Malaria prophylaxis for 15 months old baby to Central America

We're planning an overland trip through Central and South America. What types of malaria prophylaxis do you recommend for our son (currently 15 months old)? We plan to be in malarial regions for several months at least.

We do not recommend malaria prophylaxis for Mexico. This risk is very small and the American guidelines from the CDC are not recommending malaria pills for Mexico. 
South of Mexico to the Panama canal, you can use chloroquine, and you can find our guidelines for how to dose chloroquine  to children here:

http://www.traveldoctor.eu/page/38.html

South of the Panama canal you can use Malarone and Lariam. We would recommend Malarone because it has less side effects. Malarone will also work fine for the rest of Central America, but is is more expensive compared to chloroquine. You can find our guidelines for Malarone here:

http://www.traveldoctor.eu/page/41.html

Malaria prophylaxis is not needed in all countries and some areas are free of malaria. If you search for instance on Guatemala, you will find our map of areas where malaria phrophylaxis is needed at the bottom of the page, if you follow this link:

http://www.traveldoctor.eu/trip/result.7.182.1.html





Dominican Republic with 2 year child

What immunisation does a child of two require before travelling to the Dominican Republic.

I suppose the child have received an MMR. If so, we would only recommend a vaccine against hepatitis A.

There is a small risk of malaria in the eastern province, and if you follow this link

http://www.rejsedoktor.dk/trip/result.7.174.1.html

you will find a map at the bottom of the page of the area where we advice malaria prophylaxis. The maps can be moved and zoomed in and out. 



3 year old to Thailand

Me and my wife are going to Thailand in november 2009 and are covered for yellow fever and the like but we are taking our 3 year old daughter with us and would like to know what injections she may need. 
We are not going in the jungel just a beach holiday..

I suppose your daugther has all the relevant childhood vaccinations including MMR. If she has we would just recomment a vaccination against hepatitis A. After a second vaccination 12 months after the first she is covered for the next 25 years. You could consider giving her the combined hepatitis A and B vaccine so she is covered for hepatitis B as well for the next 25 years, but is is not necessary strictly looking at this particular travel alone.




Solomon Islands with 2 infants

I have been living in Honiara, Solomon Islands for 6 weeks and will be here for another 4 months. I am with my 5 year old daughter and 3 month old baby and husband. I am currently breast feeding my baby but plan to finish soon. Before I left my local doctor in Australia said I could not have any vaccinations as I am breast feeding and did not recommend any for my daughter and baby so w have had nothing except the rota virus for my daughter. My baby had his 2 month injections before we left. Can you please advise whether we should have any vaccinations now that we are here such as Hep A and typhoid or any others as I am concerned. Can you tell me if it is too late and what is suitable and needed for my family. We live in a house and are protected here and dont drink the water but my daughter swims in the rivers and plays with the local kids so may be mre prone to catching something. We are taking precautions for malaria by sparying repellant and not going out after 5pm and using mosquito nets. Any advise would be greatful.

Many vaccines do you work in small children and for instance the hepatitis A vaccine can not be used before 12 months and typhoid before 2 years of age.
It is a good idea with the rotavirus vaccine and you should immunize the 3 months baby against hepatitis B and the 5 years child against hepatitis A nad B (Twinrix).
Malaria is a problem in the Solomon, and we would usually recommend prophylaxis. Malarone is regisred to children down to 11 kilo body weight, but you can crus the tablets and divide them into halves and threequarters. Half a children malarone tablet to a child og 5 kilo and 3/4 to children from 7 - 10 kilo and from 11 kilo one children Malarone tablet daily.




Vaccination of children

My children are 11 and 8. We are considering travelling to China, SE Asia, India and East Africa.
I am concerned about children of their age being vaccinated. Is it safe for them to be vaccinated and what vaccinations would they require?

Vaccinations are not more dangerous to children compared to adults, and vaccinations is a very efficient way of protecting against severe diaseases with a very low risk of side effects.
It is difficult to answer your question without knowing how long time you will be travelling.
Our basic recommendations for travels less than 4 weeks would be the usual childhood vaccinations especially MMR is important plus hepatitis A and B,and yellow fever for East Africa.



Bali with a child

We are travelling to Indonesia - 1 week Bali and 1 week Lombok in April. One of our two children only weighs 30 kg and therefore we are not sure if we can give him Malarone. His paediatrician advises Lariam, but we are a bit wary about the side-effects on such a small child.

Malarone is available for children as tablet of one quarter strength af teh adult tablets. These may not be available in Switzerland, but they can usually be obtained through application to your national drug authority.
Children weighing 30 kg skould receive 3/4 adult dose or 3 childrens tablets daily or if he is just under 30 kg 2 tablets childrens dose will be enough.
There is no malaria on Bali, so you only need prophylaxis for the stay at Lombok.



11 months child to Thailand

I have been visiting Thailand for almost 15 years and we would like to take our baby who will be 11 months at the time of travel.
We will be going to the tourist areas of Phuket and Ko Samui. What are the risks and vaccinations needed as I have had varying advise.

My biggest concern would be measles and I would give the child the first Measles-Mumps-Rubella vaccine before leaving.
The child is protected aganist diphteria, tetanus and polio from the other childhood immunizations and hepatitis A is a mild disease in infants. Malaria risks at the destinations you mention is negligible and we do not recommend prophylaxis with tablets.
Make sure that the child has proper protection against the sun.

You are also welcome to ask your own questions.