MALARIA IN THAILAND

Malaria in Thailand: For rural areas bordering Cambodia and Myanmar, prophylaxis with Malarone or doxycycline is recommended. For rural areas bordering Laos, either Malarone, doxycycline, or Lariam should be taken.

Prophylaxis is recommended for rural areas bordering Cambodia, Laos, and Myanmar, including Mae Hong Son. The malaria risk in Phang Nga and Phuket is very limited; therefore, prophylaxis is not recommended for these two areas. There is no malaria risk in Bangkok, Chiang Mai, Chiang Rai, Pattaya, Ko Samui, and Ko Phangan.

Insect 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 reapplied 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 against Malaria in Thailand, apply permethrin-containing compounds to clothing, shoes, and bed nets. 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.