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Health & Safety Laos

01/10/16 23:03 3461

Before You Go

Pack medications in their original, clearly labelled, containers. A signed and dated letter from your physician describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician's letter documenting their medical necessity.

If you happen to take any regular medication, bring double your needs in case of loss or theft. In Laos it can be difficult to find some newer drugs, particularly the latest antidepressant drugs, blood-pressure medications and contraceptive pills.

Infectious Diseases

Dengue Fever

This mosquito-borne disease is becomingly increasingly problematic throughout Laos, especially in the cities. As there is no vaccine it can only be prevented by avoiding mosquito bites. The mosquito that carries dengue bites day and night, so use insect avoidance measures at all times. Symptoms include high fever, severe headache and body ache (dengue was once known as 'breakbone fever'). Some people develop a rash and diarrhoea. There's no specific treatment, just rest and paracetamol. Do not take aspirin as it increases the likelihood of haemorrhaging. See a doctor to be diagnosed and monitored.

Hepatitis A

A problem throughout the region, this food- and water-borne virus infects the liver, causing jaundice (yellow skin and eyes), nausea and lethargy. There is no specific treatment for hepatitis A, you just need to allow time for the liver to heal. All travellers to Southeast Asia should be vaccinated against hepatitis A.

Hepatitis E

Hepatitis E is transmitted through contaminated food and water and has similar symptoms to hepatitis A, but is far less common. It is a severe problem in pregnant women and can result in the death of both mother and baby. There is currently no vaccine; prevention is by following safe eating and drinking guidelines.

STDs

Sexually transmitted diseases most common in Laos include herpes, warts, syphilis, gonorrhoea and chlamydia. People carrying these diseases often have no signs of infection. Condoms will prevent gonorrhoea and chlamydia but not warts or herpes. If after a sexual encounter you develop any rash, lumps, discharge or pain when passing urine seek immediate medical attention. If you have been sexually active during your travels have an STD check on your return home.

Tuberculosis

Tuberculosis (TB) is very rare in short-term travellers. Medical and aid workers, and long-term travellers who have significant contact with the local population should take precautions, however. Vaccination is usually only given to children under the age of five, but adults at risk are advised to get pre- and post-travel TB testing. The main symptoms are fever, cough, weight loss, night sweats and tiredness.

Typhoid

This serious bacterial infection is also spread via food and water. It gives a high, slowly progressive fever and headache, and may be accompanied by a dry cough and stomach pain. It is diagnosed by blood tests and treated with antibiotics. Vaccination is recommended for all travellers spending more than a week in Southeast Asia, or travelling outside of the major cities.

Hepatitis B

The only sexually transmitted disease that can be prevented by vaccination, hepatitis B is spread by body fluids, including sexual contact. In some parts of Southeast Asia, up to 20% of the population are carriers of hepatitis B, and usually are unaware of this. The long-term consequences can include liver cancer and cirrhosis.

Rabies

This uniformly fatal disease is spread by the bite or lick of an infected animal, most commonly a dog or monkey. You should seek medical advice immediately after any animal bite and commence post-exposure treatment. Having a pretravel vaccination means the postbite treatment is greatly simplified. If an animal bites you, gently wash the wound with soap and water, and apply iodine based antiseptic. If you are not vaccinated you will need to receive rabies immunoglobulin as soon as possible.

HIV

According to Unaids and WHO, Laos remains a 'low HIV prevalence country'. However, it's estimated that only about one fifth of all HIV cases in Laos are actually reported. Heterosexual sex is the main method of transmission in Laos. The use of condoms greatly decreases but does not eliminate the risk of HIV infection.

Malaria

Many parts of Laos, particularly populated areas, have minimal to no risk of malaria, and the risk of side effects from the antimalaria medication may outweigh the risk of getting the disease. For some rural areas, however, the risk of contracting the disease far outweighs the risk of any tablet side effects. Remember that malaria can be fatal.

Malaria is caused by a parasite transmitted by the bite of an infected mosquito. The most important symptom of malaria is fever, but general symptoms such as headache, diarrhoea, cough or chills may also occur. Diagnosis can only be made by taking a blood sample.

Two strategies should be combined to prevent malaria: mosquito avoidance and antimalarial medications. Most people who catch malaria are taking inadequate or no antimalarial medication.

Travellers are advised to prevent mosquito bites by taking these steps:

  • Choose accommodation with screens and fans.
  • Impregnate clothing with Permethrin in high-risk areas.
  • Sleep under a mosquito net impregnated with Permethrin.
  • Spray your room with insect repellent before going out for your evening meal.
  • Use an insect repellent containing DEET on exposed skin.
  • Wear long sleeves and trousers in light colours.
Malaria Medication

There are a variety of medications available. Lariam (Mefloquine) has received much bad press, some of it justified, some not. This weekly tablet suits many people. Serious side effects are rare but include depression, anxiety, psychosis and seizures. Anyone with a history of depression, anxiety, other psychological disorders or epilepsy should not take Lariam. It is around 90% effective in most parts of Southeast Asia, but there is significant resistance in parts of northern Thailand, Laos and Cambodia. Tablets must be taken for four weeks after leaving the risk area.

Doxycycline, taken as a daily tablet, is a broad-spectrum antibiotic that has the added benefit of helping to prevent a variety of tropical diseases. The potential side effects include photosensitivity (a tendency to sunburn), thrush in women, indigestion, heartburn, nausea and interference with the contraceptive pill. More serious side effects include ulceration of the oesophagus – you can help prevent this by taking your tablet with a meal and a large glass of water, and never lying down within half an hour of taking it. It must be taken for four weeks after leaving the risk area.

Malarone is a new drug combining Atovaquone and Proguanil. Side effects are uncommon and mild, most commonly nausea and headaches. It is the best tablet for those on short trips to high-risk areas. It must be taken for one week after leaving the risk area.

A final option is to take no preventive medication but to have a supply of emergency medication should you develop the symptoms of malaria. This is less than ideal, and you'll need to get to a good medical facility within 24 hours of developing a fever. If you choose this option the most effective and safest treatment is Malarone (four tablets once daily for three days).

Opisthorchiasis (Liver Flukes)

These are tiny worms that are occasionally present in freshwater fish in Laos. The main risk comes from eating raw or undercooked fish. Travellers should in particular avoid eating uncooked Ъąh dàak (an unpasteurised fermented fish used as an accompaniment for many Lao foods) when travelling in rural Laos.

A rarer way to contract liver flukes is by swimming in the Mekong River or its tributaries around Don Khong in the far south of Laos.

At low levels, there are virtually no symptoms at all; at higher levels, an overall fatigue, low-grade fever and swollen or tender liver (or general abdominal pain) are the usual symptoms, along with worms or worm eggs in the faeces. Opisthorchiasis is easily treated with medication.

Environmental Hazards

Snakes

Southeast Asia is home to many species of both poisonous and harmless snakes. Assume all snakes are poisonous and never try to catch one. Always wear boots and long pants if walking in an area that may have snakes. First aid in the event of a snakebite involves pressure immobilisation via an elastic bandage firmly wrapped around the affected limb, starting at the bite site and working up towards the chest. The bandage should not be so tight that the circulation is cut off, and the fingers or toes should be kept free so the circulation can be checked. Do not use tourniquets or try to suck the venom out.

Food

Eating in restaurants is the biggest risk factor for contracting traveller's diarrhoea. Ways to avoid it include eating only freshly cooked food, and avoiding shellfish and food that has been sitting around in buffets. Peel all fruit and cook all vegetables. Eat in busy restaurants with a high turnover of customers.

Drinking Water

All water should be regarded as being potentially contaminated. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised. Avoid dairy products that are likely to have been made from unboiled milk. Only eat well-cooked meat and fish. Vegetables should be cooked and fruit peeled.

  • Never drink tap water.
  • Bottled water is generally safe, but do check the seal is intact at purchase.
  • Boiling water is the most efficient method of purifying it.
  • The best chemical purifier is iodine. It should not be used by pregnant women or people who suffer with thyroid problems.
  • Water filters should protect against viruses. Ensure your filter has a chemical barrier such as iodine and a small pore size.

Sunburn

Even on a cloudy day, sunburn can occur rapidly. Always use a strong sunscreen (at least factor 30), making sure to reapply after a swim, and always wear a wide-brimmed hat and sunglasses outdoors. Avoid lying in the sun during the hottest part of the day (from 10am to 2pm). If you are sunburnt stay out of the sun until you have recovered.

Skin Problems

Fungal rashes are common in humid climates. Watch out for moist areas that get less air, such as the groin, armpits and between the toes. The problem starts as a red patch that slowly spreads and is usually itchy. Treatment involves keeping the skin dry, avoiding chafing and using an antifungal cream such as Clotrimazole or Lamisil.

Cuts and scratches become easily infected in humid climates. Take meticulous care of any cuts and scratches to prevent complications such as abscesses. Immediately wash all wounds in clean water and apply antiseptic.

Insect Bites & Stings

Bedbugs don't carry disease but their bites are very itchy. They live in the cracks of furniture and walls and then migrate to the bed at night to feed on you. You can treat the itch with an antihistamine.

Ticks are contracted during walks in rural areas. They are commonly found behind the ears, on the belly and in armpits. If you have had a tick bite and experience symptoms such as a rash, fever or muscle aches, then see a doctor. Doxycycline prevents tick-borne diseases.

Leeches are found in humid forest areas. They do not transmit any disease but their bites are often intensely itchy for weeks afterwards and can easily become infected. Apply an iodine-based antiseptic to any leech bite to help prevent infection.

Bee and wasp stings mainly cause problems for people who are allergic to them. Anyone with a serious bee or wasp allergy should carry an injection of adrenaline (eg an Epipen) for emergency treatment.

Heat

Many parts of Southeast Asia are hot and humid throughout the year and it takes time to adapt to the climate. Swelling of the feet and ankles is common, as are muscle cramps caused by excessive sweating. Prevent these by avoiding dehydration and excessive activity in the heat.

Dehydration is the main contributor to heat exhaustion. Symptoms include feeling weak, headache, irritability, nausea or vomiting, sweaty skin, a fast, weak pulse and a normal or slightly elevated body temperature. Treatment involves getting out of the heat and/or sun, fanning the victim and applying cool wet cloths to the skin and rehydrating with water containing a quarter of a teaspoon of salt per litre. Recovery is usually rapid, though it is common to feel weak for some days afterwards.

Heatstroke is a serious medical emergency. Symptoms come on suddenly and include weakness, nausea, a hot dry body with a body temperature of over 41°C, dizziness, confusion, loss of coordination, seizures and eventually collapse and loss of consciousness. Seek medical help and commence cooling by getting the person out of the heat, removing their clothes, fanning them and applying cool wet cloths or ice to their body, especially to the groin and armpits.

Prickly heat is a common skin rash in the tropics, caused by sweat being trapped under the skin. The result is an itchy rash of tiny lumps. Treat by moving out of the heat and into an air-conditioned area for a few hours and by having cool showers. Locally bought prickly heat powder can be helpful.

Traveller's Diarrhoea

Traveller's diarrhoea is by far the most common problem affecting travellers. Somewhere between 30% and 50% of people will suffer from it within two weeks of starting their trip.

Traveller's diarrhoea is defined as the passage of more than three watery bowel actions within 24 hours, plus at least one other symptom such as fever, cramps, nausea, vomiting or feeling generally unwell.

Treatment consists of staying well hydrated. Rehydration solutions like Gastrolyte are the best for this. Antibiotics such as Norfloxacin, Ciprofloxacin or Azithromycin will kill the bacteria quickly.

Loperamide is just a 'stopper' and doesn't get to the cause of the problem, but can be helpful when taking a long bus ride. Don't take Loperamide if you have a fever, or blood in your stools. Seek medical attention quickly if you do not respond to an appropriate antibiotic.

Availability & Cost of Healthcare

Laos has no facilities for major medical emergencies. The state-run hospitals and clinics are among the most basic in Southeast Asia in terms of the standards of hygiene, staff training, supplies and equipment.

For minor to moderate conditions, including malaria, Mahasot Hospital's International Clinic in Vientiane has a decent reputation. Some foreign embassies in Vientiane also maintain small but professional medical centres

For any serious conditions, Thailand is the destination of choice. If a medical problem can wait until Bangkok, then all the better, as there are excellent hospitals there.

For medical emergencies that can't be delayed before reaching Bangkok, ambulances can be arranged from nearby Nong Khai or Udon Thani in Thailand. Nong Khai Wattana General Hospital in Nong Khai is the closest. The better Aek Udon Hospital in Udon Thani is an hour further from the border by road.

Buying medication over the counter is not recommended, as fake medications and poorly stored or out-of-date drugs are common in Laos.

Related

The unique and fascinating handicrafts available in Lao PDR allow visitors to take some special reminders of their travels in this beautiful country. A rich selection of silk and cotton textiles, exquisite silver and gold jewelry, handmade baskets, intricate carvings and traditional musical instruments and utensils are just some of the delights awaiting visitors on the markets.
Public holidays in Laos are days when workers get the day off work. There are 11 public holidays in Laos in 2017.
The official national currency in Laos is the Lao kip (K). Although only kip is legally negotiable in everyday transactions, in reality three currencies are used for commerce: kip, Thai baht (B) and US dollars (US$).
Laos enjoys a warm, tropical climate with two distinct seasons -the rainy season from the beginning of May to the end of September and the dry season from October through to April.Temperatures and rainfall very considerably throughout the year and also according to latitude and altitude.from November February the temperatures are lower and cool breezes bring a pleasant and refreshing change from the humidity of the rainy season. Temperatures drop to as low as 15 C (or well below that in the mountains) in December and January. During this Cool season, rainfall is at its lowest. From mid February the temperatures gradually increase to their highest levels, close to 38 C, in March to May. The rains start towards the end of this hot period too bring a welcome relief to the land.
Laos has no facilities for major medical emergencies. The state-run hospitals and clinics are among the most basic in Southeast Asia in terms of the standards of hygiene, staff training, supplies and equipment.
You are advised to avoid any protests or demonstrations and follow the instructions of local authorities. Curfews may be enforced and can include roadblocks, spot roadside checks and occasional raids on premises.
Tourist visas are readily available at airports and most land borders for between US$30 and US$42 for one month.
Laos is a very popular stop in South East Asia, although it remains one of the poorest country in the region, relatively isolated and undeveloped. But just has long been popular with the backpacker market, but the country is now attracting a wider range of travellers. It is also busy developing its standing as an eco-tourism centre due to the many hill tribe villages, river communities and unspoilt national parks. These settings all lend themselves to outdoor activities such as trekking, kayaking and caving. The capital, Vientiane, and the other major towns have been spared major modern developments with traditional and colonial architecture still dominant.