If you are currently taking prescription medicines, take the instruction leaflet with you, and some spare medicine so that (a) there is no doubt that you are not a drug abuser and (b) if you were unfortunate enough to lose your medication, it makes life a lot easier when you're in a Thai pharmacy, trying to explain exactly which medicine it was and what it was for, because the marketing name may vary from country to country but the chemist will understand the written chemical contents.

If you wear glasses or use contact lenses, take a copy of the optician’s written results of your last examination, extra glasses or spare lenses. Prescription diving masks are available for purchase or hire in most dive shops and diving schools.

Contact a medical centre specialising in tropical diseases before you leave (e.g. a hospital or specialist advice centre in larger cities). A ‘last minute’ journey to Thailand should provide no problem to an already healthy person provided that your departure airport has a ‘walk in’ medical facility. Always carry your vaccinations booklet with you.

Obviously it’s preferable to be vaccinated in advance of your travel date. What is important here is that the medical centre providing the vaccination has regular contact with the NHS advisors on Tropical Diseases.

Websites:
http://www.fitfortravel.scot.nhs.uk/destinations/asia-(east)/thailand.aspx 
www.nhsdirect.nhs.uk
www.tripprep.com

Malaria
Malaria occurs in Thailand, principally in the northern border areas and on the islands of Ko Chang and Ko Samet. Malaria is generally not a big problem in Thailand, however the few malaria parasites there are, are resistant to the normal anti-malaria (prophylactics) medicines. It makes sense then to reduce the risk by taking preventive measures without swallowing malaria prophylactics. Measures such as covering your arms, legs and feet in the evening, and spreading an anti-mosquito cream (containing DEET) on exposed areas of skin and sleeping under a mosquito net. You can also impregnate the mosquito net with an insecticide. Make sure that you always have something to hand to suspend your mosquito net from; for example, a piece of rope, screw-in hook or a screwdriver (Swiss Army knife). If despite all measures, you find yourself with flu-like symptoms lasting longer than two days, seek the advice of a medical doctor to rule out malaria. This also applies for the first two months after your return to the UK.

Vaccinations
Vaccinations against DTP (diphtheria, tetanus and polio; valid for about 10 years) and hepatitis B are advised. Most people had a DTP vaccination as a child. You can safely travel with a booster in this case. The normal injection with hepatitis A anti-body has a limited effective period, and therefore it makes good sense to have this vaccination just before travelling. If you travel frequently to a country where hepatitis A is present, or plan to stay longer in tropical countries, you should opt for a vaccination with a longer effective period. Keep in mind that long-term vaccinations are more expensive and still require a booster after six months. Vaccination against enteric fever is advised if you plan to stay in Thailand longer than three months. Vaccination against yellow fever is only advised if you have been in an infected area prior to travelling to Thailand.

Dengue fever and Japanese B encephalitis
Both of these diseases are carried by mosquitoes, so you can take the same preventative measures as for malaria. These mosquitoes bite during the daytime and under artificial light. For more information about these diseases, and the status of any epidemics, you're advised to seek the advice of the NHS or suitable medical institution.
There is no vaccine against dengue, however, there is for Japanese B encephalitis, which is advised, if you are going to be in Asia for longer than six months.
You can assemble your own tropical first aid kit or buy a ready-made kit. We advise you to obtain a book on how to stay healthy in the tropics, which will contain information about contents of a first aid kit. Sites like http://www.travelhealth.co.uk/books/index.html can point you in the right direction.


Thailand Travel Health - on location

Alongside the general advice given here; ensure that you have the correct vaccinations for where you are going on holiday and remain as healthy as possible before you leave. Of course it's important that you avoid becoming ill while you are on holiday. When you're away on holiday remain alert: when in doubt, consult a doctor.

Jet lag & overcoming it

"Jet lag" is when your biological clock is confused (primarily your sleeping and waking rhythms) caused by flying through time zones. The body has to adjust to the new biorhythm for the first few days after your flight; during which time you can feel tired and irritable.

Overcoming jetlag: We advise that during the flight you drink very limited amounts of coffee or alcohol, and, upon arrival don't demand too much of your body for the first couple of days. It's also handy to get into the new sleeping rhythm as quickly as possible. We recommend an hours sleep after arrival, and then stay awake until you go to bed (but have an early night). Another good method of combating jet lag is to take a Thai massage. We recommend the School of Massage at Wat Po.

Diarrhoea
A change of rhythm, climate and food (especially spicy) can throw your stomach out of sorts. As long as it is only loose, watery stools and no other symptoms, it's normally unnecessary to take anything, just take it easy and drink plenty of water in small quantities. It may be necessary to take some Oral Rehydration Salts (ORS) dissolved in water to prevent dehydration, and this is especially important for the elderly and children. Drugs, such as loperamide and diphenoxylate, may be taken if you really have to travel when you have diarrhoea (not suitable for children under two years old). These drugs have the effect of sedating the intestine, which stops stomach cramps and suppresses the feeling of diarrhoea. Only use these drugs when you're on the move and cannot get to the toilet regularly. If the diarrhoea: persists for more than 48 hours, AND is accompanied by headache, vomiting, or blood in the stool OR; you’re taking any other medication at the time, you should contact a doctor. The doctor can send a sample for lab analysis to determine exactly what’s going on. Your diarrhoea can stop quite quickly, but can leave a lasting feeling of lethargy due to the fact that your intestines needs time to recover.

To prevent diarrhoea
Only consume water and soft drinks from properly closed and sealed tins or bottles, or drink boiled water; such as tea or coffee. Ice is trustworthy in the form of machine-produced ice cubes. Fruit juice is safe, provided no water has been added.
Food, particularly meat and fish, must be well cooked. We advise against the western-style salads offered in salad bars (in expensive hotels). Hamburgers (personal experience) are generally a lot less safe than the normal meat the locals eat. Generally it is safe to eat from street stalls, even though you would expect the opposite. Eat where it's busy, the time between food preparation and consumption is therefore the shortest, which is good for the hygiene. Take note of how the plates, glasses and cutlery is washed. There is often no running water and only a bucket with soap in it, baking in the sun. If that is the case, it's sensible to find somewhere else to eat.
Restaurants where you can see how clean it is are recommended. With regards to street stalls, it’s probably smart not to eat meat at the end of the day; the meat can sometimes have been lying around all day un-refrigerated. A tried and trusted housewife's remedy to prevent dehydration during diarrhoea is to drink cola and bouillon (not at the same time). Cola can be bought everywhere and you can bring stock cubes and a single-cup beverage with you from the UK.

Bilharzia
To avoid the infection, carried by tiny worms, don't swim in stagnant water, especially in the reservoirs in northern Thailand. The southern part of the River Mekong is also not safe for swimming.

A few more general tips for Thailand travel health

Skin care
Take all cuts, scratches etc in the tropics seriously: keep a close eye on them, clean them with disinfectant and keep them covered with a plaster during the day. Don't scratch mosquito bites.
Always use a high factor sunscreen cream on exposed skin, even in the rainy season. Snorkelling with a T-shirt and shorts is not unusual (we do it all the time as a matter of course). The sun is super strong at the equator, even if it's cloudy.
You can avoid attracting biting insects, by not wearing brightly coloured or black clothing, strong perfume or deodorant or aftershave (try to avoid resembling a flower). It you’re prone to skin irritations, wear cotton or linen clothing. You can help avoid prickly heat by using talcum powder on your body after your morning shower.
Wash or disinfect your hands after using the toilet, and don't bite your nails.
During the dry season, in the woods, there’s a slight chance that a tick may land on you (In European woods there is a far greater chance). Check your body for these bugs in the morning and evening; especially behind the knees and in the crotch. Should you find one, don't try to just pull it out, use tick pincers (obtainable from chemists) or seek medical attention. If, after being in the woods, you find a bloody circular skin wound, slowly increasing in size, seek professional medical attention.

Sunstroke
Sunstroke can be prevented by wearing a hat, and sunglasses. Always keep a bottle of water with you, especially if you're in the wilderness and unlikely to come across drinking water. If you suspect sunstroke (feeling light-headed, headaches), you can prevent it from getting worse by drinking water and finding somewhere in the shade to sit and stay there, if possible.

Health upon return

If, upon your return (and this can also be months later), you contract influenza, stomach problems, or experience some other unusual symptoms; contact your GP, and let them know where and when you were last in Thailand, and what you did there. If you have a lot of close contact with the local population it's sensible to take a TB test.

 

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