v_sapi

Just trying to see how many people get vaccination when traveling to Thailand...We are doing a trip in April, with Smartours. We are a healthy couple, and frequent travelers abroad, although we have never been to South East Asia. We heard conflicting advise about vaccinations. What has been your experience? Have you heard of poeple getting ill with serious food bourne or water bourne viruses?
What type of vaccination did you get? Should we bother with it?

We heard not to drink water, use ice, or anything that may have been washed in water, like fruits and vegetables..etc...This is an issue, as we do like to eat salads, and fruits and drink cocktails.

We are pretty adventurous eaters, we love Thai food...and heard that local food is the best. Is it safe to eat in small local restaurants or should we stick to hotel or major restaurants?

Any other health advice specific to Thailand?

Kathie

First of all, read the cdc website www.cdc.gov/travel You should of course, consult with a travel med doc before your trip.

Here are the basic issues:

vaccines: make sure your routine vaccines are up to date: diptheris/tetanus, MMR (measles mumps rubella).

There are alos routine travelers vaccines: Hep A and Typhoid These are both food and water bourne illnesses are spread by inadequate handwashing. As you know, you can get Hep A in North America and Western Europe. I think people should have Hep A vaccine just to stay at home. Since you have no control over who handles your food, having both of these are wise.

There are other vaccines appropriate for people doing more unusual trips: Jap. Encephalitis if you are spending more than 6 weeks in a rural farming area, or for those working on farms, rabies if you will be handling animals, etc.

Know what food and water precautions are so you can make a conscious decision about if and when to violate those precautions. I always drink bottled water, but I do eat salads in restaurants I know (including some tiny, hole in the wall places). Personally, I don't eat street food (even in the US). Some people do and do fine, some people get sick. Part of this has to do with individual differences. I do eat lots of fruit - that I can peel myself, and in my hotel at breakfast. I do not eat pre-cut fruit from vendors (I know sveral people who have gotten sick that way). I do use ice that is commercially made (cylindrical with a hole in the middle) but not crushed ice.

Do use mosquito repellant. Dengue is present in Thailand. Malaria is a risk only in the border areas with Burma, Laos and Cambodia, places you are unlikely to be visiting.

Also, the sun is very hot. Drink lots of water, use sunscreen, and take breaks out of the sun.

simpsonc510

FYI: Some of us do not get the vaccinations. Just to let you know, it's not 100% on this board who visit the travel doc before heading to Thailand. I've been 12 times, 13th time will be in April/May. No shots for me. DS and DH have also not had shots for their many many trips to Bangkok. Other friends who have joined us in Bangkok (and who do not post here) also have opted not to take them.

Your choice!!!

No, don't drink the water. There is plenty of bottled water at 7-11 and in most hotels (provided free daily). We buy the huge 5 gal jugs of water at 7-11 for making coffee. We stay in serviced apartments so we have a big fridge.

I eat salads at the better known restaurants. There are plenty of American brand hotels with restaurants that you can "trust" to serve you properly prepared veggies.

One of my favorites is a plate of steamed veggies with a side of rice that a Thai friend cooks for me. I would trust her to make sure they are prepared properly as well.

I like fruit that I can peel. The fresh fruit in Thailand is delicious!

Have a great time on your trip.

v_sapi

Thanks Kathie...good advice..I did go to the website and it said that people returning from Southeast Asia, including Thailand, may need to show the proof of vaccination against the yellow fever..anyone had to show the proof? I jsut cant see it happening in the JFK airport..especially if you are just coming back from a brief vacation.

travelgirlatl

DH and I are going to Thailand next month (Bangkok, Chiang Rai or Mai, Koh Phangan, and Koh Tao) and actually just got back from seeing the doctor for our vaccinations. After a lot of research, we decided to go with Tetanus (we were both overdue for a booster of that anyway!), Hep A, and typhoid (we're doing the oral vaccine for this one). We are both young and healthy, and the risk of contracting these conditions is small, but we figured better safe than sorry, it's a small price to pay for peace of mind, and so forth.

On the other hand, we did decide that for the areas we will be visiting, the Polio and JE vaccs were not worth getting, nor Hep B since we don't intend to have sexual contact with anyone but each other. (You can also get Hep B from blood transfusions, but the risk of needing one while there and getting tainted blood is so very small we decided to chance it.)

LynnieD

I got all recommended vaccines and then ate/drank whatever I wanted, although I did use bottled water exclusively.

Since I knew I'd eat street food, which included cut pineapple, mangoes, etc, I thought it would be prudent. Also, the Hep series is worthwhile anywhere imho.

Gpanda

I'm with LynneD. get the shots, drink bottles water and be careful, but not psychotic about hygiene. we eat street food from clean looking vendors. We also eat copious quantities of Pomelo salad and Papaya salad, both are true Thia delicacies. I only got sick when I drank tap water in Laos. On no trip to Thailand did either my wife or I get sick. have a great time.

Kathie

Clarification about Yellow Fever: you only need to show a yellow fever certificate upon return to the US if you have been in a yellow fever area. There is no yellow fever in SE Asia. Only parts of Africa and South America are yellow fever areas.

rhkkmk

we are cautious, over-cautious, about what we eat in order to fully enjoy our thai trips....no salads for us....washing of fruits, etc must be in pure water, not tap water...so be careful...no street food for us at all...

we go to the travel clinic before each asian trip and do exactly what they suggest....my wife is a nurse and we feel that not doing so is like having unprotected sex in thailand....

rkkwan

According to CDC's Yellow Fever page, the US does not require proof of vaccination to return to the country, regardless where you've been.

Kathie

rkkwan, I just checked and couldn't find it either. I took v sapi's word for it that it was mentioned (often it's mentioned as a requirement for entry into a country if you are coming from a yellow fever area). The only vaccine worldwide that is required by any country is Yellow Fever. People entering yellow fever endemic countries must show proof of vaccination, and quite a few countries require proof of yellow fever vaccination for returning travelers from yellow fever areas. With the recent outbreaks of yellow fever in several South American countries (Brazil, Paraguay) I thought perhaps it had been added back into the requirement for re-entering the US from Yellow Fever areas. Apparently not.

easytraveler

I load up on all the shots. Tetanus, Hep A, Hep B, etc. etc.

I used to have to travel often for business and some years would be on the road 80% of the time, here in the States and abroad.

I figured taking the shots was a small precaution with big rewards. Some of my colleagues would be in too much of a hurry or felt they didn't need the shots. For the majority who did not get the shots nothing much happened, but for a few, they got very very ill. One person, in particular, came back with a debilitating stomach problem that will stay with him for the rest of his life.

So it's a judgment thing for each person.

In Asia, I drink only bottled water, brush teeth with bottled water, never open my mouth in the shower, and carry Purell with me everywhere.

Nothing raw or undercooked to eat, except fresh fruit in good hotels and restaurants. If I buy fruit, it's always with the skin intact. Bring it back to the hotel and wash thoroughly. I recently described how I washed some mangoes in Bangkok with soap and some Fodorites were falling out of their chairs with laughter.

Hey, an ounce of prevention is worth is pound of trouble!

Get some mosquito repellent and some After-bite. Bring some Imodium.

jgg

easytraveler - thanks for mentioning afterbite. I just bought some this weekend as it looked like something we might want to have with us, but didn't know if it really works. Thanks for the recommendation!

glorialf

I'm like Bob in that I am over cautious. There is no food or drink in the world that is worth my missing one or more days of my vacation because I'm sick, So I don't eat street food ever (but then I don't eat street food in the U.S. either). I only use ice in top hotels or restaurants that I completely trust like the Oriental. Same with salads or unpeeled fruit or raw vegetables. I have been going to asia since 1985 and have NEVER gotten sick so I'm going to keep doing what I'm doing.

v_sapi

I appreciate everyone's feeback. I spoke with a couple of docs and the opinions vary on whether you need the shots going to Thailand. We have only 3 weeks left before our trip, but for effective immunization you need to do the repeats, and ideally start 6 months before you go. So we are clearly late, but will likely get Hep A only. Thanks for advice about bringing insect repellent and after bite...will do that.

I guess its not hard to follow basic precautions that everyone here seems to agree with. The only thing that worries me is ICE. How do I know what was put in my glass, commercially made or not?

I am not planning on eating in hotel restaurants only, so this is going to be a judgement call. We have always had good meals in small, off the beaten path type restaurants...


As far as yellow fever, I was confused by the information on the cdc.gov site. On the Thailand page the mention YE, and that they require proof of vaccinations, but they say only for people returning from countires where its a problem. I assumed this wws the case with Thailand since it was on a Thailand page, but after reading it more carefully I relaized that its not. Sorry for false alarm.

Gpanda

I've eaten ice all over Thailand and never had a problem. Just use common sense.

Kathie

In Thailand, commercially made ice is cylindrical in shape and has a hole in the middle. It is made from purified water. Crushed ice is not typically made from purified water.

Do you need vaccines to travel to Thailand? While nothing is required, it is wise to have vaccines, as per the cdc website. Hep A does need a booster after your initial shot, but it is then effective for at least 20 years. So make sure you get your booster shot.

The other vaccines mentioned do not need a booster. Typhoid is a single shot, or a series of pills completed in less than a week. SInce typhoid is a food and water borne illness, it's wise to have this vaccine. Also, there are antibiotic-resistant strains in SE Asia.

So really, the only vaccine that should be started 6 months in advance is Hep A/B. Only three weeks left before your departure is not a reason to forgo vaccines.

v_sapi

Great information. Will do. Thanks.

rhkkmk

we will use ice in bkk, but only at top 5 star hotels...no place else...coke without ice at mcdonalds for instance...

everything is served very chilled i find

beer is a good alternative