An explosive increase of HIV infection has occurred in commercial sex workers, of whom 14-72% is now zero positive. The majority of patients are heterosexual. Thailand now has the highest number of officially-reported AIDS cases in Southeast Asia. Blood used for transfusion in Thailand is checked for the AIDS virus.
Accidents & Medical Insurance :
- Accidents and injuries are the leading cause of death among travellers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drowning, aircraft crashes, homicides, and burns are lesser causes.
- Heart attacks cause most fatalities in older travellers.
- Infections cause only 1% of fatalities in overseas travellers, but, overall, infections are the most common cause of travel-related illness.
- MEDICAL INSURANCE: Travellers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance centre that can help arrange and monitor delivery of medical care and determine if Mede vac or air ambulance services are required.
- NOTE: Bangkok is sometimes called "the gridlock city" because of its chaotic traffic. The traffic is left hand (as in England) and there is a high incidence of accidents and pedestrian injury. All drivers should be alert, and seat belts should be worn at all time.
Animal Hazards :
Animal hazards include snakes (kraits, vipers, and cobras), centipedes, scorpions, and black widow spiders. (Snake bite antivenin is available from the Thai Red Cross.) Other possible hazards include tigers, leopards, crocodiles, pythons, poisonous toads and frogs, and large, aggressive lizards. Stingrays, jellyfish, and several species of poisonous fish (puffer, goblin, stone, toad, scorpion, pig, porcupine, and box jellyfish) are common in the country's coastal waters and are potentially hazardous to unprotected or careless swimmers. Large sharks are common on the Andaman (Indian Ocean) side. There are no saltwater crocodiles in Thailand.
Sporadic cases may occur. Cholera is an extremely rare disease in travellers from developed countries. Cholera vaccine is recommended primarily for people at high risk (e.g., relief workers) who work and live in highly endemic areas under less than adequate sanitary conditions.
- The manufacture and availability of the inject able cholera vaccine in the United States ceased in June 2000.
- Many countries, including Canada, license an oral cholera vaccine. The oral vaccine is not available in the United States.
- Cholera vaccine is not "officially" required for entry into, or exit from, any country. Despite this, some countries, on occasion, require proof of cholera vaccination from travellers coming from cholera-infected countries. Anticipating such a situation, certain travellers may wish to carry a medical exemption letter from their health-care provider.
Travel Medicine, Inc., recommends that travellers use the International Certificate of Vaccination (Yellow Card) for this purpose, having their health-care provider state "exempt from cholera vaccine" and validate the exemption with both their signature and their official stamp (the "Uniform Stamp" in the United States).
Dengue Fever :
Highly endemic, and a risk for travellers. Peak infection rates occur in the rainy season, between June and August, countrywide, but particularly in north-eastern Thailand. Dengue and dengue hemorrhagic fever are major health problems both in Thailand and throughout SE Asia. Prevention is by avoiding daytime mosquito bites.
Both the Malayan and Bancroftian varieties occur in scattered areas, primarily the southern peninsular coastal provinces, the central provinces of Sisaket and Surin, and the forested areas along the Thailand-Burma border. Travellers should prevent mosquito bites.
Hepatitis A vaccine is recommended for all no immune travellers. Hepatitis E is endemic, with seroposivity rates of 22% in adults. There is no vaccine for hepatitis E. The hepatitis B carrier rate in the adult general population is about 9%. The usual traveller without lifestyle problems is at virtually no risk of acquiring hepatitis B virus (HBV), but vaccination is recommended for sexual tourists, long-term visitors, and anybody wanting increased protection. Hepatitis C is endemic and is largely transmitted by blood products and body fluids. Like HBV, hepatitis C carries no increased risk for travellers who have a normal lifestyle.