I am traveling to Thailand in two weeks. Do I need any particular vaccinations?
Q: I am traveling to Thailand in two weeks. Do I need any particular vaccinations?
A: The Centers for Disease Control (CDC) advises you to get your vaccinations four to six weeks before your trip, to give them time to take effect. Obviously, it is too late for that, but you should get whatever immunizations you need as soon as possible.
Start by making sure you are up to date on all your routine vaccinations, such as tetanus, diphtheria, polio, etc. The same applies to any immunizations that may not be routine, but that you have had reason to get in the past, such as influenza or pneumonia.
For travel to the South East Asia , the CDC recommends that you get immunized for hepatitis A. The agency says a typhoid vaccine is a good idea if you will be traveling in undeveloped parts of the region, which could include parts of Burma, Cambodia and Vietnam. Meningitis, hepatitis B and rabies vaccines may be advised depending on what part of the country you are visiting, what you will be doing and how long you will be staying.
In addition to vaccine recommendations, the CDC Web site also provides travel health information regarding traveler’s diarrhea and food, water and other precautions for traveling abroad.
The preventive measures you need to take while traveling in the South East Asia depend on the areas you visit and the length of time you stay. You should observe the precautions listed in this document in most areas of this region. However, in highly developed areas, you should observe health precautions similar to those that would apply while traveling in the United States.
Travelers’ diarrhea, the number one illness in travelers, can be caused by viruses, bacteria, or parasites, which can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe.
Malaria is a preventable infection that can be fatal if left untreated. Prevent infection by taking prescription antimalaria drugs and protecting yourself against mosquito bites . A low risk for malaria exists in parts of Iran, Iraq, Oman, Saudi Arabia, Syrian Arab Republic, Turkey, United Arab Emirates, and Yemen. Travelers to rural Iran and all areas of Oman should take mefloquine for malaria prevention; travelers to other risk areas should take chloroquine. For specific locations.
Dengue, filariasis, leishmaniasis, onchocerciasis, and plague are diseases carried by insects that also occur in this region, but the risk to travelers is low. Protecting yourself against insect bites will help to prevent these diseases. CDC-Recommended Vaccines (as Appropriate for Age and Area Visited):
See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect.
Hepatitis A or immune globulin (IG).
Hepatitis B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay longer than 6 months, or be exposed through medical treatment.
Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
Typhoid, particularly if you are visiting developing countries in this region.
As needed, booster doses for tetanus-diphtheria and measles, and a one-time dose of polio for adults. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who have not completed the series.
All travelers should take the following precautions, no matter the destination:
Wash hands often with soap and water.
Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively. Avoid travel at night if possible and always use seat belts.
Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
Don’t eat or drink dairy products unless you know they have been pasteurized.
Don’t share needles with anyone.
Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
Never eat undercooked ground beef and poultry, raw eggs, and unpasteurized dairy products. Raw shellfish is particularly dangerous to persons who have liver disease or compromised immune systems.
Travelers visiting undeveloped areas should take the following precautions: To Stay Healthy, Do:
Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an “absolute 1-micron or less” filter AND adding iodine tablets to the filtered water. “Absolute 1-micron filters” are found in camping/outdoor supply stores.
If you visit an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals), and wearing long-sleeved shirts and long pants from dusk through dawn.
To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
To Avoid Getting Sick:
Don’t eat food purchased from street vendors.
Don’t drink beverages with ice.
Don’t handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague).
Don’t swim in fresh water. Salt water is usually safer.
What You Need To Bring with You:
Long-sleeved shirt and long pants to wear while outside whenever possible, to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis, and onchocerciasis).
Insect repellent containing DEET (diethylmethyltoluamide), in 30%–35% strength for adults and 6%–10% for children.
Over-the-counter antidiarrheal medicine to take if you have diarrhea.
Iodine tablets and water filters to purify water if bottled water is not available. See Do’s above for more details about water filters.
Sunblock, sunglasses, hat.
Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).
After You Return Home:
If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area.
If you become ill—even as long as a year after your trip—tell your doctor the areas you have visited.
For More Information:
Ask your doctor or check the CDC web sites for more information about protecting yourself against diseases that occur in the South East Asia, such as:
MALARIA: GENERAL INFORMATION
Malaria is caused by a parasite that is transmitted from person to person by the bite of an infected Anopheles mosquito. These mosquitoes are present in almost all countries in the tropics and subtropics. Anopheles mosquitoes bite during nighttime hours, from dusk to dawn. Therefore, antimalarial drugs are only recommended for travelers who will have exposure during evening and nighttime hours in malaria risk areas.
Symptoms of malaria include fever, chills, headache, muscle ache, and malaise. Early stages of malaria may resemble the onset of the flu. Travelers who become ill with a fever during or after travel in a malaria risk area should seek prompt medical attention and should inform their physician of their recent travel history. Neither the traveler nor the physician should assume that the traveler has the flu or some other disease without doing a laboratory test to determine if the symptoms are caused by malaria.
Malaria can often be prevented by the use of antimalarial drugs and use of personal protection measures against mosquito bites. The risk of malaria depends on the traveler’s itinerary, the duration of travel, and the place where the traveler will spend the evenings and nights.
Travelers can still get malaria, despite use of prevention measures. Malaria symptoms can develop as early as 6-8 days after being bitten by an infected mosquito or as late as several months after departure from a malarious area, after antimalarial drugs are discontinued. Malaria can be treated effectively in its early stages, but delaying treatment can have serious consequences.
Viral Hepatitis B
Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.
Hepatitis B vaccine is available for all age groups to prevent hepatitis B virus infection.
Children previously immunized with the 2.5 mcg dose of vaccine do not need to be revaccinated.
Children started on the 2.5 mcg dose may complete with 2.5 mcg, or they may complete with the 5.0 mcg dose.
All new vaccinees, 0-19 years of age, should be started on the 5 mcg dose. The dosing regimen has not changed