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Thailand Health Info

MEDICATIONS FOR TRAVELING IN THAILAND

Travelers’ diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. Most cases of travelers’ diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential. If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought. Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.
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MALARIA IN THAILAND

Malaria Thailand: For rural areas bordering Cambodia and Myanmar, prophylaxis with Malarone or doxycycline is recommended. For rural areas bordering Laos, either Malarone, doxycycline, or Lariam should be taken.

Prophylaxis is recommended for rural areas bordering Cambodia, Laos, and Myanmar, including Mae Hong Son. The malaria risk in Phang Nga and Phuket is very limited; therefore, prophylaxis is not recommended for these two areas. There is no malaria risk in Bangkok, Chiang Mai, Chiang Rai, Pattaya, Ko Samui, and Ko Phangan.

INSECT PROTECTION

Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be reapplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age.

For additional protection against Malaria in Thailand, apply permethrin-containing compounds to clothing, shoes, and bed nets. Don’t sleep with the window open unless there is a screen. If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.

FOOD AND WATER INFORMATION FOR THAILAND

Water Thailand: Tap water in Thailand should not be consumed unless it has been boiled, filtered, or chemically disinfected. In the major cities, water comes from water purification plants, but may be contaminated due to inadequate sewage facilities. This is especially common during times of flooding. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Fruits and vegetables should not be eaten unless they have been peeled or cooked.

Food Thailand: Foods that have been cooked but left at room temperature, such as buffets, should be avoided, as well as raw or undercooked meat or fish. Do not buy food or beverages from street vendors. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose.