Dive Travel Destination Health Precautions For Southeast Asia

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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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