Inoculations or vaccinations are not required unless applicants have been to an infected area. At present, Thailand requires a yellow fever certificate from persons who have been to or have come from countries and areas included in endemic zones.

To maintain good health in Thailand most travelers will need vaccinations for hepatitis A and typhoid fever, as well as medications for travelers diarrhea. Malaria prophylaxis is recommended for certain regions, in conjunction with insect repellents and other measures to prevent mosquito bites. Additional immunizations may be necessary depending upon the circumstances of the trip and the medical history of the traveler. All travelers should visit either a health clinic or their personal physician 4-8 weeks before departure.

Food
Thailand has a wide variety of exotic and delicious foods and fruits. By taking certain precautions travelers can enjoy most food items in Thailand. Eat only food that has been cooked thoroughly and is still hot. Avoid uncooked food, apart from fruit and vegetables that can be peeled or shelled, and avoid fruits with damaged skins.

Water
Bottled water is safe in Thailand. There are a variety of brands available. Please ensure that the bottles are sealed properly prior to opening and consuming the contents. Hot beverages, such as tea and coffee are usually safe. In up-country situations where bottled water may not be available, boil drinking-water if its safety is doubtful. Avoid ice unless it has been made from safe water. Generally ice available in hotels and better restaurants is made from bottled or filtered water and considered safe.

There are a variety of infectious diseases in Thailand, with varying degrees of severity. Taking some general precautions can reduce exposure to such diseases. Some of the communicable diseases of current concern in Thailand are:

Sexually transmitted diseases
Sexually transmitted diseases are passed from person to person through unsafe sexual practices. The risk of infection can be reduced by avoiding casual and unprotected sexual intercourse, and by use of condoms. Examples of sexually transmitted diseases are hepatitis B, HIV/AIDS and gonorrhea. There are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale, but Thailand is an exception. A massive program to control HIV has reduced visits to commercial sex workers by half, raised condom usage, decreased STDs (Sexually Transmitted Diseases) dramatically, and achieved substantial reductions in new HIV infections.

There have been human cases of avian influenza in Thailand. Travellers who reside in Thailand for an extended period are advised to consider, as a precautionary measure, having access to influenza antiviral medicine for treatment. Long term residents are at a greater risk of exposure to avian influenza over time. Medical advice should be sought before antiviral medicines are commenced. Visitors intending to travel to Thailand for shorter periods are at much lower risk of infection but should discuss the risk of avian influenza with their doctor as part of their routine pre-travel health checks.

World Health Organization (WHO) had been reporting Avian Influenza situation (Influenza A H5N1 strain) since December 26, 2003 thru October 10, 2005.

Bird Flu (Avian Influenza)
There had been 117 confirmed human cases of avian influenza in 4 countries, namely Vietnam 91 cases, Cambodia 4 cases, Thailand 17 cases and Indonesia 5 cases, of which 60 cases died. Meanwhile, in 2005, the Organization of International Epizoonotic diseases (OIE) had reported the outbreaks in poultry in Cambodia, China, Thailand, Vietnam, Russia, Kazakhstan, Turkey and Romania. (Details in Ministry of Public Health – Kingdom of Thailand website: (http://epid.moph.go.th/invest/ai/aimain.php).

The Ministry of Public Health, hence, issued the health advice for disease prevention for traveler who will travel to the affected countries as followed:

Before the journey
Antivirus drugs as bird flu pre-exposure chemoprophylaxis is strongly forbidden. There is absolutely no use, despite, the side effects will outweigh the prophylactic effect. Furthermore, wide spread use of this kind of prophylaxis will create the drug-resistance virus. Therefore, should symptoms resemblance bird flu occur, consult the doctor immediately. Human influenza vaccine is used specifically to prevent the disease of yearly influenza season. It can not be used to prevent bird flu (Influenza A- H5N1).

During the journey
– Avoid traveling into the area where outbreak in poultry have still been reporting or where there are potential risks of poultry outbreak such as live animal market or poultry farms.

– Avoid contacting with natural birds and all kinds of poultry including feces or excretion contaminated surfaces where bird flu virus excreted from infected poultry would be present.

– Cooked poultry meat or egg are safe for consumption but refrain from eating poultry or their products which had not thoroughly cooked such as raw blood, raw egg or half cooked.

– Wash hand frequently with soap and water or alcohol-based hand scrub after touching public for mites or common used objects such as vehicles, stair rails, door knob, elevator or computer.

– Mask or any other personal protection equipments is not recommended when in public place unless symptoms of cold or upper respiratory tracts occur, in order to prevent transmission to others.

When preparing food
– Separate raw meat from cooked meat. Do not put cooked food back in utensil used to put raw meat in, in order to prevent cross contamination.

– Wash hand every time when handling food.

– All food prepared from poultry including egg and blood must be cooked thoroughly. Egg yolk must be harden not half cooked.

– Wash outer egg shell with soap and water before preparation.

– After handling poultry meat or raw egg, wash hands with soap and water. Utensils and kitchen equipments used to put raw meat and raw egg in must be washed with soap and water or dish washer solution, every time.

Should you suspect of contacting bird flu virus
– Observe your symptoms for 10 days after contacting the disease.

– Should fever, cough or difficulty in breathing any other symptoms occur within 10 days, consult the doctor at once, give detail of symptoms, poultry or bird flu contacting history and also traveling history.

– Stay at home while your symptoms develop. Limit contacting with other people to prevent the transmission of disease.

Malaria
Malaria risk exists throughout the year in rural, especially forested and hilly, areas of the whole country, mainly towards the international borders. There is no risk in cities and the main tourist resorts (e.g. Bangkok, Chiangmai, Pattaya, Phuket, Samui). You should use repellents and treated bed nets if you are going out into the mountainous areas and plan to overnight. The malignant falciparum form is present and is reported to be highly resistant to chloroquine and resistant to sulfadoxine-pyrimethamine. Resistance to mefloquine and to quinine has been reported from areas near the borders with Myanmar and Cambodia.

For the latest information on the extent of malaria transmission in a specific area of the country, please contact the Bureau of Vector Borne Diseases, Ministry of Public Health, Tiwanon Road Nonthaburi, Thailand 11000 (Email: pornpim@health.moph.go.th, morning@health.moph.go.th, or rtipmontree@hotmail.com Tel: 662-590-3126, 662-590-3127, 662-590-3271, 662-590-3132 Fax : 662-591-8422)

Dengue
Dengue is common everywhere in Thailand below altitudes of 600 meters, including Bangkok. Prevalence is higher in southern Thailand. There is no prophylaxis for dengue, so precautions should be taken to ensure that mosquitoes won’t bite, especially during the daylight hours (repellents are best bet). Transmission of dengue has much to do with how residents of a particular area take care to keep dry any objects that could collect water and serve as breeding sites for mosquitoes.

Other risks
Amoebic and bacillary dysentery and hepatitis A and E may occur. Hepatitis B is highly endemic and trachoma is also reported. Japanese encephalitis may occur, particularly in rural areas. A vaccine is available, and travelers are advised to consult their doctor prior to departure. Rare cases of Bengal Cholera have been reported and an outbreak of leptospiros in the northeast of the country, following flooding in 1999 caused a number of deaths. Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay.

Travel and health insurance is strongly recommended for all overseas travel. Travellers should check with their insurer to make sure that their policy meets their needs. In particular, travellers should seek advice from their insurer on what type of circumstances and activities are the subject of exclusions in their policy. Medical facilities are good in main centers. All major hotels have doctors on call.