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Health info for the Philippines
December 18, 2010 in Health Philippines
Health info for the Philippines: No special vaccination certificates are required, except by travelers entering the Philippines from an area infected with yellow fever. Recommended vaccinations include typhoid as there are frequent outbreaks of typhoid fever. There is a malaria risk in parts of the Philippines and visitors should seek medical advice before traveling; urban areas are generally considered risk-free. Dengue fever is a risk throughout the country; the best prevention is to avoid mosquito bites. Tap water is not safe to drink and ice in drinks should be avoided; cholera is a risk in the country and precautions are advised. Sea snakes can be highly venomous; travelers should be cautious in remote coastal waters, lakes and rivers, as anti-venom may not be readily available. Medical care is good in the major cities, although very expensive, however it is limited in the remoter areas. Comprehensive medical insurance is advised.
Vaccinations for the Philippines
December 17, 2010 in Health Philippines
Hepatitis A: Recommended for all travelers
Typhoid: For travelers who may eat or drink outside major restaurants and hotels
Yellow fever: Required for all travelers greater than one year of age arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.
Japanese encephalitis: For long-term (>1 month) travelers to rural areas or travelers who may engage in extensive unprotected outdoor activities in rural areas, especially after dusk
Hepatitis B: For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months
Rabies: For travelers who may have direct contact with animals and may not have access to medical care
Measles, mumps, rubella (MMR): Two doses recommended for all travelers born after 1956, if not previously given
Tetanus-diphtheria: Revaccination recommended every 10 years
Most cases of travelers’ diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.
If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
Insect protection measures are essential.
There is no malaria risk in metropolitan Manila and other urban areas. There is also thought be no malaria risk in the plains or at altitudes above 600 m.
For further information on malaria in the Philippines, go to the World Health Organization – Western Pacific Region (includes maps which show the risk of malaria in different parts of the country) and Roll Back Malaria.
Dengue fever, a flu-like illness sometimes complicated by hemorrhage or shock, is highly prevalent throughout the Philippines.
Dengue is transmitted by Aedes mosquitoes, which bite primarily in the daytime and favor densely populated areas, though they also inhabit rural environments. An unusually large number of cases was reported in 1998, possibly related to climatic changes due to El Nino. Fewer cases were reported in 1999 and 2000, but the numbers began to rise again in 2001. See the World Health Organization for details. No vaccine is available at this time. Insect protection measures are strongly advised, as below. For further information on dengue in the Philippines, go to the World Health Organization – Western Pacific Region.
HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.
Insect and Tick protection
December 17, 2010 in Health Indonesia, Health Philippines, Health Thailand
Insect and tick protection: Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don’t sleep with the window open unless there is a screen. If sleeping outdoors or in an accomodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.
Swimming and bathing precautions
December 17, 2010 in Health Indonesia, Health Philippines, Health Thailand
Swimming and bathing precautions: Avoid swimming, wading, or rafting in bodies of fresh water, such as lakes, ponds, streams, or rivers. Do not use fresh water for bathing or showering unless it has been heated to 150 degrees F for at least five minutes or held in a storage tank for at least three days. Toweling oneself dry after unavoidable or accidental exposure to contaminated water may reduce the likelihood of schistosomiasis, but does not reliably prevent the disease and is no substitute for the precautions above. Chlorinated swimming pools are considered safe.
Hospitals in the Philippines
December 17, 2010 in Health Philippines, Hospitals Philippines
Ambulance: There is no national ambulance service in the Philippines. For an ambulance in Manila, call St. Luke’s Hospital at (011-63-2) 722-6161, 723-0101, or 723-0199.
Medical facilities: High-quality medical care is available in Manila, but may be difficult to locate elsewhere. Many expatriates go to St. Luke’s Hospital (279 E. Rodriguez Avenue, Quezon City, tel. (011-63-2) 722-6161, 723-0101, 723-0199; website http://www.stluke.com.ph/; 24-hour emergency room with ambulance services; accredited by the Joint Commission International; member of the international networks of the Massachusetts General Hospital and the New York-Presbyterian Hospital, two leading U.S. hospitals). Another option is the Makati Medical Center (2 Amorsolo Street, Makati City, tel. (011-63-2) 815-9911, 892-5544; website http://www.makatimed.ph/).
For a comprehensive guide to health care in the Philippines, including lists of doctors and hospitals, go to your Embassy website. Most hospitals will require a downpayment at the time of admission. In some cases, public and private hospitals have withheld lifesaving medicines and treatments for non-payment of bills. Hospitals may refuse to discharge patients or release important medical documents until the bill has been paid in full. Life-threatening medical problems may require air evacuation to a country with state-of-the-art medical facilities.
Traveling when pregnant
December 17, 2010 in Health Philippines, Pregnancy Philippines
Travel and pregnancy: International travel should be avoided by pregnant women with underlying medical conditions, such as diabetes or high blood pressure, or a history of complications during previous pregnancies, such as miscarriage or premature labor. For pregnant women in good health, the second trimester (18–24 weeks) is probably the safest time to go abroad and the third trimester the least safe, since it’s far better not to have to deliver in a foreign country.
Before departure, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency obstetric care if necessary (see the Embassy website). In general, pregnant women should avoid traveling to countries which do not have modern facilities for the management of premature labor and other complications of pregnancy.
As a rule, pregnant women should avoid visiting areas where malaria occurs. Malaria may cause life-threatening illness in both the mother and the unborn child. None of the currently available prophylactic medications is 100% effective. Mefloquine (Lariam) is the drug of choice for malaria prophylaxis during pregnancy, but should not be given if possible in the first trimester. If travel to malarious areas is unavoidable, insect protection measures must be strictly followed at all times. The recommendations for DEET-containing insect repellents are the same for pregnant women as for other adults.
Strict attention to food and water precautions is especially important for the pregnant traveler because some infections, such as listeriosis, have grave consequences for the developing fetus. Additionally, many of the medications used to treat travelers’ diarrhea may not be given during pregnancy. Quinolone antibiotics, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin), should not be given because of concern they might interfere with fetal joint development. Data are limited concerning trimethoprim-sulfamethoxazole, but the drug should probably be avoided during pregnancy, especially the first trimester. Options for treating travelers’ diarrhea in pregnant women include azithromycin and third-generation cephalosporins. For symptomatic relief, the combination of kaolin and pectin (Kaopectate; Donnagel) appears to be safe, but loperamide (Imodium) should be used only when necessary. Adequate fluid intake is essential.
All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.
Why you need a Health and or Dive insurance
December 17, 2010 in Diving Philippines, Health Philippines, Health/Dive Insurance
Travel and Dive insurance: Make sure your health and Dive insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.
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