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Tap water in Thailand should not be consumed unless it has been boiled, filtered, or chemically disinfected. In the major cities, water comes from water purification plants, but may be contaminated due to inadequate sewage facilities. This is especially common during times of flooding. It might also be as well to be aware that the ground around and in the location of the Pattaya reservoir is heavily bauxited (contains aluminium) which can build up in the brain and cause health problems in later life. Best advice is to drink bottled water.

Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Fruits and vegetables should not be eaten unless they have been peeled or cooked. Foods that have been cooked but left at room temperature, such as buffets, should be avoided, as well as raw or undercooked meat or fish. Do not buy food or beverages from street vendors. There are several products on the market here that can be added to the water in which to wash or soak fresh fruit and vegetables.

All residents should keep at home an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool.
Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), and azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.

If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought. If you live in Pattaya, don’t ask the pharmacy stores or get your girl friend to go out, but go to the Bangkok Pattaya hospital or a major hospital in Bangkok or Chonburi General.

Protection against insects
Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be reapplied more frequently.
Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Don’t sleep with the window open unless there is a screen.
The scorpions in Thailand do have poison, however it is so mild that it is comparable to the sting of a bee or a wasp. The sting is painful but harmless, however some people might develop an allergic reaction. The sting should therefore be immediately disinfected.
For conservation reasons please do not kill these animals, but catch them and free them into the wild.
Note: The trader does not offer any suggestions as to how you would capture the insect, only that you should be very careful in doing it.

The risk of malaria in Thailand is low and is mainly found in areas towards the Burmese border. If trekking is planned in these areas malaria tablets should be taken. There is strong resistance against Chloroquine and Lariam and the choice is between Malarone and Doxycycline. Protection against mosquito bites (IE insect repellent sprays and light repellent creams) will reduce the risk further.

If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.

Air pollution
Air pollution may be a significant health problem in Bangkok and Chiang Mai and also Pattaya. People living in those areas with respiratory or cardiac conditions and those who are elderly or extremely young are at greatest risk for complications from air pollution, which may include cough, difficulty breathing, wheezing, or chest pain. The risk may be minimized by staying indoors, avoiding outdoor exercise, and drinking plenty of fluids.
Airconditioned offices are a very effective way of spreading air pollution of any sort and if you are in fact an office worker, take special care.

General advice
Keep at home adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician’s letter documenting their medical necessity. Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while living here medical expenses including evacuation may run to tens if not 100,000’s of thousands of Baht. Always make sure you carry a health insurance card or a credit card at all times as local hospitals may be reluctant to treat or admit you without there are sufficient funds available for the hospital to cover their immediate expenses.

Finally, always go to see a doctor whenever you feel unwell. What might initially seem like an irritating discomfort could in fact become a serious condition if not attended to. Bacteria and virus strains can survive for an exceptionally long time in the heat and humidity here in Pattaya.

For best advice go to: Dr. Olivier
20/29 Moo 10, Soi Hotel Day Night 20150 Pattaya Tel.: 038-723600, 038-723590
Fax : 038-723590
Emergency Mobile Number : 086-8276922
EMail: info@dr-olivier-clinic.com