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Destination
Health Precautions for
Southeast Asia
Brunei
Darussalam, Burma (Myanmar), Cambodia,
East Timor, Indonesia, Lao People's
Democratic Republic (Laos), Malaysia,
Philippines, Singapore, Thailand,
Vietnam
Food and waterborne diseases are the
number one cause of illness in travelers.
Travelers’ diarrhea can be caused
by viruses, bacteria, or parasites,
which are found throughout the region
and can contaminate food or water.
Infections may cause diarrhea and
vomiting (E. coli, Salmonella, cholera,
and parasites), fever (typhoid fever
and toxoplasmosis), or liver damage
(hepatitis). Make sure your food and
drinking water are safe.
Malaria is a preventable infection
that can be fatal if left untreated.
Prevent infection by taking prescription
antimalarial drugs and protecting
yourself against mosquito bites (see
below). Travelers to some areas in
Southeast Asia may be at risk for
malaria; there is no risk of malaria
in Brunei Darussalam and Singapore.
Dengue, filariasis, Japanese encephalitis,
and plague are diseases carried by
insects that also occur in this region.
Protecting yourself against insect
bites (see below) will help to prevent
these diseases.
Do not swim in fresh water (except
in well-chlorinated swimming pools)
in certain areas of Cambodia, Indonesia,
Laos, Philippines, and Thailand to
avoid infection with schistosomiasis.
Because motor vehicle crashes are
a leading cause of injury among travelers,
walk and drive defensively. Avoid
travel at night if possible and always
use seat belts.
There is no risk for yellow fever
in Southeast Asia. A certificate of
yellow fever vaccination may be required
for entry into certain of these countries
if you are coming from countries in
South America or sub-Saharan Africa.
CDC recommends the following vaccines
(as appropriate for age):
See your doctor at least 4–6 weeks
before your trip to allow time for
shots to take effect.
- Hepatitis
A or immune globulin (IG).
- Hepatitis
B if you might be exposed to blood
(for example, health-care workers),
have sexual contact with the local
population, stay longer than 6 months
in the region, or be exposed through
medical treatment.
- Japanese
encephalitis, only if you plan to
visit rural areas for 4 weeks or
more, except under special circumstances,
such as a known outbreak of Japanese
encephalitis.
- Rabies,
if you might be exposed to wild
or domestic animals through your
work or recreation.
- Typhoid
vaccination is particularly important
because of the presence of S. typhi
strains resistant to multiple antibiotics
in this region.
- As
needed, booster doses for tetanus-diphtheria
and measles, and a one-time dose
of polio for adults. Hepatitis B
vaccine is now recommended for all
infants and for children ages 11–12
years who did not complete the series
as infants.
All travelers should take the following
precautions, no matter the destination:
- Wash
hands often with soap and water.
- Because
motor vehicle crashes are a leading
cause of injury among travelers,
walk and drive defensively. Avoid
travel at night if possible and
always use seat belts.
- Always
use latex condoms to reduce the
risk of HIV and other sexually transmitted
diseases.
- Don’t
eat or drink dairy products unless
you know they have been pasteurized.
- Don’t
share needles with anyone.
- Eat
only thoroughly cooked food or fruits
and vegetables you have peeled yourself.
Remember: boil it, cook it, peel
it, or forget it. Never eat undercooked
ground beef and poultry, raw eggs,
and unpasteurized dairy products.
Raw shellfish is particularly dangerous
to persons who have liver disease
or compromised immune systems.
Travelers visiting undeveloped
areas should take the following precautions:
To stay healthy, do...
- Drink
only bottled or boiled water, or
carbonated (bubbly) drinks in cans
or bottles. Avoid tap water, fountain
drinks, and ice cubes. If this is
not possible, make water safer by
BOTH filtering through an “absolute
1-micron or less” filter AND adding
iodine tablets to the filtered water.
“Absolute 1-micron filters” are
found in camping/outdoor supply
stores.
- If
you visit an area where there is
risk for malaria, take your malaria
prevention medication before, during,
and after travel, as directed. (See
your doctor for a prescription.)
- Protect
yourself from insects by remaining
in well-screened areas, using repellents
(applied sparingly at 4-hour intervals),
and wearing long-sleeved shirts
and long pants from dusk through
dawn.
- To
prevent fungal and parasitic infections,
keep feet clean and dry, and do
not go barefoot. To avoid getting
sick...
- Don’t
eat food purchased from street vendors.
- Don’t
drink beverages with ice.
- Don’t
share needles with anyone.
- Don’t
handle animals (especially monkeys,
dogs, and cats), to avoid bites
and serious diseases (including
rabies and plague).
What you need to bring with you:
- Long-sleeved
shirt and long pants to wear while
outside whenever possible, to prevent
illnesses carried by insects.
- Insect
repellent containing DEET (diethylmethyltoluamide),
in 30%–35% strength for adults and
6%–10% for children, as well as
a bed net impregnated with the insecticide
permethrin. (Bed nets can be purchased
in camping or military supply stores.)
- Over-the-counter
antidiarrheal medicine to take if
you have diarrhea.
- Iodine
tablets and portable water filters
to purify water if bottled water
is not available.
- Sunblock,
sunglasses, hat.
- Prescription
medications: make sure you have
enough to last during your trip,
as well as a copy of the prescription(s).
After you return home:
If you have visited a malaria-risk
area, continue taking your antimalarial
drug for 4 weeks (Lariam®, doxycycline)
or seven days (Malarone™) after leaving
the risk area. Travelers who become
ill with a fever or flu-like illness
while traveling in a malaria-risk
area and up to one year after returning
home should seek prompt medical attention
and should tell the physician their
travel history.
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