Health advice for travelers

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1 Health advice for travelers Welcome to Thailand Every year millions of tourists set Thailand as one of their favorite destinations. The information provided here will help you come up with appropriate protection against some common illnesses and promote enjoyment of your happy stay in Thailand. Malaria Malaria is caused by a parasite that is transmitted by the bite of an Anopheles mosquito that is found in almost occurs between dusk and dawn. Bangkok and most popular tourist destinations such as Chiang Mai, Phuket, Hua-Hin, Pattaya and Koh Samui have been free from malaria for decades. Now all urban cities in Thailand are malaria free. However, malaria is still transmitted in rural areas especially in forested areas that border Burma, Cambodia and Laos. The estimated risk of acquiring malaria in Thailand varies markedly within various regions, depending on the intensity of disease transmission as well as the itinerary, season, duration and type of travel. Chloroquine and most other chemoprophylactic drugs have proved to be ineffective against falciparum malaria in Thailand. All travelers visiting malaria endemic areas are recommended to take precautions against mosquito bite. After sunset, they should stay in screened quarters or mosquito nets, wear long-sleeved shirts and pants, and may apply mosquito repellents. All travelers should be informed that regardless of methods employed malaria still may be contracted. Therefore those who develop fever within two weeks of entry to risk areas should seek prompt medical examination and treatment.

2 Dengue fever and dengue hemorrhagic fever Dengue fever is a common viral disease in Southeast Asia. The viruses are transmitted through the bite of infected mosquitoes that feed both indoors and outdoors during the daytime (from dawn to dusk). The highest infection and transmission rates occur during rainy seasons (approximately May to September in Thailand). All travelers are at risk if going to a destination where dengue endemics; however travelers are not at high risk for severe dengue hemorrhagic fever. Travelers with no prior dengue infection history are less likely to develop severe forms of the disease than natives from an endemic region. Long-term travelers and those who participate in outdoor activities during endemic season are at higher risk. In most cases, the illnesses are asymptomatic or mild. In rare case, dengue fever may progress to dengue hemorrhagic fever, which can be fatal. The infection is characterized by flu-like symptoms such as high fever, severe headache, muscle pain and rash. Travelers can protect themselves from dengue infection by using insect repellent while indoors or out, not taking aspirin or other kind of NSAIDs for fever and if the travelers get fever more than 2 days, they must see doctor for diagnosis and prompt treatment. There is currently no preventive medication or vaccine against Dengue.

3 Rabies Rabies is a deadly disease caused by a virus. Any mammal, including dogs, cats and humans, can get rabies. It can be transmitted to another animal or a person through saliva. Thailand has been working toward elimination of the disease and the situation has been much improved, however travelers are advised to take prevention if their travel itineraries increase risk for exposure to animal bites. Those who plan a trip for walking tour or sightseeing trip should consider having pre-exposure rabies vaccination prior a trip. If you get bitten or scratched by an animal that might has rabies, immediately wash the wound with soap and water for at least 5 minutes to try and rinse away animal s saliva. Then visit your doctor or local emergency room as soon as possible for evaluation and consideration for vaccination. If the biting animal tests positive for rabies (or if the biting animal can t be found), you will need to get the anti-rabies shots as soon as possible. The shots help your body make "antibodies" that will attack the virus and make it harder for it to enter a nerve cell. If you get the shots started in time (usually within 7-10 days), the virus will die. Without the treatment, the virus will reach brain and spinal cord, and by then it s usually too late for doctors to help.

4 Typhoid fever Typhoid fever is a serious disease caused by the bacterium called Salmonella typhi. People get typhoid from food or water contaminated with feces of infected people. Typhoid is not common in Thailand, so routine typhoid vaccination is not recommended. To prevent typhoid and other diarrheal diseases, avoid uncooked food and drink only boiled or bottled or carbonated water. Food served at street vendors should be considered at risk. Fresh vegetables and fruits should be adequately washed with clean water. Fresh salad should be taken only from a salad bar or a restaurant of hygienic standard. Tap water in many cities is claimed to be safe for drinking, but it is still advisable to stick to safety precautions. Danger from diarrhea primarily is the result of the loss of water and electrolytes from the body. If you happen to have diarrhea during your travel, the most helpful remedy is drinking electrolyte solution to replace the loss. Therefore, it is always useful to keep some electrolyte solution packets in your first-aid kit. If your diarrhea gets worse or does not improve within hours, consult the physicians for proper investigation and treatment.

5 Viral hepatitis *Credit by Microbiology and Immunology On-line ( There are two major groups of viral hepatitis. Hepatitis spread by contaminated food and water, hepatitis A and E, are endemic in many parts of Asia. Most local people are immune to these types of hepatitis through natural infection, but travelers from better hygienic environments can be receptive to infection- Therefore, travelers are recommended to practice prevention measures against food and water borne diseases, as suggested for diarrhea. An alternative protection for hepatitis A is the immunization with hyper immune serum or hepatitis A vaccine. Consult with the physician at an established medical service for the immunization. Another group of hepatitis; hepatitis B, C and D; are transmitted through contaminated blood and sexual contacts, or passed from infected mothers to their babies at the time of birth; similar to the ways HIV/AIDS is transmitted. This group of hepatitis can be simultaneously and effectively avoided if precautions immunization against HIV/AIDS are strictly taken. However, for those who require immunization, effective vaccine against hepatitis B is available at most medical services.

6 Sexually transmitted diseases and HIV/AIDS Urethritis remains the most common treatable sexually transmitted disease (STD) among tourists to Asia. Gonorrhea in Southeast Asia region is frequently multi-drug resistant. While syphilis become less common, HIV/AIDS is spreading at worrisome speeds in most Asian countries, resulting mostly from unprotected sexual contacts. Promiscuous sex anywhere can be dangerous. For travelers, local sex workers, either of explicit or concealed types, are potential sources of STDs and HIV/Aids. All casual sex should be avoided or strictly protected with the use of condoms. For more information, please contact: International Communicable Disease Control Section, Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health or Tel

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