Thailand, like all third-world countries, poses a small risk to travelers. The same precautions for visiting tropical climes apply to the more remote areas of the Thai kingdom, where some types of mosquito can transmit malaria or dengue fever. Ask healthcare professionals to supply you with the latest information about health risks specific to the region as well as global pandemics such as the H1N1 virus (swine flu).
It is recommended that travelers have current immunizations for hepatitis A, polio, and tetanus. Young people are advised to get a rubella vaccine to protect against the TB virus; check that you are protected. Wounds can be aggravated by heat and humidity, so watch out for infections; wash cuts promptly with iodine or saline solution, and keep them dry.
General Availability of Healthcare
Dispensaries and hospital facilities in Thailand, especially in urban centers, are generally excellent. In Phuket, hospitals are familiar with holidaymakers, especially victims of the island's many car and motorbike crashes. Smaller towns will usually have a basic clinic, but Bangkok is always the best bet.
Stomach Trouble -- Often the change in climate and diet will provoke diarrhea in travelers to Thailand. You can best avoid upset stomachs by sticking to bottled water at all times, and drinking lots of it. Also be sure canned or bottled drinks are unopened, and wash your hands regularly, especially before eating.
It's useful to keep good antidiarrhea medicine, such as Imodium, handy in your travel bag, plus a fruit-flavored electrolyte powder, such as Dechamp, to mix with water to prevent dehydration. Note: A roll of toilet paper or packet of tissues is a good idea too; Thai toilets do not always provide this. Pharmacies here, such as Boots or Watson's, have a wide range of Western brand drugs, including Imodium. 7-Eleven stores sell single toilet-paper rolls and ready-to-go electrolyte drinks, such as Gatorade, as well as the familiar items and brands such as Bayer, Tylenol, and Eno antacids.
While restaurant hygiene throughout the country is generally excellent, be wary of street food stalls in areas of heavy traffic where pollution might affect the cleanliness of ingredients. If you develop a condition that includes cramps and lasts more than 24 hours, find a doctor for possible antibiotic treatment.
Tropical Illnesses -- Hepatitis A can be avoided using the same precautions as for diarrhea. Most Asians are immune through exposure, but people from the West are very susceptible. Consider starting a course of vaccines at least 3 months before your trip.
Major tourist areas, such as Bangkok, Phuket, Ko Samui, and Chiang Mai, are generally malaria free. However, malaria is still a problem in rural parts, particularly territories in the mountains to the north and near the borders with Cambodia, Laos, and Myanmar. When you're traveling to remote areas, start taking a malarial prophylaxis well in advance (most dosages start 4 weeks before travel), such as Malarone (a combo of Atovaquone and Proguanil) or Doxycycline -- but see a travel med specialist to confer, and have him or her advise you on the potentially harmful side effects. Note that Mefloquine (sold under the name Larium) is no longer recommended for Thailand.
The best way to prevent malarial transmission or catching any other diseases listed here is to cover up with light-colored clothing, and wear long pants and sleeves after dark. Sleep with Permethrin-treated mosquito netting well tucked in, and use repellents. And make sure your repellent contains a high percentage of DEET. If you do get bitten, apply a dab of calamine lotion to ease the itching, and avoid scratching, which only makes it worse. If you develop a fever within 2 weeks of entering a high-risk area, be sure to consult a physician.
Dengue fever is now a major problem throughout Southeast Asia. Recent years have seen epidemics in the region. Similar to malaria, the virus is spread by a mosquito, but this one can bite during the day as well as at night. Symptoms are similar to those of the flu, with high fever, severe aches, fatigue, and possible skin rashes or headaches, lasting about a week. Drink plenty of water and seek medical attention immediately if you experience these symptoms.
Japanese encephalitis is a deadly viral infection that attacks the brain and is spread by a mosquito bite. Outbreaks have been known to occur in the region, so stay abreast of the most up-to-date CDC information. As for malaria and dengue, the best protection is to avoid being bitten, but seek medical attention if you develop symptoms such as fever, severe aches, and skin rashes.
Bugs & Other Wildlife Concerns -- On jungle hikes in particular, wear long sleeves and trousers instead of shorts, which will protect against not just mosquito bites, but the ubiquitous ticks, leeches, nasty biting giant centipedes, and (rarely seen) snakes. In order to survive the heat and humidity, wear loose cotton pants, socks, and sturdy boots -- natural fibers are perfect for this terrain. Always try to minimize the chance of getting cuts and scrapes (they can get infected 10 times faster than back home). When venturing into thick jungle terrain, do so with a qualified guide and follow his or her example. Don't pick or touch plants unless the guide says it's safe.
Rabies is a concern in Thailand, as are bites from any stray animals -- infected or not. Temples house many mangy dogs because Buddhists believe their duty is to feed them. Such dogs are often members of a pack and can get aggressive toward strangers of any kind. Occasionally, a rabid animal makes its way into the mix. Stay clear of all stray animals; and seek medical attention immediately, if you've been bitten. If you find yourself cornered, look for a stick to keep these mutts at bay. Bangkok has a rabies and snakebite help desk at tel. 02256-4214.
Avoid freshwater streams or lagoons, as they can be contaminated by chemicals or parasites. Sadly, lack of environmental regulations means sewage outlet pipes often pour into the sea or freshwater streams. Coral reefs pose minor risks from such things as poisonous sea snakes, jellyfish, and sea urchins. You can alleviate Jellyfish burns simply by applying vinegar. In the case of any cuts or stings, try to clean with bottled water and apply an antimicrobial ointment or antihistamine, if you have an allergic response. If you catch an ear infection, ear drops are sold in pharmacies, or mild boric acid or vinegar solutions can help.
Respiratory Illness -- The air in Bangkok at certain times of the year can be smog-laden and is especially bad on sidewalks, next to busy roads, or under the BTS. Chiang Mai can also be very hazy in March. Anyone with respiratory issues such as asthma should carry both regular and emergency inhalers, though brands such as Seretide, Bricanyl, and Ventolin are available without prescription. SARS and H5N1 Flu (bird flu) have caused problems here in the past; at present H1N1 influenza, or swine flu, is a growing problem. Check out the latest situation at www.cdc.gov.
Coping with the Heat -- The symptoms for sunstroke or heat exhaustion are unbearable headaches, nausea, vomiting, dizziness, and extreme fatigue. Avoid these ailments by drinking mineral (not purified) water, electrolyte drinks, or soda water regularly, but in small amounts, to replace minerals and increase hydration. An aspirin or Tylenol can help lower body temperatures. Expose yourself gradually to the heat; wearing a high-SPF sunscreen and a hat will prevent sunburn but not heatstroke. Low alcohol consumption, light meals, and eating minimally spiced food will help you to acclimatize much faster.
Use talcum powder after showering to avoid incapacitating heat rash, and only use clean, dry towels to avoid pervasive fungal growths such as tinea or candida. Fast-acting antifungal powders, creams, or suppositories, such as Canesten (for tinea) and Diflucan (for yeast infections), are available in pharmacies without a prescription.
What To Do If You Get Sick In Thailand
Medical services in Thailand are good in cities, and high street dispensaries -- though unregulated -- sell most drugs, even those normally available only by prescription overseas. The pharmacist may have an almanac on the counter in English, where you can check the different brand names of generic pharmaceutical products in your country, but always seek professional advice.
In most cases, your existing health plan should provide the coverage you need. But double-check; you may want to buy travel medical insurance instead. Bring your insurance ID card (for hospital visits only) with you when you travel.
If you don't feel well, consider asking any hotel concierge to recommend a local doctor or clinic. Typically, doctors see patients on a first-come, first-served basis, unless there is an emergency. You may have to fill in a form telling of allergies or existing conditions before you see a physician. In only very grave cases will you be sent to the emergency room.
You'll need to get a taxi to the hospital (rohng pha yaa baan, in Thai), as Thailand does not normally offer ambulance services. In an emergency, some embassies or consulates can offer basic advice.