Sanitary products are readily available in Malaysia. Birth-control options may be limited, so bring adequate supplies of your own form of contraception.
Heat, humidity and antibiotics can contribute to thrush. Treat with antifungal creams and pessaries such as Clotrimazole. A practical alternative is a tablet of fluconazole (Diflucan).
Lice Most commonly inhabit your head and pubic area. Transmission is via close contact with an infected person. Treat with numerous applications of an anti-lice shampoo containing permethrin.
Ticks Contracted after walking in rural areas. If you are bitten and experience symptoms such as a rash at the site of the bite or elsewhere, fever, or muscle aches, see a doctor. Doxycycline prevents tick-borne diseases.
Leeches Found in humid rainforest areas. They don’t transmit disease, but their bites can be itchy for weeks afterwards and can easily become infected. Apply an iodine-based antiseptic to any leech bite to prevent infection.
Bees or wasps If allergic to their stings, carry an injection of adrenaline (eg an Epipen) for emergency treatment.
Bedbugs live in the cracks of furniture and walls and migrate to the bed at night to feed on you. They are more likely to strike in high-turnover accommodation, especially hostels, though they can be found anywhere. An appearance of cleanliness is no guarantee there are no bedbugs. Protect yourself with the following strategies:
If you do get bitten, try the following:
Always use a strong sunscreen (at least SPF 30), and wear a wide-brimmed hat and sunglasses outdoors. If you become sunburnt, 1% hydrocortisone cream applied twice daily to the burn is helpful.
There are good clinics and international-standard hospitals in KL. Over-the-counter medicines and prescription drugs are widely available.
It can take up to two weeks to adapt to Malaysia’s hot climate. Swelling of the feet and ankles is common, as are muscle cramps caused by excessive sweating. Prevent cramps by avoiding dehydration and excessive activity in the heat.
Dehydration is the main contributor to heat exhaustion. Symptoms include feeling weak, headache, irritability, nausea or vomiting, sweaty skin, a fast, weak pulse and slightly elevated body temperature. Treat by getting out of the heat, applying cool, wet cloths to the skin, lying flat with legs raised and rehydrating with water containing a quarter of a teaspoon of salt per litre.
Heatstroke is a serious medical emergency. Symptoms come on suddenly and include weakness, nausea, a hot, dry body with a body temperature of over 41°C, dizziness, confusion, loss of coordination, fits and eventually collapse and loss of consciousness. Seek medical help and commence cooling by getting the person out of the heat, removing their clothes and applying cool, wet cloths or ice to their body, especially to the groin and armpits.
Prickly heat – an itchy rash of tiny lumps – is caused by sweat being trapped under the skin. Treat by moving out of the heat and into an air-conditioned area for a few hours and by having cool showers.
Fungal rashes can occur in moist areas that get less air, such as the groin, the armpits and between the toes. Treatment involves keeping the skin dry, avoiding chafing and using an antifungal cream such as Clotrimazole or Lamisil. The fungus tinea versicolor causes small, light-coloured patches, most commonly on the back, chest and shoulders. Consult a doctor.
Immediately wash all wounds in clean water and apply antiseptic. If you develop signs of infection (increasing pain and redness), see a doctor.
The following are the most common for travellers:
Dengue fever Increasingly common in cities. The mosquito that carries dengue bites day and night, so use insect-avoidance measures at all times. Symptoms can include high fever, severe headache, body ache, a rash and diarrhoea. There is no specific treatment, just rest and paracetamol – do not take aspirin, as it increases the likelihood of haemorrhaging.
Hepatitis A This food- and water-borne virus infects the liver, causing jaundice (yellow skin and eyes), nausea and lethargy. All travellers to Malaysia should be vaccinated against it.
Hepatitis B The only sexually transmitted disease (STD) that can be prevented by vaccination, hepatitis B is spread by body fluids.
Hepatitis E Transmitted through contaminated food and water and has similar symptoms to hepatitis A but is far less common. It is a severe problem in pregnant women and can result in the death of both mother and baby. There is currently no vaccine, and prevention is by following safe eating and drinking guidelines.
HIV Unprotected sex is the main method of transmission.
Influenza Can be very severe in people over the age of 65 or in those with underlying medical conditions such as heart disease or diabetes; vaccination is recommended for these individuals. There is no specific treatment, just rest and paracetamol.
Malaria Uncommon in Peninsular Malaysia and antimalarial drugs are rarely recommended for travellers. However, there may be a small risk in rural areas. Remember that malaria can be fatal. Before you travel, seek medical advice on the right medication and dosage for you.
Rabies A potential risk, and invariably fatal if untreated, rabies is spread by the bite or lick of an infected animal – most commonly a dog or monkey. Pretravel vaccination means the post-bite treatment is greatly simplified. If an animal bites you, gently wash the wound with soap and water, and apply iodine-based antiseptic. If you have not been vaccinated you will need to receive rabies immunoglobulin as soon as possible.
Typhoid This serious bacterial infection is spread via food and water. Symptoms include high and slowly progressive fever, headache, a dry cough and stomach pain. Vaccination, recommended for all travellers spending more than a week in Malaysia, is not 100% effective, so you must still be careful with what you eat and drink.
If you're troubled by the air pollution, leave KL for a few days to get some fresh air. Consult the Air Pollutant Index of Malaysia (http://apims.doe.gov.my/public_v2/home.html) for the current situation.
By far the most common problem affecting travellers, travellers diarrhoea is usually caused by bacteria. Treatment consists of staying well hydrated; use a solution such as Gastrolyte. Antibiotics such as Norfloxacin, Ciprofloxacin or Azithromycin will kill the bacteria quickly.
Loperamide is just a ‘stopper’, but it can be helpful in certain situations, such as if you have to go on a long bus ride. Seek medical attention quickly if you do not respond to an appropriate antibiotic.
Giardiasis is relatively common. Symptoms include nausea, bloating, excess gas, fatigue and intermittent diarrhoea. The treatment of choice is Tinidazole, with Metronidazole being a second option.
Proof of yellow-fever vaccination will be required if you have visited a country in the yellow-fever zone (such as those in Africa or South America) within the six days prior to entering Malaysia. The World Health Organization (WHO) recommends the following vaccinations for travellers to Malaysia:
Adult diphtheria and tetanus Single booster recommended if none in the previous 10 years.
Hepatitis A Provides almost 100% protection for up to a year. A booster after 12 months provides at least another 20 years’ protection.
Hepatitis B Now considered routine for most travellers. Given as three shots over six months. A rapid schedule is also available, as is a combined vaccination with hepatitis A.
Measles, mumps and rubella (MMR) Two doses of MMR are required unless you have had the diseases. Many young adults require a booster.
Polio There have been no reported cases of polio in Malaysia in recent years. Only one booster is required as an adult for lifetime protection.
Typhoid Recommended unless your trip is less than a week and only to developed cities. The vaccine offers around 70% protection, lasts for two to three years and is given as a single shot. Tablets are also available; however, the injection is usually recommended as it has fewer side effects.
Varicella If you haven’t had chickenpox, discuss this vaccination with your doctor.
Before you go:
Consult your government’s website on health and travel before departure:
New Zealand www.safetravel.govt.nz
Centers for Disease Control and Prevention (www.cdc.gov) Check health conditions and get up-to-date travel advice.
World Health Organization (www.who.int/ith) Has links to national travel and health websites.
Even if you’re fit and healthy, don’t travel without health insurance – accidents do happen. You may require extra cover for adventure activities such as rock climbing, as well as scooter/motorcycle riding. If your health insurance doesn’t cover you for medical expenses abroad, ensure you get specific travel insurance. Most hospitals require an upfront guarantee of payment (from yourself or your insurer) prior to admission. Enquire before your trip about payment of medical charges and retain all documentation (medical reports, invoices etc) for claim purposes.
KL is an increasingly popular destination for health tourism, for everything from cosmetic surgery to dental veneers. Medical centres and dentists are found in all the big malls and a private consultation will cost around RM50. Pharmacies are all over town; the most common is Watsons, in most malls.
Hospital Kuala Lumpur City's main hospital, north of the centre.
Twin Towers Medical Centre KLCC Handily located in the mall attached to the Petronas Towers, with a second clinic near KL Sentral.
Kien Fatt Medical Store In business since 1943, this traditional pharmacy sells both Chinese and Western medicines. A qualified English-speaking doctor is available for consultations.
Tung Shin Hospital A general hospital with a Chinese traditional medicine clinic.
Klinik Medicare For check-ups and emergency treatments. Based in Mid Valley Megamall.