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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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