Thailand is a reasonably safe place to visit and health risks in Bangkok, for your average traveller, are nothing to be concerned about. Compared to most other Southeast Asian cities Bangkok is relatively clean and hygienic, although you will find parts of it grubby compared to European or North American cities.
Unfortunately, there are a few isolated incidents, which do happen from time to time, but taking heed of the advice given on our safety page will significantly reduce the risk of any of these happening to you. Below are descriptions of common health risks when travelling in Bangkok.
Thailand is a developing country and has a tropical climate, but there is a good tourist infrastructure and excellent healthcare to be found in Bangkok, particularly at the world-renowned Bumrungrad hospital. For the most part, you can travel safely and don’t need any special vaccinations before arriving.
If you do have to visit a hospital, be aware that they charge considerably more than public ones, overcharging on imported medicines on the assumption that you’re covered by travel insurance. Often you can get an equally professional service at decent government hospitals, who are more ethical.
First Aid Bangkok provides people with emergency medical training. Having the confidence and ability to provide CardioPulmonary Resuscitation (CPR) is vital for everyone these days, along with various other life-saving techniques. 23rd Floor, The Trendy Office Building, Sukhumvit Soi 13. Tel: (062) 547 3998, Email.
Health in Bangkok
Thailand’s healthcare is of a very good standard in both government and private hospitals. Neither are very expensive (a typical visit and prescription should cost less than US$25) and staff are very professional, helpful and generally speak some English. Pharmacies are found all over the city and stay open late, often 24 hours-a-day.
Bird flu: has largely faded as a threat and no cases have been reported in the country for several years. During its height in 2003, the general public were not considered at risk of exposure and cases resulted mainly in rural areas among those exposed to live poultry.
Swine flu (H1N1): the global outbreak of swine flu has also affected Thailand, to a degree. Like most of the cases around the world, the disease appears to affect older and more vulnerable people. By mid 2010, the threat had largely subsided and although cases are still being reported, it has not turned out to be quite the health risk that was anticipated. The chance of infection here is no greater than most other countries and the symptoms appear to mostly be mild.
Dengue fever: is a mosquito-borne sickness, similar to malaria, but with milder symptoms. Its spread is on the rise in Asia, with Thailand reporting a marked increase in cases in recent years. There is no prevention medicine available and the body is generally left to recover on its own over several weeks. Symptoms start with a fever, followed by aching bones, rashes, headaches and often bleeding gums.
With a low platelet count, patients will suffer listlessness, fatigue and headaches. Severe cases need to be admitted to hospital, as a small chance of the deadly haemorrhaging dengue strain might occur which can be fatal. Only the immature Egyptis variety of mosquito carries the infection; therefore, it thrives where larvae can breed in still water that has remained undisturbed for a week or more.
Dehydration: is a threat during the hot season, from March to June, when Bangkok can become extremely hot, with temperatures reaching 40°C and beyond. Coupled with the cityscape’s enclosed streets, pollution and thick air, dehydration can be a problem if precautions aren’t taken. Drink plenty of water and try to escape from the heat as often as you can – if you start to feel overly fatigued, have difficulty breathing and have a dry mouth then medical attention should be sought. Rehydration salts (‘O-lyte’, DeChamp are widely available) and should be taken if you notice your urine is constantly yellow.
Diarrhoea: Part of the process of adjusting to Bangkok’s climate and its food is often a bout of the runs, particularly if you frequent the roadside food stalls or eat something overly spicy.
Usually the effects will only be mild and should pass in a day or two, but if symptoms persist then you may want to consider anti-diarrhoeal medication (available everywhere) or, if very severe or combined with vomiting, a trip to the hospital. If you plan to stay longer, a few ‘runny tummy’ experiences might help harden your resistance to spicy food and mild bugs. It’s important to take rehydration salts or electrolyte beverages after a bout of diarrhoea to avoid dehydration, which leaves you weak and listless. ‘O-lyte’ is a popular brand found in most pharmacies or 7-Eleven and is mixed with water. Most pharmacists speak English. Imodium (severe cases) or Dissento (milder) are two suggested over-the-counter remedies.
Drinking water: the tap water is apparently drinkable but no one trusts it, preferring bottled water or reverse-osmosis filtering systems. Bottled water is widely available and cheap, while all water and ice given to you in restaurants will be safe, no matter how basic the establishment might be.
Food: eating from Bangkok’s many street food stalls can be a cheap and fun way to sample some very good value food, although you should still be wary when you do so. If a stall or its vendor looks grubby or unclean, simply move onto a different one – there’s bound to be another not far away. However, if you are new to Asia and have a sensitive stomach then these street stalls aren’t recommended as you could end up with a nasty bout of diarrhoea. They aren’t subject to regular health checks and some of the foodstuffs, such as coconut-milk based sweets, go off pretty quick in the tropical heat.
A recent survey revealed that street and market food has quite a high level of bacteria and toxic additives included. Meanwhile, in a proper restaurant you can be more at ease, especially if it is displaying the ‘healthy food, good taste’ sign of approval from the health inspectors. In expensive tourist restaurants you needn’t worry, although your stomach might not be used to the typically spicy food.
Hepatitis: literally means inflammation of the liver, and there are various strains – the most serious being Hepatitis B. It is spread through sexual contact or blood transfusions, so ensure that your vaccination is up to date before travelling and take the usual sexual precautions. The less deadly Hepatitis A is common but symptoms can be mild.
HIV: Thailand seems to be winning the war on the spread of HIV; with condoms widely on sale. However, on a global scale the level of infection is still quite high, and estimated at three per cent. Those working in the tourist sex industry are some of the most cautious and educated, and mostly insist on condom use, while the same cannot be said for the cheaper end that services the Thai working-classes. On the whole, a campaign in the 1990s proved to be very successful, but those indulging in the bar girl scene need to be careful.
Hygiene: Bangkok is far cleaner than many other cities in the developing world, yet it is still far from perfect and it is wise to be a bit more vigilant with hygiene when staying here. The stench, which occasionally wafts up from the sewers below the pavements, will become a familiar reminder that this isn’t quite Singapore. Rats do appear from time to time, especially near construction sites, wet markets and street side noodle stalls. With so much monsoon water about for six months of the year, and a tropical climate, bacteria thrives and spreads easily. Many shopping centres and hotels now have hand-cleaning dispensers for public use.
Malaria and mosquitoes: there is no malaria risk in Bangkok or the surrounding areas; however, pockets remain along the Mekong River and other parts of Thailand. There is a chronic mosquito problem resulting from the moist and damp conditions from the tropical rains and waterways everywhere. This poses a greater threat of dengue fever, which is at its worst in the wet months between May and November. Wear white, body-covering clothes at dusk, or use repellent. There’s no need for a course of malaria pills before arriving and, in any case, those issued by your local doctor might not be affective for strains here.
Pollution: Bangkok is quite polluted, with poor enforcement of pollutant controls. Streets are swept and individual hotels, shopping centres and shops go to professional effort to maintain a clean and neat environment but many locals routinely use public space to irresponsibly discard trash. Older buses belch out smoke and congested traffic can contribute to air that would be considered unacceptable in many first world cities. The river and canals are particularly dirty.
Rabies: Bangkok’s many ‘soi dogs’ are an eyesore and a nuisance, although they are rarely aggressive towards people, or friendly for that matter; which will probably be as much of a relief when you see the state of some of them. However, a rabid dog is a different matter and dogs do get infected from time to time in Bangkok. Usually a rabies infected dog will act aggressively and be foaming at the mouth. If you’re bitten, or an open wound is licked by such a dog, then you should report to hospital immediately. A pre-exposure vaccination is also available and recommended as rabies can be fatal.
STDs: with the rampant sex trade, there are other sexually transmitted diseases besides HIV, and the same basic rules about condom usage apply. These include syphilis and herpes, and even with a condom you can still catch these orally. The symptoms might only show up months later when you get home.
Tattoo and piercing: there are many of tattoo studios in Bangkok. Before you rush in and get your unique holiday memento, make sure that the place seems clean and professional, all instruments are cleaned in front of you and a fresh needle is used. Ask the proprietor plenty of questions and make sure you’re 100 per cent sure of the cleanliness of the studio before getting your ink. Remember, cheap tattoos often look cheaper still and can’t be removed.
Tropical infections: always make sure any cuts and scratches are cleaned thoroughly, sterilising them with iodine or other antiseptic. Betadine, which is available in all chemists and many convenience stores, is very effective. In Bangkok’s heat and humidity, and often less than sanitary conditions, wounds are easily infected unless precautions are taken. This includes open sores resulting from motorcycle accidents.