Andys Real Guide to Thailand

As with most tropical countries there are some health hazards to prepare for before arriving in Thailand. The primary ones are Japanese Encephalitis, Yellow Fever, Dengue Fever and Hepatitis-A & C. You should get jabs for these before coming. Also make sure that your Tetanus is up-to-date. Rabies is endemic - stay away from animals. 

Cholera is a non-issue unless you do something stupid like swim in a river or lake. Stick to the hotel pools (which you WANT to stink of chlorine) and the sea. 

Malaria
Most western health services have Thailand listed as Malaria free. However WHO lists the border and northern hills areas as dangerous - with drug resistant strains in the area near the Burmese border. Travellers to the Isan region (north east) should note that that malaria infested Laos is only a short hop over the Mekong river.....

Unless you intend to trek in border areas Malaria precautions are unnecessary. If you are, then coax some Mefloquine out of your doctor at least 4 weeks beforehand. You should also have a look at my Borders page to read up on some of the other hazards in border trekking. 

There is no 100% effective drug against Malaria and there are a number of strains that are resistant to all drugs.

Be aware that Malaria, Yellow Fever and Encephalitis all have incubation periods of 5-15 days. This means that you could have returned from your holiday before falling ill. All of these diseases can be fatal if untreated - consult a doctor and make sure that they know where you've been.

Dehydration
The most practical health concern is dehydration especially during the summer. If you fly in from Europe or North America for a couple of weeks holiday at any time of year, you are likely to be sweating all the time that you're not in an air-conditioned environment. It follows therefore that you must drink water, and lots of it, to replace that which you lose in sweat. If you're one of these health conscious people who religiously avoid salt then you need to put some thought into consuming some whilst you're in the country:
      sweat = water + salt
Take care when consuming alcohol. Farang regularly drop dead in Thailand from the effects of over consumption, usually as a result of heart-attacks, strokes etc brought on by dehydration.

Wildlife
A lessor concern is the "wild life". Highly venomous Cobra snakes are common in the North of the country, rabid dogs are less common now than a few years ago, but are still present in numbers. Also beware of smaller creepy-crawly insects, many of which can inflict painful bits and are in some cases poisonous.. One poisonous example being a large (20cm) millipede which is brightly coloured and bound to attract the attention of children - parents beware...  (Sorry, no photo)

Whilst malaria is not generally a problem, mosquito and ant bites definitely are. Mosquitos are the primary carriers (vectors) for the nasty diseases listed above.

Baygon, made by Bayer AG. Past products include Zyklon-B.. See also bayerhazard

If your hotel room doesn't have separate insect screens over the windows you must close the windows from dusk until morning. Good hotels will do this and spray your room with a powerful insecticide (pictured left) in the late afternoon. When checking into the downmarket hotels insist on inspecting the room first, and check the windows/insect barriers.  Women and children are particularly susceptible to insect bites (soft skin) and I'm afraid that most western insect repellents don't hack it in South East Asia, you can try the local brews (be careful) but the only assured way is keeping the buggers away from you.  I'd quite to squash the popular myth that air conditioning somehow stops mosquitoes.  Mosquitoes are poor flyers and actually like cool still air. If your a/c can drop the temperature below around 20°C it might slow them down. Fan's are much more effective however.

Final note about air quality - If you suffer from Asthma do not stay in Bangkok. 

Hospitals & Pharmacies

The Hospitals & Clinics in Thailand that cater for Foreigners are generally of an excellent quality and very reasonably priced. The doctors speak excellent English, and the service is fast and efficient. You will need to pay for any treatment on the spot however, credit card acceptance is high.

Pharmacies are generally well stocked with western drugs and are easy to find. Generally drugs are only sold in these dedicated stores, so don't expect to be able to buy aspirin in your local 7-11. Many medicines that require Doctor's prescriptions in the West are available over the counter in Thailand. And yes, Viagra is generally available...