Does your family have the right vaccinations for Thailand?
Like many countries in the tropics, Thailand has some certain diseases where vaccination is recommended. Although vaccinations for Thailand are not compulsory if you are here for the long term or may be exposed to greater risk it is certainly advisable to take precautions. According to the UK’s NHS website courses or boosters for Hepatitis A and Tetanus are recommended for those visiting Thailand but you could also consider Cholera, Hepatitis B, Diphtheria, Typhoid, Rabies and Japanese Encephalitis and a description of each of these diseases and the risks associated with them and Thailand will discussed in the following section.
- Tetanus: This is spread via the contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil anywhere in the world. A total of 5 doses of tetanus vaccine are recommended for life in the UK but similar or more should be considered for Thailand. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.
- Hepatitis A: This is spread by consuming contaminated food or water or by person to person through faecal-oral route. Only a high risk is if there is poor personal hygiene and lack of sanitation. This is possible in more rural areas although not in the major cities.
Protection that should be considered:
- Cholera: This is spread by consuming contaminated food or water. The most common outbreaks occur during flooding and other natural disasters, areas with a lack of clean drinking water and/or poor sanitation. Cholera is unusual in Thailand as long as travellers take basic precautions regarding food, water and their own levels of hygiene.
- Hepatitis B: This is spread through infected blood or blood products. This could be via medical instruments, contaminated needs or sexual intercourse. This risk is higher for those at occupational risk, those who travel frequently or have long stays in other countries and individuals who need/request surgery overseas. Children maybe exposed through cuts and scratches.
- Diphtheria: This is spread via person to person through respiratory droplets. The risk is higher if you are mixing with locals in poor, overcrowded living conditions.
- Japanese Encephalitis: This is spread via the bite of an infected mosquito. These mosquitoes breed in rice paddy fields and mainly bite between dusk and dawn. The risk is higher for travellers staying for long periods in rural areas, particularly if unable to avoid mosquito bites.
- Typhoid: This is spread usually through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is restricted.
- Rabies: This is spread via the saliva of an infected animal, usually through a bite, scratch or lick that either breaks the skin or on skin that is already broken. Dogs and related species are most common, but also bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of coming into contact with animals, and children. Even when pre-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.
One disease that is slightly more prevalent is dengue fever. This is a viral illness that is transmitted via by mosquito bites. The mosquito that spreads dengue bites during the day and is more common in urban areas. Symptoms include fever, headache, severe joint, bone and muscular pain – hence its other name ‘breakbone fever’. There is no vaccine and prevention is through avoidance of mosquito bites.
If you are travelling to mountainous areas there is a small risk of altitude sickness. Thailand has areas of high altitude (2400m or more) and areas of very high altitude (3658m or more). If you are travelling to these areas you should take care to avoid ill effects of being at altitude including Acute Mountain Sickness, a potentially life-threatening condition.
There are other diseases that could be considered if you are travelling to remote areas such as malaria although this is only present is heavily forested areas close to other international borders. There is deemed to be no to low risk in the places popular with tourists and expats such as: Bangkok, Chiang Mai, Chiang Rai, Pattaya and Phuket, the islands of Ko Samui and Ko Chang and the River Quai bridge area.
If you are considering travelling to other remote locations it is essential that you take precautions. Where possible, avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset. Use insect repellents on exposed skin that contain DEET and, where necessary, sleep under a mosquito net.
Common antimalarial drugs include: Atovaquone/proguanil OR doxycycline is usually advised for those visiting the borders with Cambodia and Myanmar. For all other border areas, Atovaquone/proguanil OR doxycycline OR mefloquine is advised throughout the year.
It is important to seek immediate medical attention if you have been travelling in a malarious area and develop a fever. Remember malaria can develop even up to one year after exposure.