Advice about visit in the near future

[boulderjohn]

I am scheduled to go to Phuket in late February. We have heard that the reefs we are planning to visit are in pretty good shape already. My main concern, though, is the potential for disease. I had (and paid for!) an official travel advisory meeting with my doctor, and learned in doing so that the doctor did not really know any more about the disease potential there than I do now.

She gave me prescriptions (which I have not yet filled) to prevent typhus and malaria (figuring on a mosquito outbreak with all that standing water). I am wondering if I should also be concerned about cholera and dengue fever.

Anyone with good knowledge out there?

 

[boulderjohn]

I
Anyone with good knowledge out there?

I finally got smart and called DAN, who gave me advice and especially told me to visit the CDC web site (http://www.cdc.gov/). They have a regular section on travel advisories, and they have a special section referring specifically to the tsunamis. Here is some of what I learned from the two sources.

Malaria: Mosquito born. atovaquone/proguanil (brand name: Malarone™ ) and doxycycline are effective in preventing it, but DAN says that doxycycline may make your skin photosensitive and raise your sunburning potential.

Dengue Fever: Mosquito born, but no vaccine available. Make sure you are not bitten!

Cholera:: Concern is small. No preventative medicines are possible. Just remember to drink only purified or boiled water and eat only fully cooked or peeled foods.

Hepatitus A & B:: You should be immunized. If not, get to your doctor ASAP to start the series.

Typhoid:: There is a preventive medication that you need to take before, during, and after the trip. Get a prescription early.

Tetanus/Diptheria: Make sure you are up to date on these.

 

[ssra30]

I would not worry about Phuket as the infrastructure is well intact and the clean up is going on well. Phuket is not in malaria infested area so I don't think the benefit of prophylaxis is worth the possible side effect. Outside of Phuket, all the standing water created by the tsunami is salt water so I doubt that there would be an explosion of mosquito population. Dengue fever is endamic in Thailand, usually spread by day mosquito. Typhoid is waterborn, again usually freshwater such as during flooding so risk here is very minimal.
Hep A/B/E is endemic in SE Asia so if you plan to spend extended period or visit the area frequently, it is highly recommended but might not be worth it for a brief trip as it takes 3 shots over 6 months for Hep B and 2 shots over 1 month for Hep A vaccine.
There are a few kinds of typhus is spread by human lice, rat fleas, certain mites. Since sanitation is not a problem in Phuket currently, it should be OK. Certain typhus is endemic in the country but I certainly have never seen it in metropolitan area in Thailand.
I am not disagreeing with the CDC about their warning but think that you have to look at the location where you are going as well. I would be more worry about cholera etc in the more remote parts that were affected where there is no clean water supply, inadequate clean up effort, high concentration of homeless with poor sanitation etc etc, fortunately Phuket is not one of those areas.

 

[Allison Finch]

I finally got smart and called DAN, who gave me advice and especially told me to visit the CDC web site (http://www.cdc.gov/). They have a regular section on travel advisories, and they have a special section referring specifically to the tsunamis. Here is some of what I learned from the two sources.

Malaria: Mosquito born. atovaquone/proguanil (brand name: Malarone™ ) and doxycycline are effective in preventing it, but DAN says that doxycycline may make your skin photosensitive and raise your sunburning potential.

Dengue Fever: Mosquito born, but no vaccine available. Make sure you are not bitten!

Cholera:: Concern is small. No preventative medicines are possible. Just remember to drink only purified or boiled water and eat only fully cooked or peeled foods.

Hepatitus A & B:: You should be immunized. If not, get to your doctor ASAP to start the series.

Typhoid:: There is a preventive medication that you need to take before, during, and after the trip. Get a prescription early.

Tetanus/Diptheria: Make sure you are up to date on these.

There IS a vaccine for cholera. I've had one. I would HIGHLY recommend getting one. Although most liveaboards have their own water purifiers, anything that comes from shore may have had contact with tainted water. Why risk it.

Every time I go to PNG I use doxy. Since I don't sun bathe, I don't worry about the photosensitivity. An added benefit is that it might help protect you from dengue (also known as "breakbone fever" because of the pain) fever too.
Go on your trip as planned. The local economy could use the help. Get the cholera, typhoid and tetanus (yellow fever?) before you go.

 

[domino22]

We were to go to Patong Beach and also do a live aboard in Feb. The emails from Thailand we recieved acted like nothing happened and all was fine. As I sat there reading them and watching the news and looking at the bodies etc. Humm do you think I should take their word for it? Nope cancealed trip, gonna take a $$ hit.

 

[boulderjohn]

We were to go to Patong Beach and also do a live aboard in Feb. The emails from Thailand we recieved acted like nothing happened and all was fine. As I sat there reading them and watching the news and looking at the bodies etc. Humm do you think I should take their word for it? Nope cancealed trip, gonna take a $$ hit.

I think that you can take their word from it. We are seeing something similar in our messages from Thailand. These messages don't act is if nothing happened, though. They describe which areas were hit hard and which areas came through relatively unscathed.

As Allison said earlier, NOT going can hurt the area's economy. I saw a news report that said that the next stage of this disaster will come when the people who now have no means of making a living struggle to survive in the new economy. These people are depending upon people like you and me to bring needed income.

 

[birdchua]

I think that you can take their word from it. We are seeing something similar in our messages from Thailand. These messages don't act is if nothing happened, though. They describe which areas were hit hard and which areas came through relatively unscathed.

As Allison said earlier, NOT going can hurt the area's economy. I saw a news report that said that the next stage of this disaster will come when the people who now have no means of making a living struggle to survive in the new economy. These people are depending upon people like you and me to bring needed income.

Totaly agree with boulderjohn, I have book a trip to phuket at end feb and will be going as plan.

 

[Batfish]

We were to go to Patong Beach and also do a live aboard in Feb. The emails from Thailand we recieved acted like nothing happened and all was fine. As I sat there reading them and watching the news and looking at the bodies etc. Humm do you think I should take their word for it? Nope cancealed trip, gonna take a $$ hit.

Yes, the TV is screwing us all here. If you are booked for a trip in February, you really have no reason to cancel. CNN today was still talking about the "devastated" island of Phuket. This is complete c**p. You can get very good updates of what is really happening at these web sites, and many more :

www.phuket.com
www.image-asia.com/post_tsunami_phuket_krabi.htm
www.phuket-photos.com

and

also many of the dive company web sites have updates, photos etc.

Yes, you should take their word for it, though of course we are not telling people that "nothing happened". We are realistic. We do not try and kid our customers, this would be extremely counter productive. We would not advise people to come and dive if it were unsafe, dirty, destroyed...that would just lead to many many complaints and would give the dive industry a bad name. We give people our best advise and if they do decide to cancel, well, then they may indeed have to take a $$ hit.

 

[Shader]

I am scheduled to go to Phuket in late February. We have heard that the reefs we are planning to visit are in pretty good shape already. My main concern, though, is the potential for disease. I had (and paid for!) an official travel advisory meeting with my doctor, and learned in doing so that the doctor did not really know any more about the disease potential there than I do now.

She gave me prescriptions (which I have not yet filled) to prevent typhus and malaria (figuring on a mosquito outbreak with all that standing water). I am wondering if I should also be concerned about cholera and dengue fever.

Anyone with good knowledge out there?

My reply from a thread in the Asia forum on vaccinces:

I am actually leaving for Koh Tao this Thursday and will be there over a month doing my DM and IDC. To be on the safe side and in case I do make it over to Phuket I went and got my shots from the travel doctors at Northwest Memorial Hospital here in Chicago. They are updated continously by The Center for Disease Control and have travel specific data and charts on what types of medications and shots are required for specific areas of travel. I received shots for Influenza, Tetanus, Hepatitus A, and am finishing my oral med for Typhoid today. The 3 Hepatitus B shots are expensive and take up to 6 months to start working and are more important for aid workers and doctors who are exposed to blood. My doctor was very informative and thorough in explaining what and why I needed certain meds or shots. My girlfriend is also going to take an oral med for Malaria since she will be in the northern part of Thailand in Chiang Mai but this is not necessary in the southern part and Koh Tao. We both got Cipro antibiotics prescribed as well in case we get a bad case of diahrrea. There are usually travel medecine centers at all major hospitals that would be worth looking into.

 

[wytch]

Big Bravo for everyone who's sticking with Thailand. I am off to Koh Tao in February too (just for a week, boo-hoo) with a bunch of friends, the best advice we have had from the dive centre is to spend money there - if you want one drink buy two etc etc to give them some much needed revenue!