Thailand (Lonely Planet, 13th Edition) - China Williams [662]
Ticks are contracted when walking in rural areas. Ticks 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 at the site of the bite or elsewhere, fever or muscle aches you should see a doctor. Doxycycline prevents tick-borne diseases.
Leeches are found in humid rainforest 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. For others, pain is the main problem – apply ice to the sting and take painkillers.
Parasites
Numerous parasites are common in local populations in Thailand; but most of these are rare in travellers. The two rules to follow if you wish to avoid parasitic infections are to wear shoes and to avoid eating raw food, especially fish, pork and vegetables. A number of parasites are transmitted via the skin by walking barefoot, including strongyloides, hookworm and cutaneous larva migrans.
* * *
JELLYFISH STINGS
It is difficult to get accurate statistics on the incidence of serious or fatal jellyfish stings in Thailand, however there have been at least 10 tourist deaths in the past 20 years. Of note, between December 2007 and May 2008 there were nine serious envenomations in four separate incidents reported from popular tourist beaches (on Ko Tao, Ko Samet, Ko Lanta and Pattaya). One of these victims died.
Not all box jellyfish are dangerous, and stings range from minor to deadly. A good rule of thumb, however, is to presume a box jelly is dangerous until proven otherwise. There are two main types of box jellyfish – multi-tentacled and single-tentacled.
Multi-tentacled box jellyfish are present in Thai waters – these are potentially the most dangerous of jellyfish and a severe envenomation can kill an adult within two minutes. They are generally found on sandy beaches near river mouths and mangroves during the warmer months but can be found at any time of the year.
There are many types of single-tentacled box jellyfish, some of which can cause severe symptoms known as the Irukandji syndrome. The initial sting can seem minor; however severe symptoms such as back pain, nausea, vomiting, sweating, difficulty breathing and a feeling of impending doom can develop between five and 40 minutes later. There has been the occasional death reported from this syndrome as a result of high blood pressure causing strokes or heart attacks.
There are many other jellyfish in Thailand that cause irritating stings but no serious effects. The only effective way to prevent these stings is to provide a barrier between human skin and the jellyfish. This can be achieved most effectively with protective clothing. For example in the tropical waters of Australia it is recommended to wear a ‘stinger suit’ – a full length lycra suit. Multi tentacled jellyfish stinger nets at beaches are also effective, however, these are not yet found on Thai beaches.
First Aid for Severe Stings
For severe life-threatening envenomations the first priority is keeping the person alive. Stay with the person, send someone to call for medical help, and start immediate CPR if they are unconscious. If the victim is conscious douse the stung area liberally with vinegar – simple household vinegar is fine – for 30 seconds. Keep a close eye on their conscious state and get them immediately to medical care. For single-tentacled jellyfish stings pour vinegar onto the stung area as above;