Guide to Common Diseases in Thailand

Located in the centre of mainland Southeast Asia, Thailand has become a very popular tourist and expat destination mainly for its natural attractions. The country underwent remarkable progress from a low-income country to an upper-income country in less than a generation, but poverty and inequality continue to pose significant challenges in the country.

Given the variation in the ecosystem and socioeconomic background of its population, disease distribution varies slightly across locality and periodically affected by its tropical monsoon climate. The following are the common diseases in Thailand:


Main Tropical Diseases in Thailand

Malaria

Disease background:  One of the main mosquito-borne diseases in Thailand, Malaria is a life-threatening disease caused by parasites that are transmitted through the bites of infected female Anopheles mosquitoes. The symptoms include high fever, headache, and chills.

The wide development of parasite resistance to medicines is reported to reach more than 20 to 50 percent in Mekong area. Do keep in mind that Thailand has multidrug-resistant malaria.

Risk and prevalence: Persons travelling or through rural and forested areas across the country should be made aware of this risk. Malaria is primarily found in provinces that border Burma (Myanmar), Cambodia, and Laos and the provinces of Kalasin, Krabi (Plai Phraya district), Nakhon Si Thammarat, Narathiwat, Pattani, Phang Nga (including Phang Nga City), Rayong, Sakon Nakhon, Songkhla, Surat Thani, and Yala.  Occasional cases are recorded in areas from Phuket, Phang Nga, Kho Samui, and Kho Pha Ngan.

Prevention and treatment: Anti-mosquito bite measures should be taken in risky areas. Preventive anti-malarial medication can be taken before and whilst travelling to the high risk areas.


Dengue

Diseases background: Listed as one of Thailand’s infectious diseases to watch for in 2018, dengue is a mosquito-borne viral infection causing a severe flu-like illness and, sometimes causing a potentially lethal complication called severe dengue. A person infected by the dengue virus come out with severe flu-like symptoms. The contamination, also called ‘break-bone’ fever affects infants, children and adults alike and it could be incurable. The appearances of dengue fever vary according to the age of the patient.

Risk and prevalence: The disease is endemic throughout the country in rainy season (May to October) in both urban and rural areas, with elevated risk in the northeastern part of the country. Aedes aegypti, the mosquitoes responsible for dengue fever, can also spread yellow fever and Zika virus.

Treatment and prevention:  No specific treatment for Dengue virus. Using mosquito repellents and getting rid of any water stagnation are recommended to prevent risks of the disease.


Japanese Encephalitis

Disease background: Japanese encephalitis is a mosquito borne virus infection and most common vaccine-preventable cause of encephalitis in Asia. Acute encephalitis syndrome was defined as sudden onset of fever with neurological signs such as altered mental status, motor deficit, sensory deficit and seizures.

Risk and prevalence: Outbreaks occur mostly in the northern region (Chiang Mai Valley) found in the agricultural countryside, with seasonal peaks from May to October.

Treatment and prevention: There is no efficient anti-viral treatment available. Protection from mosquito bites and vaccination are the only effective ways reported. Vaccination is suggested for travellers and expatriates who stays in rural endemic areas for at least one month during the rainy season.


 Leptospirosis

Disease background: Leptospirosis is a bacterial disease contracted through direct contact with the urine of infected animals or with a urine-contaminated environment. Symptoms include high fever, severe headache, muscle pain, chills, redness of the eyes, abdominal pain, jaundice, haemorrhages in the skin and mucous membranes, vomiting, diarrhoea, and rash.

Risk and prevalence: Leptospirosis is most common in urban slum areas due to inadequate sewage disposal and water treatment. Travellers participating in water-related activities can be at risk. Visiting agricultural or flooded areas can also increase exposure.

Treatment and prevention: Avoiding suspicious water contact such as in canals, swamps, lakes and rivers may reduce its risk.


Soil-transmitted worm diseases

Disease background: Soil-transmitted helminth (worm) infections are among the most common infections worldwide especially in poverty-stricken communities. They are transmitted by eggs present in human excrement which in turn pollute soil in areas where sanitation is poor.

Symptoms include diarrhoea, abdominal pain, malnourishment, general malaise and weakness, and impaired growth and physical development.

Risk and prevalence: The disease remains prevalent in certain rural areas of Thailand. Disease statistics based on a national survey in 2009 reported as high as 18.1% of Thais population suffer from intestinal parasitic infection, especially in the northeastern and southern regions of Thailand.

Treatment and prevention: The WHO recommended medicines; albendazole and mebendazole are effective, inexpensive and easy to administer even by non-medical personnel. Practice good food and body hygiene as well as having cooked food is recommended to prevent infection.

Common Infectious Diseases

Hepatitis B

Disease background: The Hepatitis B virus (HBV) can cause acute and chronic liver epidemics. It is disseminated through infected blood products, unprotected sex, infected items such as needles, razor blades, dental or medical equipment, unscreened blood transfusions, as well as from mother to child at birth. Those infected will usually get ill 30 days to six months after virus exposure. Symptoms include fatigue or weakness, malaise or discomfort, vomiting, abdominal pain, dark urine, and jaundice.

Risk and prevalence: In some parts of Thailand up to 20% of the population are carriers of hepatitis B, and usually are unaware of this. Main routes of contamination are food & water, sexual relations, and contact with blood.

Treatment and prevention: Hepatitis B vaccination is recommended for anyone living in Thailand and Asia. And, always practice safe sex by using the condom correctly and consistently or abstain from intercourse.


Hepatitis A

Disease background: The Hepatitis A Virus (HAV) is usually spread through the faecal-oral route, meaning through contaminated food, water or drinks and person-to-person transmission. The virus affects the liver, causing jaundice (yellow skin and eyes), nausea and lethargy or drowsiness.

Risk and prevalence: The risk in Bangkok is decreasing, but there is still significant risk in most of the country. The level of prevalence depends mostly on local sanitary conditions. HAV disseminates widely in populations with poor sanitation infrastructure.

Treatment and prevention: There is no specific treatment for hepatitis A but food hygiene and vaccination can prevent HAV infection.


HIV

Disease background: HIV is a virus spread through certain body fluids that attacks the body’s immune system. Over time, HIV can weaken a person’s immune system until opportunistic infections or cancers occur.

Risk and prevalence: HIV is now one of the most common causes of death in people under the age of 50 in Thailand. Thailand also has the highest adult prevalence of HIV in Southeast Asia.  This burden was driven largely by high rates of infection among men who have sex with men, sex workers, youth, and drug users. The declining of HIV prevalence in Thailand is due to successful HIV prevention programmes.

Treatment and prevention: Always practice safe sex, avoid getting tattoos or using unclean syringes. Anti-retroviral therapy has now made it possible for patients to live without contracting AIDS by suppressing viral loads to such an extent that they are likely to be in good health and will not pass the virus onto others if maintained.


 

Sexually Transmitted Diseases

Disease background: Sexually transmitted diseases are caused by bacteria, viruses or parasites that are transmitted through unprotected sex and skin to skin genital contact.

Sexually transmitted diseases are most common in Thailand include herpes, warts, syphilis, gonorrhoea and chlamydia. Zika Virus can also be sexually transmitted.

Common symptoms include abnormal genital discharge, burning sensation when urinating, bleeding after intercourse or between periods, rashes and sores in the genital or anal areas, swollen lymph glands in the private parts, and sudden fever or appearance of flu-like symptoms.

Risk and prevalence: Travellers are at high risk of acquiring STDs if they have unprotected sex outside a monogamous relationship, engage in casual sex, or use the services of sex workers. The use of condoms will avoid gonorrhoea and chlamydia, but cannot prevent warts or herpes from infecting.

Treatment and prevention: Always practice safe sex and avoid behavior that increases the risk of contracting STDs.


Tuberculosis

Disease background: Tuberculosis is spread through contaminated air droplets coughed or sneezed by a person with active Tuberculosis or ingestion of unpasteurized contaminated milk products. The most frequent form of the infection is pulmonary TB which affects the lungs.

TB is presented with excessive coughing (sometimes with blood), chest pain, general weakness, lack of appetite, weight loss, swollen lymph glands, fever, chills, and night sweats. If untreated, active TB can be fatal.

Risk and prevalence: Tuberculosis is endemic in Thailand as the country is classified as one of the 22 countries in the world with the highest TB burden by WHO. Risk of TB is significantly higher in cramped and overcrowded conditions.

Treatment and prevention: Tuberculosis treatment involves taking antibiotics for a minimum of 6 months but drug-resistant TB is now a major concern. You can prevent the infection by avoiding exposure to people known to have active Tuberculosis and consume only pasteurized milk products. Travellers who are at risk should be tested before and after returning home.


Seasonal Flu

Disease background: Influenza or flu is a contagious respiratory illness caused by influenza viruses. Symptoms include body aches, chills, cough, fever, headache, runny nose, sore throat, and tiredness.

Risk and prevalence: Infuenza is expected to be one of the top 10 diseases in Thailand in 2018. Thailand’s flu season usually coincides with its wet season, around June and October each year. Small children, elderly, pregnant women and anyone with a compromised immune system are the most at risk.

Treatment and prevention: Seasonal flu can be prevented through vaccination in Thailand, but simple measure as avoiding close contact and cleaning your hands can also help.

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Other Health Issues

Food Poisoning

Disease background: Exposure to contaminated food is a common source of gastrointestinal illnesses. Poor hygiene and food handling practices can contribute to food contamination.

Risk and prevalence: According to WHO, diarrhoeal diseases have been a major public health problem in Thailand, and food is considered the main route of transmission of microorganisms. There are approximately a million cases of diarrhoeal diseases per year reported with more than 120,000 cases are due to food poisoning in Thailand. Eating pattern in some areas, such as the consumption of raw or undercooked food, are one of the major causes of diarrhoeal diseases in Thailand.

Treatment and prevention: Oral rehydration solution is usually the first line of treatment for diarrhoea. Prevention of food poisoning can be made by being aware of the risk, make safe choices and practising good hygiene.


Water Borne Diseases

Disease background: A disease transmitted by drinking water or by contact with water is referred to as a water-borne disease. It is usually transmitted by ingestion of water that has been contaminated with human faeces or faeces from domestic and wild animals.

Risk and prevalence: Food and water borne diseases are usually interrelated with diarrhoea usually the manifesting symptom. Infection from contaminated water or soil is third most-deadly infectious disease in Thailand and reported to cause death of 40 percent of those infected.

Treatment and prevention: Always drink clean water or bottled water from a reputable source. Avoid drinking tap water in Thailand and ensure that the ice in your drink is tubular in shape. Antidiarrhoea medications are recommended as one of travel medicines you should have during a trip to Thailand.


Traffic Accidents

Background: Road traffic injuries are an important public health problem worldwide, with the majority of it occurring in low- and middle-income countries. Minor injuries, long-term disability and even death can be caused by road traffic accidents.

Risk and prevalence: Thailand has the second highest road traffic fatality rate in the world.

70% of the people injured or killed in traffic crashes in Thailand are aged between 10–39.

Treatment and prevention: Adapting yourself to Thailand’s traffic behaviour can be the best prevention from road traffic accident. Get a proper accident insurance as road traffic accidents are highly expected in this country.


Rabies

Disease background: Rabies is a vaccine-preventable viral disease with dogs contributing up to 99% of all rabies transmissions to humans. The disease is almost always fatal as the virus attacks the central nervous system. It is spread via saliva encounter through bites or scratches.

Rabies typically exhibit signs of hyperactivity, excitable behaviour, fear of water and sometimes fear of drafts or of fresh air. Death occurs due to cardio-respiratory arrest in few days time.

Risk and prevalence: According to the Centers for Disease Control and Prevention, rabies is not a major risk to most travellers to Thailand.

Treatment and prevention: Effective human vaccines and immunoglobulins exist for rabies, but may not be readily available or accessible as treatment can be expensive or in short supply.

Snakebites

Background: Snake venom consists of a complex mixture of toxins and enzymes, each of which may be responsible for one or more distinct toxic actions. In bites by South Asian vipers, for example, envenoming results in local pain and tissue damage, characterised by swelling, blistering, bleeding, and necrosis at the bite site, sometimes extending to the whole limb.

Risk and prevalence: Thailand has an abundance of venomous snakes, some are considered as occupational hazard for farmers and rubber tappers.  There are about 7,000-9,000 bites by snakes and about 5-100 deaths per year in Thailand due to venomous snakebite.

Treatment and prevention:  Venomous snakebites in Thailand can cause serious morbidity but only rare deaths, since competent treatment is now widely available throughout Thailand. Purified antivenoms are manufactured locally for the treatment of snakebites.


Bottom Line

Take safety precautions to avoid any medical diseases or accidents in Thailand. Having a health insurance coverage will be vital as many hospitals require a guarantee of payment before they will start treatment. Private hospitals in Thailand are excellent but can be expensive. While public hospitals and clinics particularly outside Bangkok and in the coastal islands may not be always up to western standards.

In case of emergency, contact 1669 for the ambulance in Thailand or call your hospital’s emergency number. Contact your insurance provider promptly if you are referred to a medical facility for treatment.

Take medications only from a reputable pharmacy when you are in Thailand. You may notice some prescription medications like Viagra, Cialis and Valium are readily available in popular nightlife districts across Thailand. Know that counterfeit medications become an alarming issue in Thailand, so these medications are most probably not genuine. Avoid taking medications without medical advice or a prescription.

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