And you wash it off when you go indoors at night into a nice screened room."

As part of your planning, remember to visit a travel clinic or doctor to discuss how to keep your family healthy while abroad. And don't forget to seek care if anyone succumbs to fever-like symptoms after the holiday as this serious parasitic infection can mimic a fever's headaches, chills and shakes.

Malaria is treatable if it's treated promptly and properly, says Dr. Wise, who says health issues shouldn't stop people from travelling. "You just need to be informed of what the potential risks are, how great the risks are and how you can minimize the risks."

Send your family travel questions to concierge@globeandmail.com

Karan Smith is a former Globe Travel editor. Special to The Globe and Mail

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