... Relevant Travel Information

Every year, more than 10 million tourists visit this country as one of their travel destinations. Many arrive with insufficient health advice which often results in bounts of illnesses that spoil a good part of their journey. The information provided in this page will help you come up with appropriate protection against some common illnesses and promote enjoyment of your happy stay in Thailand. 

Before You Travel - Medical Kit Check List 

Following is a list of items you should consider including in your medical kit. Consult your pharmacist for brands available in your country. 

• Aspirin or paracetamol (acetaminophen in the US) - for pain or fever. 

• Antihistamine - for allergies, such as hay fever; to ease the itch from insect bites or stings; and to prevent motion sickness. 

• Antibiotics - consider including these if you're travelling well off the beaten track; see your doctor, as they must be prescribed, and carry the prescription with you. 

• Loperarnide or diphenoxylate - which are 'biockers' for diarrhoea; prochlor- perazine or metaclopramide for nausea and vomiting. 

• Rehydration mixture - to prevent dehydration, eg due to severe diarrhoea; particularly important when travelling with children. 

• Insect repellent, sunscreen, lip balm and eye drops. 

• Calamine lotion, sting relief spray or aloe vera - to ease irritation from sunburn and insect bites or stings. 

• Antifungal cream or powder - for fungal skin infections and thrush. 

• Antiseptic (such as povidone-iodine) - for cuts and grazes. 

• Bandages, Band-Aids (plasters) and other wound dressings. 

• Water purification tablets or iodine. 

• Scissors, tweezers and a thermometer (note that mercury thermometers are prohibited by airlines). 

• Syringes and needles - in case you need injections in a country with medical hygiene problems. To avoid problems with local authorities, ask your doctor for a note explaining why you have them. 

• Cold and flu tablets, throat lozenges and nasal decongestant. 
Multivitamins - consider for long trips, when dietary vitamin intake may be inadequate. 

Immunizations

Yellow Fever

Although yellow fever does not occur in Thailand, an official yellow fever vaccination certificate may be required depending on your itinerary.

The Requirement is that a yellow fever vaccination certificate is required for travelers over 1 year of age coming from infected areas. A certificate is also required from travelers arriving from endemic countries.

Other Vaccines:

Depending on your itinerary, your personal risk factors and the length of your visit, your health care provider may offer you vaccination against hepatitis A, typhoid, hepatitis B, Japanese encephalitis, rabies, influenza, or a one-time polio booster if you haven't previously received one for travel. Routine immunizations, such as those that prevent tetanus/diphtheria or childhood" diseases, should be reviewed and updated as needed.

Determine whether you'll be at risk for malaria and what preventive medicine you should take if you are. Risk is limited to evening or nighttime exposure in rural forest/jungle areas rarely visited by travelers: primarily border regions with Myanmar in the west (Tak Province poses a risk), with Cambodia in the southeast (Trat Province poses high risk), and with Laos in the north. There is no risk in the interior of Thailand nor in the cities and main tourist resorts (Bangkok, Chiang Mai, Chiang Rai, gulf islands, Pattaya, Phuket Island, Ko Samui, etc.)

Medicines that protect against malaria in this area include doxycycline or atovaquone/proguanil (Malarone). The best drug for you depends on your itinerary and on a number of personal factors that should be discussed between you and your health care provider. Because no malaria drug is 100% effective, if you have traveled in an area of malaria risk, seek immediate medical attention for any fever or flu-like illness occurring within 3 months of your return home. Be sure to tell your health care provider your travel history.

About Travel Diseases

Malaria

Bangkok and most provinces in the central region as well as major tourist resorts such as Chiang Mai, Phuket, Hua-Hin and Koh Samui have been free from malaria for decades. Now all cities in Thailand are malaria free. However, tourist destinations in rural neighborhoods, especially those in the mountainous and border areas are still at certain risks.

Chloroquinine and most other chemoprophylactic drugs have proved to be ineffective against falciparum malaria in Thailand. Tourists visiting these endemic areas are rather recommended to take general precautions against mosquito bite. After sunset, they should stay in screened quarters or mosquito nets, wear long sleeve shirts and pants, and may apply mosquito repellents. Those who develop fever within two weeks of entry to risk areas should seek prompt medical examination and treatment.

Japanese Encephalitis

This viral infection of the brain, is contracted through the bite of mosquitoes that prevail in rural agricultural areas. It is found in many Eastern and Southeastern Asian countries, primarily in the rural and suburban areas. Similar to malaria, the disease can be prevented by avoiding mosquito bite during the night time. Travelers who plan to spend their time exposing to rural environment in these regions for over several months are recommended to take Japanese encephalitis vaccination before entry.

Dengue Fever and Dengue Hemorrhagic Fever

These diseases are endemic in Southeast Asia. They are caused by dengue virus from the bite of aedes mosquito that lives in the houses and their neighborhood. This mosquito bites during the day time. Dengue infection in local people, mostly children, often results in fever with bleeding in the skin and other organs (dengue hemorrhagic fever) which is sometime fatal but for travelers from non-endemic areas, the infection usually manifests as fever with a rash on the skin, severe headache and muscle and pains and is usually non-fatal. 

Dengue infection is common in the rainy season (approximately May to September in Thailand) when aedes mosquito is abundant. Travelers visiting local households or their vicinity, especially in the rainy season, should be using mosquito repellent even in the day time. Ones who are ill with symptoms suspected of dengue infection should seek medical consultation to establish the cause of the illness. 

Rabies

Rabies can be found in many animals especially dogs and cats. Although Thailand has been working toward elimination of the disease and the situation has been much improved, travelers are recommended to take prevention if their travel itineraries allow possible exposure to animal bites. 

Those who plan walking sight-seeing in local communities should consider having pre-exposure rabies vaccination before starting off. Three intramuscular injections of cell-culture rabies vaccine are required. In case of exposure to animals without prior vaccination, the pose-exposure vaccination is usually effective if it is initiated without delay. However, for those who have had pre-exposure vaccination, if they are bitten, they should also seek prompt consultation with the physician for evaluation and consideration for booster vaccination.

Diarrhea

Diarrhea is mostly caused by ingestion of food and drinks contaminated with bacteria or viruses. To prevent diarrhea, avoid uncooked food and drink only boiled of 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 Southeast Asian 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 12-24 hours, consult the physicians for proper investigation and treatment.

Typhoid Fever

Typhoid fever has become uncommon among Thai people. However, travelers should not neglect taking prevention against this food and water borne disease. Precaution measures for diarrhea, as mentioned above, are effective for typhoid as well. It is also recommended that the travelers receive typhoid vaccination, in injectable or oral form, before start of the journey. However, those who need initiation or booster vaccination can find the service at most hospitals and clinics in Thailand.

Sexually transmitted diseases STD's & HIV/AIDS

Urethritis remains the most common treatable sexually transmitted disease (STD) among tourists to Asia. Gonorrhea from Southeast Asia is frequently multidrug 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. Danger from intravenous drug use with sharing of needles and syringes cannot be overemphasized. However, blood transfusion at all medical centers in Thailand is considered safe as intensive screening of donated blood for HIV, hepatitis B and syphilis is implemented nationwide.

Viral Hepatitis

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 hyperimmune 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 against HIV/AIDS are strictly taken. However, for those who require immunization, effective vaccine against hepatitis B is available at most medical services. 

Insectborne Diseases

Mosquitoes transmit a variety of diseases in this country, including malaria, dengue fever, and Japanese encephalitis. Personal protective measures are extremely important since insects cannot be avoided. 

Food and Waterborne Diseases

Quite a few diseases, including hepatitis A and typhoid fever, are transmitted by unsanitary food handling procedures and contaminated water. Food and beverage precautions are essential in order to reduce chance of illness. Anti-diarrhea drugs may be prescribed by your provider. 

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