Anti-malarial medication support available for veterans
DVA is working with private health insurer Bupa to deliver a national health assessment program for veterans concerned about having taken the anti-malarial medications mefloquine and tafenoquine during service in the Australian Defence Force (ADF).
The program enables veterans to receive a comprehensive health assessment free of charge from a Bupa-contracted general practitioner (GP). The GPs delivering the health assessment have been selected based on their unique experience in providing medical care to veterans.
Veterans will receive a health support recommendations report at the end of the assessment, which forms the basis for clinical and diagnostic testing and appropriate pathways for ongoing treatment by the veteran’s regular GP.
Bupa has recruited 15 GPs across the country to provide free health assessments. A list of GP locations is available on the DVA website. If a GP is not available in your location, telehealth appointments are available by phone or videoconference.
DVA encourages any veterans, including current serving members of the ADF, who may be interested in receiving a health assessment to call DVA’s 1800 MEFLOQUINE hotline (1800 633 567) or Bupa directly on 1800 612 798 to schedule an appointment.
Further information about the program is available on the DVA website.
Hello Ray,
Good to see John Dwyer has received the OAM, as a former commander of 7 Platoon C Coy 1RAR in 1965 in South Vietnam, he led us through a very difficult and stressful time. We suffered more than enough casualties for one platoon during that tour of duty (5 killed & 20 wounded) and John remained stoic to the end. Congratulations John.
Regards
Pete Lindwall
Good day Ray,
As an RAAMC MO I am interested in the outcome and side effects of the Mefloquine trial which I understand was conducted in East Timor apparently under appropriate drug trial protocols. However, I understand that is disputed and some ADF members in the trial may have suffered side effects.
Our experience in Vietnam was relevant. There are a number of human malarias but the one that is potentially fatal is that caused by the Falciparum variety and this type of malaria was responsible for a significant loss of manpower in Vietnam and unfortunately one death.
This is all started in North Malaya about 1963–4 when first soldiers from 2RAR and then 1NZIR suffered an outbreak of Falciparum malaria. The mainstay for treatment at that time was a drug called Chloroquine. To the considerable dismay of the treating medical team the malaria was found to be resistant to this agent. This was the first time that Chloroquine resistant Falciparum malaria was identified. To treat the disease it was necessary to fall back on Quinine in combination with other medications. Even then there was a significant number of “breakthrough” and the treatment had to be repeated. The soldier who suffered this malaria lost weight and was physically weakened to the extent that he was unfit for the rigours of infantry duty.
We went to Vietnam with the knowledge that Falciparum malaria was resistant to Chloroquine and Paludrine which was the chemoprophylaxis used by the Australian Army. And we had a lot of problems with this and most sufferers had to be medevaced for treatment and Rehabilitation
This was the situation until the drug Dapsone used in the treatment of leprosy was found to give protection against Falciparum malaria. There was experience with this drug and its side effect profile was well known. A drug trial using Dapsone was undertaken by two Australian battalions one on Dapsone and one of a placebo. The results were spectacular in that the unit on Dapsone had a “cliff fall” response with cessation of cases of Falciparum. And so the trial was discontinued and the force started taking both Paludrine (still effective against Vivax malaria) and Dapsone.
The main side effect of Dapsone was a condition effecting the white cells of the blood, called Agranulocytosis and this rendered the sufferer prone to serious bacterial infection. The main symptom of this was as sore throat and so any ADF member presenting with a sore throat had to have an urgent blood count to determine the condition of the white cells in the patient’s blood.
As far as I know we had two cases of agranulocytosis and both recovered with cessation of the Dapsone and routine medical treatment including isolation.
So there we have an example of the widespread use of a medication with known complications where the advantages out weighed the risk.
So all this Ray to explain that there is a need to keep researching and trialling for a medication to protect a ADF commitment in a dangerous malarial area. The definitive answer may be in the development of a malarial vaccine.
For your information. Best Regards Mate.