EMERGENCY

ACTIONS

FA Q S
Q. What are my chances of catching malaria in Angola? A. You can expect between 65 to 300 infected mosquito bites per year in various parts of Angola. Zaire province has stable year round malaria exposure and is considered the highest risk. Q. How quickly can I expect symptoms to appear? A. Typically 7-30 days after being bitten by infected mosquito.

1. Feel feverish, have cold or lu symptoms? Consider Malaria irst 2. Go to medical provider and insist on malaria test 3. If this is not an optionfollow the directions on the malaria emergency kit 4. Call Emergency Contact Numbers for further advice

EMERGENCY CONT ACT NUMBERS

of MALARIA

IT ONLY TAKES ONE TO BITE CATCH MALARIA

BECHTEL CORPORATE HEALTH Jenette Walker: (301) 228 7767

This malaria warning card shall be issued to all personnel returning from site.

ANGOLA ES&H SITE MANAGER Steve Martin: 001 244 935-545-251 ANGOLA SITE MEDICAL Kenny Kopytek: 001 244 927-568-959

Angola LNG Project

What are the ABCDEs of Malaria?

The ABCDEs are the components of Bechtels Anti Malaria campaign: Awareness, Bite Prevention, Chemoprophylaxis, Diagnosis and Emergency Treatment. This pamphlet is an introduction to the ABCDE philosophy and Bechtels anti malaria program on the Angola LNG Project. Additional information will be provided in the Site Orientation Training and is located in the Environmental, Safety & Health Management Plan.

CHEMOPROPHYLAXIS
Anti malaria medications are a secondary defense against malaria; they only work when a person is exposed to malaria from a mosquito bite. There are three choices of anti malaria medication in Angola (Chloroquine is no longer effective in this country): Doxycycline An antibiotic that works on the parasitic cell division in the blood. This pill has a short half-life and needs to be taken daily. Side effects include nausea if taken on an empty stomach, sun light sensitivity and increased susceptibility to yeast infections. In addition, this medication should not be taken by women on birth control pills as it decreases their effectiveness. Me loquine Similar to Doxycycline, this medication works on parasitic cell division. This drug is chemically similar to quinine which has been used for centuries as an antimalarial. It is taken once a week because of its long half-life and is highly effective. Side effects include potential bad dreams and psychological symptoms. This drug may not be best for you if you if you have had a history of depression or seizures. Malarone This is a combination of two drugs that ight the parasite in the blood stage and liver stage of the parasites life cycle. It is new to the pharmacological market so long term data are not available. Side Effects include headaches and upset stomach. For those people who choose to protect their health and avoid a potentially life-threatening medical emergency, anti-malaria medication will be provided to all employees free of charge. Expatriates are required to take anti-malaria medication prior to mobilizing, while on-site, during rotational leave

cycles and following demobilization Malarone2 days before mobilizing and 7 days after demobilizing Doxycycline2 days before mobilizing and 7 days after demobilizing Lariam1 week before mobilizing and 4 weeks after demobilizing

DIAGNOSIS
Malaria symptoms may include: Fever Headache Chills Vomiting Diarrhea Fatigue Confusion Dizziness

AWARENESS
Malaria is a very serious parasitic disease transmitted by the bite of an infected mosquito. Malaria is commonly found around the World, particularly SubSaharan Africa. Here are some facts: Falciparum type malaria is the number one health problem and cause of death in Angola If left untreated, this type of malaria can kill within 24-72 hours of the onset of symptoms Serious cases Malaria are preventable with the right combination of mosquito bite control, anti malaria medication and rapid treatment

If you experience any of these symptoms one week or more after entering a malaria risk area, and up to 3 months after departure, it is a seriouse medical emergency; seek medical attention immediately! Diagnosis for malaria can not be delayed for any reason. If you experience any of these symptoms you must be seen by a health professional who understands the urgency. Tell your doctor you have been exposed to Malaria and insist on a Malaria test! If they dont have one, use your emergency treatment kit.

BITE PREVENTION
Mosquito bite prevention is the most effective method for controlling malaria. Bechtel will manage a vector control program on site but cannot guarantee a mosquito free zone especially when considering travel through the airports and any offsite work. Personal protection against malaria-infected mosquitoes includes: The use of DEET mosquito repellents Wearing Long sleeve shirts and trousers at night Strict closure of windows and doors.

EMERGENCY TREATMENT
Malaria may be fatal if treatment is not started within 24-72 hours of YOUR FIRST SYMPTOMS, which may be just a general feeling of fatigue. Therefore, travelers doing business on behalf of the Angola LNG Project shall be issued Malaria Emergency Kits. These kits include directions, a rapid blood test, and curative drugs with instructions on how to get further care.