Thailand Travel Information

Tetanus Diphtheria should be up to date and given every 10 yrs. Polio is also recommended

Hepatitis Hepatitis A vaccine is hig h ly recommended for all travellers. Hepatitis E is endemic, with seropositivity rates of 22% in adults. There is no vaccine for hepatitis E. The hepatitis B carrier rate in the adult general population is about 9%. The usual traveller without lifestyle problem is at virtually no risk of acquiring hepatitis B virus (HBV), but vaccination for Hepatitis B is recommended for high-risk tourists, long-term visitors, and anybody wanting increased protection. Some people prefer the pre mixed vaccine of Twinrix but if they use this vaccine they must receive 2 full doses to be adequately protected against either Hep A or B for one year. A third shot taken 6 months later completes the series. Hepatitis C is endemic and is largely transmitted by blood products and body fluids. Like HBV, Hepatitis C carries no increased risk for travellers who have a normal lifestyle.

Typhoid Fever Typhoid is re ported countrywide, with the highest incidence in the northern and southern regions, and the incidence greater in the summer and during the rainy seasons (between March and October). Typhoid vaccine is re commended for those travelling off the usual tourist routes, those visiting friends or relatives, and for long-stay visitors. Typhoid vaccines are only 60-70% effective; safe food and drink precautions should continue to be observed

Traveller's Diarrhea Moderate risk . Campylobacter bacteria cause greater than 50% of cases of traveller's diarrhea in Thailand, and greater than 90% of Campylobacte r species are now reported to be resistant to quinolone antibiotics. Quinolones, however, are still recommended as the first choice for the treatment of acute diarrhea, because a good clinical response may still be obtained. Azithromycin (Zithromax) is a good alternative antibiotic. Persistent diarrhea may be due to a parasitic disease such as giardiasis or amebiasis, bur these infections rarely affect tourists. The vaccine Dukoral protects for about 20% of travelers' diarrhea and is effective for 3 months.

Malaria This disease rarely occurs in people visiting the tourist sites in Thailand. In the past 2 decades, malaria-endemic regions have been shrinking, now involving mostly land near the borders with Myanmar and Cambodia. There is no risk of malaria in Bangkok and other major urban area. However the travellers should be aware of the possibility of infection. Protection against insect bites, especially between dusk and dawn, is a high priority.

Japanese Encephalitis JE is highly endemic nationwide, especially in the central and northern provinces; sporadic cases occur in the south. There is risk of infection in the suburban areas of major cities, except Bangkok, where JE is uncommon. Highest risk in the south occurs during the rainy and early dry seasons; in the north, during late summer and autumn. Vaccination is recommended for travellers who will be staying in rural-agricultural area longer than 2 weeks during the peak transmission season. All travellers to rural areas should take measures to prevent mosquito bites.

Dengue fever highly endemic, and a risk for travellers. Peak infection rates occur in the rainy season, between June and August, countrywide, but particularly in northeastern Thailand. Prevention is by avoiding daytime mosquito bites.

Avian Influenza After a period of quiescence in Southeast Asia, out breaks of highly pathogenic avian flu (A/H5N1) are again being reported in chickens and ducks in China, Indonesia, Thailand and Vietnam. In Thailand, outbreaks have been reported in 21 of 76 provinces. Human cases, some fatal, have occurred after contact with infected poultry.

Rabies There is a high incidence of dog rabies in Thailand, and about 60 cases of human rabies were reported in 2000. Rabid, stray dogs are common in Bangkok, as well as in other urban and rural areas. Although rabies is rare among tourists there is risk. No one should pet or pick up any stray animals. Rabies vaccine is available but is very expensive.

Canadian Embassy 15 th Floor, Abdulrahim Place, 990 Rama IV, Bangkok, Bangkok 10500, Thailand; Tel: 66-2-636-0540; Fax: 66-2-636-0555: Website; www.dfaitmaeci.gc.ca/Bangkok

Hospitals/Doctors *International Travel Medicine Clinic, BNH Hospital, Bangkok; this clinic provides all routine and tropical vaccinations and can provide referral advice and counselling regarding health-related matters.*International SOS: International SOS Services (Thailand) Ltd., 11 th floor-Diethelm Towers, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330, Thailand; Alarm Centre Tel: 66-2-205-7777; Alarm Centre Fax: 66-2-256-7151/0