Yes, I can address the question of whether civilians have also been affected by mefloquine. I should point out that I believe this issue attracts a lot of attention. The issue of adverse health effects among veterans attracts the most attention because this is a large group of persons, a large population that is given the drug at one time, and so perhaps problems with the drug will be more apparent within groups of military veterans. For example, in the United States we have been using mefloquine for quite some time on our Peace Corps volunteers, who are civilians. This is increasingly an area of concern and controversy. It's the subject of significant media attention at the moment in the United States. Of course, we would expect civilians to be as susceptible as military personnel to these adverse effects.
One thing I will say—and I think it's important to understanding why our veterans may have been more affected than other persons—is to keep in mind the product insert. The manufacturer's directions explicitly state that you must discontinue the drug at the onset of certain symptoms: anxiety, depression, restlessness, or confusion. This has been the advice given to Canadians, I believe, since the drug was first marketed. Today that advice is even more strict: if you experience any psychiatric symptom, you must immediately discontinue the drug. This is recommended in order to avoid these more serious effects.
Travellers on vacation would certainly abide by that advice if it were given to them, but soldiers often don't have that luxury. Soldiers may have been experiencing all of those symptoms and more, and may have been told to continue taking the drug. That is why I think we've seen many more serious side effects in military populations than among civilian travellers, because they were in essence ordered to take the drug, contrary to the product insert guidance.
I hope that addresses the question. Civilians may simply stop taking the drug, but military personnel are in many cases ordered to, and that increases the risk of these more serious effects.