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Every year more than 5
million tourists visit Thailand. Many arrive with insufficient
health advice which often results in bounts of illnesses that
spoil a good part of their journey. This information will help
you come up with appropriate protection against some common illnesses
and promote enjoyment of your happy stay in Thailand.
Sexually transmitted
diseases and HIV/AIDS:
Urethritis remains the
most common treatable sexaully transmitted disease (STD) among
tourists to Asia. Gonorrhea from Southeast Asis 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 travellers, local sex workers, either of
explicite 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.
Malaria:
Bangkok and most provinces in the central
region as well as major tourist resorts such as Chiang Mai, Phuket,
Hua-Hin and Samui Island have been free from malaria for decades.
Now all cities in Thailand are malaria free. However, tourist
destinations in rural neighbourhoods, especially those in the
mountainous and border areas are still at certain risks. Chloroquine
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 sty in screened
quarters or mosquito nets, wear longsleeves 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.
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 neighbourhoods. 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 travellers from non-endemic areas,
the infection usually minifests as fever with rash in the skin,
severe headache and muscle and pains (dengue fever), which is
usually non-fatal.
Dengue infection is common in the rainy
season (approximately May to September in Thailand) when aedes
mosquito is abundant. Travellers 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 mainly in dogs. Although
Thailand has been working toward elimination of the disease and
the situation has been much improved, travellers are recommended
to take prevention if their travel itineraries allow possible
exposure to animals bite. 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.
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. Travellers 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.
Typhoid fever:
Typhoid fever has become uncommon among
Thai people. However, travellers should not neglect taking prevention
against this food and water borne disease. Precaution measures
for diarrhea, as mentioned later, are effective for typhoid as
well. It is also recommended that the travellers receive typhoid
vaccination, in injectable or oral form, before start of the
journey. However, those who need initiation or booster vaccination
can findthe service at most hospitals and clinics in Thailand.
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 travellers from better hygienic environments can be receptive
to infection. Therefore, travellers 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.
Diarrhea:
Diarrhea is mostly caused by ingestion
of food and drinks contaminated with bacteria or viruses. To
prevent diarrhea, aviod 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 Southeast Asian citis 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.
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