England’s players have commenced their 12-day courses of medication to combat malaria before the trip to Manaus for Saturday’s opening group game against Italy, with the team’s medical staff prepared to risk potential side effects in preference to contracting the disease.
The Football Association, having consulted with an expert at the London School of Hygiene and Tropical Medicine, have prescribed Malarone for the 23-man playing squad and 49 additional travelling back-room and administrative staff.
All were given their first pill at breakfast on Tuesday, 48 hours before they depart for Manaus but, while the drug – which contains atovaquone and proguanil hydrochloride – is effective in preventing and treating malaria, it can cause side effects over the course of the treatment. The most common of those include diarrhoea, nausea, vomiting, stomach pain and headaches, which affect around one in 10 people who take the drug, any of which might hamper England’s players before the game at the Arena da Amazônia.
The manager, Roy Hodgson, chose not to take Malarone when visiting Manaus in February before the World Cup workshop – other members of the FA’s delegation did undertake a course of tablets – but has been instructed to take the pills for the team’s three-day stay in the city this time around.
“It’s a question for the doctors really: I went to Manaus and I didn’t take any for the two days I spent there,” said Hodgson when asked about potential side effects for his players. “That might just be something to do with the fact that I’m not a football player.
“As far as I’m concerned, I’ve got to go with medical opinion. If the doctors are telling me that, when we go to Manaus, the players must take malaria tablets, whether it has side effects or not, what do I do? I can’t turn around and say: ‘We will not take malaria tablets’ because the bottom line is it’s better to have stomach cramps or whatever it is for one player in 10 than have someone contract malaria, because that would be unthinkable.”
Fifa’s chief medical officer, professor Jiri Dvorak, had addressed representatives of all 32 teams at the workshop in Florianópolis in February and stressed there was no need for any of the teams’ staff to be vaccinated against yellow fever ahead of the finals. Fifa had apparently consulted the World Health Organisation who advised them such precautions were unnecessary.