Health in Thailand

The subject of health is an important aspect of life in Thailand, and everyone should give it some thought. In order to answer the questions that arise around this theme as closely and as comprehensively as possible, we have consulted with professionals in this field.


We are glad and thankful that Dr. Tanutporn C. Lunstrum, Doctor of Hematology at Bangkok Hospital Udon, agreed to an interview with us.

Tanutporn C. Lunstrum, M.D.

 

Dr. Lunstrum received her Medical Doctorate in 2002 at the Faculty of Medicine, Siriraj Hospital, Mahidol University. In 2007 and 2009 she received diplomas of clinical science in internal medicine and hematology. Between 2003 and 2012 she was working as a doctor at hospitals in Bangkok and Khon Kaen.

 

 

 

Dr. Lunstrum, in Thailand, we have a very hot, tropical climate. What are the common health risks caused by this for foreigners unaccustomed to this?


This is due to the activities and the climate which they are used to. Overall, Thailand’s has a tropical climate with high humidity. I would like to describe 4 common types of health risks:

1. Hot weather and a high humidity

can easily cause heat stroke especially combined with outdoor exercise during daylight hours or in enclose spaces, without adequate drinking water or a cool area for rest.

2. Infections:

- Skin infections, such as fungus and bacterial infections can easily happen in the moist area of your bodies such as arm pits, and the groin. You may see some itchy rash caused by fungal infection or some pustules caused by bacterial infection. Try to keep your skin dry by using a small towel, and wear loose clothing. If it has already happened you can apply anti-fungal or antibiotic creams, which are sold over the counter all around Thailand.

- Vector–borne infection such as dengue haemorrhagic fever, malaria, filariasis. Mosquitoes are the most likely insects to infect you, so the prevention is to wear appropriate clothing to cover your skin, apply mosquito repellants, use a mosquito net, get rid of the mosquito larva storage around your house (standing water).

Schwimmen im Mekong - Parasitic infection such as fluke’s worm from uncooked fish, tapeworm from uncooked pork and beef, round worm and whipworm including strongyloides from bare-foot walking, schistosoma from swimming in the Mekong River. I recommend wear proper shoes, eat well-cook food, do not swim in the river.

- Other infections coming from animals are not very common in Thailand but occasionally happen; rabies infection from stray dogs and cats, especially in summer periods. Leptospirosis, a bacterial infection caused by exposure to flood waters and reservoirs, the hosts being rats, cows, dogs, buffalos, and pigs.

3. Snake bites

King Cobra in Thailand We have a lot of snakes all over the country, but poisonous snakes are not plentiful. In the northeast area, we have snakes with haemototoxin which can cause internal organ bleeding such as the green pit viper , Russel viper (daboia), banded krait, and Malayan Pit Viper. Other snakes with neurotoxin are the king cobra, Siamese cobra, Malayan krait. If you are bitten by a snake, first aid is placing a tourniquet around the bite site (not in head and neck area), sending the patient to the nearest hospital. All big government hospitals in Thailand have anti-venom ready for use.

 

4. Sexually transmitted disease (STD)

For people who are sexually active , there are the same health risks as all around the world such as AIDS, hepatitis B, hepatitis C, gonorrhoea, chlamydia, and syphilis.

 

What vaccinations should foreigners living in Thailand keep up to date?


- For overall healthy adult foreigners who live in Thailand, especially in north-east area, recently we have had a report of a diphtheria outbreak in Laos. First of all, I recommended a combined tetanus and diphtheria vaccine (dT) booster dose every 10 years.

- Influenza vaccine is recommended annually in adults over 50 years old (before the winter season).

- Pneumococcal vaccine (polysaccharide form) single dose for prevention of severe pneumonia in adults over 65 years old.

- Varicella vaccine is recommended for those who never had it before. (2 dose regimens)

- Zoster vaccine single dose to prevent herpes zoster in adults over 60 years old.

- For foreigners who live in rural areas, they should have a typhoid vaccine and booster every 2 years.

- Hepatitis A vaccine (2 doses, 6 months apart) for preventing contamination of the fecal-oral route.

- If you travel or live in the north of Thailand, such as Chiangmai, I recommended Japanese encephalitis vaccine, too. For immunocompromised patients, they should discuss this with their doctor before immunization. If you have an allergic reaction to eggs, neomycin or streptomycin, please notify doctor before immunization.

 

In Udon Thani many foreigners live in the more rural areas of the province. What kind of health risks are caused by animals and poisonous plants?

 

Reisfelder bei Nongbua Lamphu The health risks which are caused by animals are already described in the first topic.

As for poisonous plants, luckily, we don’t have poison ivy in Thailand. We have reports of Cassava causing cyanide intoxication, and anti-muscarinic effect in Thorn-apples or Devil’s trumpet: no part of these plants can be eaten.

บอนสี (Caladium bicolor Vent.),วานหมื่นปี (Dieffenbachia seguine Schott.), สาวน้อยประแป้ ง (Dieffenbachia picta Schott.), หน่อไม้(Bambusa vulgaris), เพชรสังฆาต (Cissus quadrangularis), พลูด่าง (Epipremnum aureum) release oxalate crystals while chewing, can cause hypocalcemia and kidney stones.

ต้นรัก (Calotropis gigantean R.Br.), ยี่โถ (Nerium oleander L.), ชวนชม (Adenium obesum), ตีนเป็ดนํ้า (Cerbera odollum Gaertn) have cardioactive substances if eaten and can cause cardiac arrhythmia.

ดองดึง Climbing Lily (Gloriosa superba) inhibits mitosis and can cause bone marrow suppression (by eating).

 

How can foreigners protect themselves against bacterial infections of the gastrointestinal tract?


Frischfleisch auf dem Markt in Thailand

 

Most of the bacterial infections in the GI tract comes from food. Hygienic food is the best, including eating well-cooked food, drink only boiled or bottle water, wash your hands before you eat, and keep your cooking area clean.

 

 

 

 

When should they consult a specialist in gastrointestinal problems?

 

Some gastrointestinal problems need special attention. If diarrhoea or constipation symptoms persist more than a week, or significant unexplained weight loss, bloody stools or black stools, this needs to be investigated by a specialist.

 

Many visitors to Thailand worry about catching malaria or dengue fever. How would you assess these risks in Udon-Thani?

 

In north-eastern Thailand we have the lowest rate of malaria infection; which is about less than 10 per 100,000 people due to genetic advantages; we have the highest population of the thalassemia trait which creates resistance to malaria. Most of the malaria cases in this area come from the migration of nearby-country workers.

Regarding dengue haemorrhagic fever in Udon-Thani, the incidence is about 8-10 per 100,000 people, which is less than national average, and no deaths reported last year. The highest risk season of dengue fever is the rainy season which begins near the end of April until July.

 

What precautions can foreigners take to protect themselves from dengue fever and malaria?

 

The best prevention is avoiding mosquito bites by wearing long sleeves and long trousers, and using mosquito repellent or mosquito nets. Search and destroy mosquito nests around your houses.

There are no vaccinations for malaria or dengue fever. Anti-malarial drugs for prevention are not always effective in south-east Asia.

 

In Udon Thani there are some large lakes that might tempt us to bathe in them. What are the health risks in relation to diseases and parasites that can be transmitted in the water?

 

Ubonrat Stausee bei Khon Kaen

 

Swimming in fresh water should be avoided because we have a prevalence of schistosomiasis and leptospirosis. Leptospirosis can cause high fever, jaundice, liver failure, kidney failure, and respiratory failure in severe cases. Schistosomiasis can cause fever, diarrhea, eosinophilia, abdominal pain, liver and spleen enlargement, kidney inflammation and genital sores.

 

The average age of foreigners living in Udon Thani is quite high. What are the specific health risks for these people?

 Die größte Gefahr in Thailand - Der Straßenverkehr

Most older people have some diseases such as; hypertension, diabetes, or cardiovascular disease which requires continuous medication. A health risk for elderly people is the increased risk of falling, drug-drug interaction, and decrease of body metabolism leading to drug overdose.

Otherwise, traffic accidents cause most serious injuries that need to be a concern, due to behaviour of drivers in Thailand.

 

What regular checkups would you recommend?

 

For patients aged about 50-64 years old, a check-up visit every 2 years, including at least cholesterol, blood pressure, colon cancer screening, abdominal aorta aneurysm.

For age 65 or more, a check-up visit every year. For men, prostate cancer screening is needed. For women, mammogram and Pap test is needed. Once in a lifetime test for hepatitis B, hepatitis C, HIV.

 

Is there, at Bangkok Hospital, a special program that provides easy and simple regular screening?

Bangkok Hospital Udon Thani

 

Yes, We have a variety of check-up programs available. You can find one age appropriate at our hospital.

 

 

Do you have any other advice or tips that you want to convey to the readers of Udon-News?

 

Just as the culture of Thailand is different than that of your home country, so are the health risks and potential pitfalls. Thailand is a wonderful place for tourists and expats, but be aware that there may be hazards that you must be careful to avoid.

Bangkok Hospital Udon Thani

If illness or injuries occur, be quick to seek qualified medical assistance. Thailand has some of the best hospitals in the world, the most dedicated health care workers, and state of the art equipment. Most of it is available at a fraction of the cost of what it would be in your home country.

Bangkok Hospitals are all foreigner-friendly, conveniently located, and experienced to help you 24 hours a day, 7 days a week.

posted on: 25.08.2016 - last update on: 20.01.2017

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