The wide range of Asian destinations we journey to presents varying degrees of medical risk. For example, a visitor to India might need certain immunizations that a visitor to Singapore would not. As we are not physicians and cannot provide you with specific medical advice, we strongly encourage you to check with your personal physician, local travel clinic or with the Center for Disease Control (contact information below) at least 6 weeks before embarking on your journey for up-to-date information regarding medical precautions and immunizations for your particular travel destinations. However, regardless of the variances, all of our destinations share common precautions. Following is information we have gathered from the Center for Disease control. Again, you may not need to adhere to all of these precautions so be sure to check in with your doctor and let them know where you are going!

 

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 local population, stay longer than 6 months in the region, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11-12 years who did not complete the series as infants.

Japanese encephalitis, if you plan to visit rural areas during the rainy season or stay longer than 4 weeks.

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.

 

And the following prophylactics:

Malarial prophylactics: Most travelers to Asia at risk for malaria should take mefloquine to prevent malaria. Recommended for extended travel outside of metropolitan areas (not needed for travel restricted to most urban areas in Asia); check with your personal physician or one of the sources below.

Center for Disease Control and Prevention "Summary of Recommendations for EAST ASIA, INDIAN SUBCONTINENT and SOUTHEAST ASIA."

 

To Stay Healthy, Do:

• Wash hands often with soap and water.
• 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 in the US
• 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.
• 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, long pants and socks from dusk through dawn.
• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
• Always use latex condoms to reduce risk of HIV and other sexually transmitted diseases.

 

To Avoid Getting Sick:

• Don’t eat food purchased from street vendors.
• Don’t drink beverages with ice.
• Don’t eat dairy products unless you know they have been pasteurized.
• 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).
• Don’t swim in fresh water (expect for well-chlorinated swimming pools) in certain areas of China (southeast, east, and Yangstee River valley) to avoid infection with schistosomiasis. Salt water is usually safer. It is also wise to avoid swimming in fresh water in India.

 

What You Need to Bring with You:

• Long-sleeved shirt, long pants and long socks to wear while outside whenever possible, to prevent illnesses carried by insects (e.g. malaria, dengue, filariasis, and Japanese encephalitis).
• Insect repellent containing DEET (diethylmethyltoluamide), in 30%-35% strength for adults and 6%-10% for children.
• Over-the-counter antidiarrheal medicine to take if you have diarrhea.
• Iodine tablets or water filters to purify water if bottled water is not available.
• Sun block, sunglasses, hat.
• Prescription medications: make sure you have enough to last during your trip, as well as copy of the prescription(s).

 

After You Return Home:

• If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area.
• If you become ill after travel -even as long as a year after your trip- tell your doctor the areas you have visited.

Pregnant travelers or travelers with children should check with the CDC or their physician for more specific information.

 

Traveler's Health Information Sources:

Center for Disease Control

Traveler’s Health

Atlanta, GA 30333

404-639-3311 or 404-639-1610 (for traveler’s information recording), or visit their website at http://www.cdc.gov/travel/

 The international Travel Medicine Clinic at the University of North Texas Health Science Center at Fort Worth’s web site at: http://www.hsc.unt.edu/clinics/itmc/travel.htm

Your physician or local health department.

 

Other Concerns:

 

Dengue Fever: There is no vaccine for dengue fever; however, the risk of infection is small for the most travelers to this area except for during periods of epidemic transmission. These mosquitoes bite mainly in the daytime, especially around dawn and dusk, so be sure to take the mosquito precautions listed above during the day if there is a risk of dengue fever. In general, it is a good idea to avoid being bitten either day or night.

 

Digestive Problems: As with any developing country, care should be taken in consuming food or drink. Bacterial dysentery, or traveler’s diarrhea, can occur, especially in rural areas where care is not taken. When venturing out on your own and when eating "street food", one should adhere to a few simple precautions. Beer and soft drinks served without ice should be safe, as should fruits and vegetables that you can peel and slice yourself. Generally speaking, cooked foods that are still hot, and which have not been sitting out exposed to the elements, are also safe.

 

Water purification: We would recommend drinking bottled water, which is generally readily available. For that very rare occasion when you may be unable to obtain bottled water, iodine tablets are recommended. They’re cheap, small, convenient and readily available in the U.S. where camping equipment is sold. Tea, since it has been boiled is typically safe. Ice is always considered suspect and should not be used unless you can be assured that it is made from purified water. (Note: Thailand has a good network of government-controlled, purified ice production plants throughout the country. Ice in Thailand is generally safe. In Indonesia, in tourist establishments, ice is also considered safe.) It is important that you follow these precautions in order to avoid the potentially serious affects of drinking biologically contaminated water. Eating utensils should be dry before placing them in your mouth or in contact with your food. Other precautions are to ensure that water used for brushing your teeth is biologically purified and be sure to avoid opening your mouth in the shower.

 

Diarrhea: Check with your personal physician or the sources listed below for any diarrhea prevention and/or treatment medicines that might be recommended. Many over-the-counter remedies that are available work fairly well in alleviating symptoms.

 

Motion, sea-or air-Sickness: Whether or not you have been prone to these ailments in the past, it may be a good idea to check with your personal physician for any anti-motion sickness medicine which might be recommended; it’s a cheap price to pay for the additional comfort and peace of mind if you should have problems. A good deal of travel in Asia will be over water and/or on very twisty, rough, and steep roads. Again, over-the counter remedies are available.

 

Wildlife Safety:

 

Sea creatures come in so many sizes, shapes and forms that to address all the hazards is beyond the scope of these notes. A good rule of thumb is to never touch or harass anything under water. This includes live shells, coral, sea creatures, and even the rocks, which could actually be stone fish in disguise! The overwhelming majority of sea creatures are non-aggressive and beautiful to observe in their natural habitat, but sometimes carelessness in handling of the wrong thing can have a dire health consequences. Look, but don’t touch!

 

Leeches, though an irritation, are not dangerous. They can be discouraged by wearing tight weave socks and tucking your pant legs into your socks and by applying insect repellent liberally to your clothes and skin. They attach to your body as you walk through wet jungle. When they either fall off or are pulled off your skin they can leave a small wound that will bleed profusely for a long time. This is because the leech injects an anticoagulant as it attaches. Though painless, these wounds can be disconcerting. The best treatment is to remove the leech, apply pressure, wait till the bleeding stops and apply antiseptic and a band aid. Leeches are common during the wet season. Dry season travelers rarely encounter these legends of the jungle.

 

Elephants - You should be aware that there are rare incidents on the record where so-called domesticated elephants have suddenly become quite aggressive and injured or killed innocent people in their immediate vicinity. These incidents are extremely rare, however, you should respect them and act cautiously around them. You should refrain from photographing them with flash units and from making loud, sudden noises. Do not approach an elephant unless their handler is present and be extra cautious around young elephants in training and mother elephants with their young. When mounting or dismounting, wait until the elephant’s handler is present to help. See our "Safety and Health" recommendations in your pre-departure packet for more information.

 

Note if traveling to Indonesia:

 

Komodo dragons are potentially very dangerous. Follow your guide attentively. Do not hike off alone. Never walk around in the dark in areas where komodo are present.

 

Orangutans, though gentle creatures, are very large and powerful. Never threaten, harass, or attempt to take food from one of these large primates. Treated with respect and caution, they are generally gentle and friendly. Follow the lead of your guide or local ranger.