HEALTHINFECTIOUS DISEASESThailand compared to most
Western countries.
Self-treatment may be
appropriate if your problem
is minor (eg traveller’s diar-
rhoea), you are carrying the
appropriate medication and
you are unable to attend
a recommended clinic or
hospital.
Buying medication over
the counter is not recom-
mended, because fake medi-
cations and poorly stored
or out-of-date drugs are
common.
Infectious
Diseases
Cutaneous Larva
Migrans
This disease, caused by
dog or cat hookworm, is
particularly common on the
beaches of Thailand. The
rash starts as a small lump,
and then slowly spreads like
a winding line. It is intensely
itchy, especially at night. It is
easily treated with medica-
tions and should not be cut
out or frozen.
Dengue Fever
This mosquitoborne disease
is increasingly problematic
throughout Southeast Asia,
especially in the cities. As
there is no vaccine it can only
be prevented by avoiding
mosquito bites. The mos-
quito that carries dengue is a
daytime biter, so use insect-
avoidance measures at all
times. Symptoms include
high fever, severe headache
(especially behind the eyes),
nausea and body aches
(dengue was previously
known as ‘breakbone fever’).
Some people develop a rash
(which can be very itchy) and
experience diarrhoea. The
southern islands of Thailand
are particularly high-risk
areas. There is no specifi c
treatment, just rest and para-
cetamol – do not take aspirin
or ibuprofen as they increase
the risk of haemorrhaging.
See a doctor to be diagnosed
and monitored.
Dengue can progress to
the more severe and life-
threatening dengue haemor-
rhagic fever, however this is
very uncommon in tourists.
The risk of this increases
substantially if you have
previously been infected with
dengue and are then infected
with a diff erent serotype.Hepatitis A
The risk in Bangkok is de-
creasing but there is still
signifi cant risk in most of
the country. This food- and
waterborne virus infects the
liver, causing jaundice (yellow
skin and eyes), nausea and
lethargy. There is no specifi c
treatment for hepatitis A.
In rare instances, it can be
fatal for those over the age of- All travellers to Thailand
should be vaccinated against
hepatitis A.
Hepatitis B
The only sexually transmit-
ted disease (STD) that can
be prevented by vaccina-
tion, hepatitis B is spread by
body fl uids, including sexual
contact. In some parts of
Thailand up to 20% of the
population are carriers of
hepatitis B, and usually are
unaware of this. The long-
term consequences can
include liver cancer, cirrhosis
and death.HIV
HIV is now one of the most
common causes of death
in people under the age of
50 in Thailand. Always prac-
tise safe sex; avoid getting
tattoos or using unclean
syringes.Infl uenza
Present year-round in the
tropics, infl uenza (fl u)
symptoms include high
fever, muscle aches, runny
nose, cough and sore throat.
Flu is the most common
vaccine-preventable disease
contracted by travellers and
everyone should consider
vaccination. There is no spe-
cifi c treatment, just rest and
paracetamol. Complications
such as bronchitis or middle-ear infection may require
antibiotic treatment.Leptospirosis
Leptospirosis is contracted
from exposure to infected
surface water – most com-
monly after river rafting or
canyoning. Early symptoms
are very similar to the fl u and
include headache and fever.
It can vary from a very mild
ailment to a fatal disease.
Diagnosis is made through
blood tests and it is easily
treated with Doxycycline.Malaria
There is an enormous
amount of misinformation
concerning malaria. Ma-
laria is caused by a parasite
transmitted by the bite of
an infected mosquito. The
most important symptom of
malaria is fever, but general
symptoms such as head-
ache, diarrhoea, cough or
chills may also occur – the
same symptoms as many
other infections. A diagnosis
can only be made by taking a
blood sample.
Most parts of Thailand vis-
ited by tourists, particularly
city and resort areas, have
minimal to no risk of malaria,
and the risk of side eff ects
from taking antimalarial
tablets is likely to outweigh
the risk of getting the disease
itself. If you are travelling to
high-risk rural areas (unlikely
for most visitors), seek medi-
cal advice on the right medi-
cation and dosage for you.
Travellers are advised to
prevent mosquito bites by
taking these steps:» (^) use a DEET-containing
insect repellent on exposed
skin; natural repellents such
as citronella can be eff ective,
but must be repeatedly
applied
» (^) sleep under a mosquito
net, ideally impregnated with
Permethrin
» (^) choose accommodation
with screens and fans
» (^) impregnate clothing with
Permethrin in high-risk areas
» (^) wear long sleeves and
trousers in light colours