While urban horror stories can make a trip to Bangkok seem frighteningly dangerous, few travellers experience anything more than an upset stomach and the resulting clenched-cheek waddles to the bathroom. If you do have a problem, Bangkok has some very good hospitals.
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Before You Go
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 or diving, 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.
You should arrange your vaccines six to eight weeks prior to departure through a specialised travel-medicine clinic.
The Centers for Disease Control and Prevention (www.cdc.gov) has a traveller’s health section that contains recommendations for vaccinations. The only vaccine required by international regulations is yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone within the six days prior to entering Thailand. If you are travelling to Thailand from Africa or South America you should check to see if you require proof of vaccination.
Recommended items for a personal medical kit include the following, most of which are available in Thailand.
- antifungal cream, eg Clotrimazole
- antibacterial cream, eg Muciprocin
- antibiotic for skin infections, eg Amoxicillin/Clavulanate or Cephalexin
- antibiotics for diarrhoea include Norfloxacin, Ciprofloxacin or Azithromycin for bacterial diarrhoea; for giardiasis or amoebic dysentery take Tinidazole
- antihistamine – there are many options, eg Cetrizine for daytime and Promethazine for night-time
- antiseptic, eg Betadine
- antispasmodic for stomach cramps, eg Buscopan
- DEET-based insect repellent
- oral rehydration solution for diarrhoea (eg Gastrolyte), diarrhoea ‘stopper’ (eg Loperamide) and antinausea medication
- first-aid items such as scissors, bandaids (Elastoplasts), bandages, gauze, thermometer (but not one with mercury), sterile needles and syringes (with a doctor’s letter), safety pins and tweezers
- hand sanitiser gel (alcohol based) or alcohol-based hand wipes
- ibuprofen or another anti-inflammatory
- indigestion medication, eg Quick-Eze or Mylanta
- laxative, eg Coloxyl
- migraine medicine – for migraine sufferers
- permethrin to impregnate clothing and mosquito nets if at high risk
- steroid cream for allergic/itchy rashes, eg 1% to 2% hydrocortisone
- sunscreen, sunglasses and hat
- throat lozenges
- thrush (vaginal yeast infection) treatment, eg Clotrimazole pessaries or Diflucan tablet
- Ural or equivalent if prone to urine infections
- International Travel & Health (www.who.int/ith) is published by the World Health Organization (WHO).
- Centers for Disease Control & Prevention (www.cdc.gov) has country-specific advice.
- Travelling Well by Dr Deborah Mills is a health guidebook and website (www.travellingwell.com.au).
Availability & Cost of Health Care
Bangkok is considered a centre of medical excellence in Southeast Asia. Private hospitals are more expensive than other medical facilities, but offer a superior standard of care and English-speaking staff. The cost of health care is relatively cheap in Thailand compared to most Western countries.
This mosquito-borne disease is increasingly problematic in Thailand, especially in the cities. As there is no vaccine it can only be prevented by avoiding mosquito bites. The mosquito that carries dengue is a daytime biter, so use insect-avoidance measures at all times. Symptoms include high fever, severe headache (especially behind the eyes), nausea and body aches (dengue was previously known as ‘breakbone fever’). Some people develop a rash (which can be very itchy) and experience diarrhoea. There is no specific treatment, just rest and paracetamol – do not take aspirin or ibuprofen as they increase the risk of haemorrhaging. See a doctor to be diagnosed and monitored.
Dengue can progress to the more severe and life-threatening dengue haemorrhagic fever, but this is very uncommon in tourists. The risk of this increases substantially if you have previously been infected with dengue and are then infected with a different serotype.
Present year-round in the tropics, influenza (flu) symptoms include high fever, muscle aches, runny nose, cough and sore throat. Flu is the most common vaccine-preventable disease contracted by travellers and everyone should consider vaccination. There is no specific treatment, just rest and paracetamol. Complications such as bronchitis or middle-ear infection may require antibiotic treatment.
HIV is now one of the most common causes of death in people under the age of 50 in Thailand. Always practise safe sex and avoid getting tattoos, piercings or using unclean syringes.
This disease, fatal if left untreated, is spread by the bite or lick of an infected animal – most commonly a dog or monkey. You should seek medical advice immediately after any animal bite and commence postexposure treatment. Having a pretravel vaccination means the postbite treatment is greatly simplified.
If an animal bites you, gently wash the wound with soap and water, and apply iodine-based antiseptic. If you are not prevaccinated you will need to receive rabies immunoglobulin as soon as possible, followed by five shots of vaccine over 28 days. If prevaccinated you need just two shots of vaccine given three days apart.
Sexually transmitted diseases most common in Thailand include herpes, warts, syphilis, gonorrhoea and chlamydia. People carrying these diseases often have no signs of infection. Condoms will prevent gonorrhoea and chlamydia, but not warts or herpes. If after a sexual encounter you develop any rash, lumps, discharge or pain when passing urine, seek immediate medical attention. If you have been sexually active during your travels, have an STD check on your return home.
Bangkok has a reputation for air pollution, and on bad days the combination of heat, dust and motor fumes can be a powerful brew of potentially toxic air.
The good news is that more efficient vehicles (and fewer of them thanks to the BTS/Skytrain and MRT/Metro) and less industrial pollution mean Bangkok’s skies are much cleaner than they used to be.
Eating in restaurants is the biggest risk factor for contracting traveller’s diarrhoea. Ways to avoid it include eating only freshly cooked food and avoiding food that has been sitting around in buffets. Peel all fruit and cook vegetables. Eat in busy restaurants with a high turnover of customers.
For most people it takes at least two weeks to adapt to the hot climate. Prevent swelling of the feet and ankles as well as muscle cramps caused by excessive sweating by avoiding dehydration and excessive activity in the heat of the day.
Heat stroke requires immediate medical treatment. Symptoms come on suddenly and include weakness, nausea, a hot dry body with a body temperature of more than 41°C, dizziness, confusion, loss of coordination, fits and eventually collapse and loss of consciousness.
Prickly heat is a common skin rash in the tropics, caused by sweat being trapped under the skin. Treat by taking cool showers and using powders.
Two fungal rashes commonly affect travellers. The first occurs in the groin, armpits and between the toes. It starts as a red patch that slowly spreads and is usually itchy. Treatment involves keeping the skin dry, avoiding chafing and using an antifungal cream such as Clotrimazole or Lamisil. The fungus Tinea versicolor causes small and light-coloured patches, most commonly on the back, chest and shoulders. Consult a doctor.
Cuts and scratches become easily infected in humid climates. Immediately wash all wounds in clean water and apply antiseptic. If you develop signs of infection, see a doctor.
Although it's deemed potable by the authorities, Thais don't drink tap water and neither should you. Stick to bottled or filtered water during your stay.
Travelling with Children
Bangkok is relatively safe for children. Consult a doctor who specialises in travel medicine prior to travel to ensure your child is appropriately prepared. A medical kit designed specifically for children includes liquid medicines for children who can not swallow tablets. Azithromycin is an ideal paediatric formula used to treat bacterial diarrhoea, as well as ear, chest and throat infections.
Good resources include Lonely Planet's Travel with Children and, for those spending longer away, Jane Wilson-Howarth’s Your Child’s Health Abroad.
Traveller’s diarrhoea is by far the most common problem affecting travellers. In over 80% of cases, traveller’s diarrhoea is caused by a bacteria (there are numerous potential culprits) and responds promptly to treatment with antibiotics.
Here we define traveller’s diarrhoea as the passage of more than three watery bowel movements within 24 hours, plus at least one other symptom such as vomiting, fever, cramps, nausea or feeling generally unwell.
Treatment consists of staying well hydrated; rehydration solutions such as Gastrolyte are the best for this. Antibiotics such as Norfloxacin, Ciprofloxacin or Azithromycin will kill the bacteria quickly. Seek medical attention if you do not respond to an appropriate antibiotic.
Loperamide is just a ‘stopper’ that only treats the symptoms. It can be helpful, for example, if you have to go on a long bus ride. Don’t take Loperamide if you have a fever, or blood in your stools.
Giardia lamblia is a parasite that is relatively common. Symptoms include nausea, bloating, excess gas, fatigue and intermittent diarrhoea. ‘Eggy’ burps are often attributed solely to giardiasis. The treatment of choice is Tinidazole, with Metronidazole being a second-line option.
Amoebic dysentery is very rare in travellers, but may be misdiagnosed by poor-quality labs. Symptoms are similar to bacterial diarrhoea. You should always seek reliable medical care if you have blood in your diarrhoea. Treatment involves two drugs: Tinidazole or Metronidazole to kill the parasite in your gut and then a second drug to kill the cysts. If left untreated complications, such as liver abscesses, can occur.
Pregnant women should receive specialised advice before travelling. The ideal time to travel is in the second trimester, when pregnancy-related risks are low. Ensure travel insurance covers all pregnancy-related possibilities, including premature labour.
Malaria is a high-risk disease in pregnancy. Pregnant women should not travel to those areas with chloroquine-resistant malaria. None of the more effective antimalarial drugs are completely safe in pregnancy.
In 2016, the Zika virus was confirmed in Thailand and two cases of birth defects related to the virus were reported. For updates on the situation, check with the International Association for Medical Assistance for Travellers (www.iamat.org).
Traveller’s diarrhoea can quickly lead to dehydration and result in inadequate blood flow to the placenta. Azithromycin is considered one of the safest antidiarrhoea drugs in pregnancy.
In Thailand’s urban areas, supplies of sanitary products are readily available. Bring adequate supplies of your personal birth-control option. Heat, humidity and antibiotics can all contribute to thrush, which can be treated with antifungal creams and Clotrimazole. A practical alternative is one tablet of fluconazole (Diflucan). Urinary-tract infections can be precipitated by dehydration or long bus journeys without toilet stops; bring suitable antibiotics for treatment.
More than Thailand’s main health-care hub, Bangkok has become a major destination for medical tourism, with patients flying in for treatment from all over the world.
Business is good in the teeth game, partly because so many fa·ràng (Westerners) are combining their holiday with a spot of cheap root-canal work or some ‘personal outlook’ care – a teeth-whitening treatment by any other name. Prices are a bargain compared with Western countries and the quality of dentistry is generally high.
Bangkok Dental Spa Dental-care centre with a spa-like environment.
DC-One the Dental Clinic Dental clinic with reputation for excellent work and relatively high prices; popular with UN staff and diplomats.
Dental Hospital A private dental clinic with fluent English-speaking dentists.
Siam Family Dental Clinic Private dental clinic in central Bangkok.
Pharmacies are plentiful, and in central areas most pharmacists will speak English. If you don’t find what you need in a Boots, Watsons or a local pharmacy, try one of the hospitals.