Thailand, the only Southeast Asian nation never to have been colonized by European powers, is a constitutional monarchy whose current head of state is HM Bhumibol Adulyadej. A unified Thai kingdom has existed since the mid-14th century, and Thailand was known as Siam until 1939 when it officially became the Kingdom of Thailand.
Thailand is the 50th largest country in the world; most nearly equal in size to Spain. Located just 15 degrees north of the equator, Thailand has a tropical climate and temperatures typically range from 19 to 38 degrees C (66-100 F). Thailand’s largest peak, Doi Inthanon, is 2,565 meters (8,415 ft) tall. Thailand covers 510,890 sq km of land and 2,230 sq km of water. The coastline of Thailand is 3,219 km long. Thailand’s longest shared border is with Myanmar (Burma), stretching 1,800 km.
The population of Thailand comprises of roughly 65 million citizens, the majority of whom are ethnically Thai, though peoples of Chinese, Indian, Malay, Mon, Khmer, Burmese, and Lao origin are also represented to varying degrees. Approximately 7 million citizens live in the capital city, Bangkok, though this number varies seasonally and is otherwise difficult to accurately count.
The vast majority (roughly 80%) of Thailand’s nearly 65 million citizens are ethnically Thai. The remainder consists primarily of peoples of Chinese, Indian, Malay, Mon, Khmer, Burmese, and Lao decent. Of the 7 million citizens who live in the capital city, Bangkok, there is a greater diversity of ethnicities, including a large number of expatriate residents from across the globe. Other geographic distinctions of the population include a Muslim majority in the south near the Malaysian border, and hill tribe ethnic groups, such as the Hmong and Karen, who live in the northern mountains.
More than 92% of the population speaks Thai or one of its regional dialects. While the Thai language is the official language of Thailand, as a result of its cosmopolitan capital city and established tourism infrastructure, English is spoken and understood throughout much of Thailand.
94.6% of Thais are Buddhist, 4.6% of Thais are Muslim 0.7% of Thais are Christian
Thailand hotels are some of the finest in the world, whether they are five star luxury spa retreats or quaint family-run beachfront bungalows. There is a hotel in Thailand for every type of traveler on every budget. That said, the best prices are during Thailand’s off-peak season (May – Aug), while the most expensive prices are typically during the cool season (Dec – Feb). Whether your accommodation choice is a homestay with local villagers, a guesthouse in a backpacker district, a beach bungalow, or a five star hotel in Thailand, unless you have booked ahead, settle for nothing less than the warmest “land of smiles” hospitality.
Medical Precaution and Vaccination
All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.
Malaria:Â Prophylaxis with Malarone (atovaquone/proguanil) or doxycycline is recommended for rural areas bordering Cambodia, Laos, and Myanmar, including Mae Hong Son. Rare local cases have been reported from Phang Nga and Phuket; insect protection measures but not malaria pills are not recommended for these two areas.
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 and for travelers who have been in transit in an airport located in a country with risk of yellow fever transmission. Not recommended or required otherwise.
Japanese encephalitis: For travelers who may spend a month or more in rural areas and for short-term travelers who may spend substantial time outdoors in rural areas, especially after dusk.
Hepatitis B: Recommended for all travelers
Rabies: For travelers spending a lot of time outdoors, or at high risk for animal bites, or involved in any activities that might bring them into direct contact with bats
Measles, mumps, rubella (MMR): Two doses recommended for all travelers born after 1956, if not previously given
Tetanus-diphtheria: Revaccination recommended every 10 years
Travelers’ diarrhea is the most common travel-related infection. It may be caused by many different organisms, including bacteria such as E. coli, Salmonella, Shigella, Campylobacter, Aeromonas, Plesiomonas, and vibrios; parasites such as Giardia, Entamoeba histolytica, Cryptosporidium, and Cyclospora; and viruses. In addition to diarrhea, symptoms may include nausea, vomiting, abdominal pain, fever, sweats, chills, headache, and malaise. The chief complication is dehydration, which may become severe, especially in warmer climes.
The best means of prevention is to avoid any questionable foods or beverages. Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, sea bass, and a large number of tropical reef fish.
Although antibiotics may be taken prophylactically to prevent travelers’ diarrhea (i.e. taken on a daily basis before symptoms have a chance to occur), this isn’t generally recommended because starting antibiotics after diarrhea begins works well and because increased antibiotic use might lead to a greater incidence of side-effects and the selection of resistant organisms. Prophylactic antibiotics might be appropriate for situations in which diarrhea might prove unusually troublesome (i.e. business trip, diplomatic mission, athletic event) or for travelers who are immunocompromised or who have a history of intestinal disorders, such as those with inflammatory bowel disease.
Appropriate regimens include ciprofloxacin (Cipro)(PDF) or levofloxacin (Levaquin)(PDF) 500 mg once daily or (less effectively) trimethoprim-sulfamethoxazole (Bactrim; Septra) one double-strength tablet daily. Bismuth subsalicylate (Pepto-Bismol) (two tablets or two ounces four times daily) will reduce the likelihood of travelers’ diarrhea, but few take this because it is inconvenient. Side-effects may include black tongue, black stools, nausea, constipation, and ringing in the ears (tinnitus). Bismuth subsalicylate should not be taken by those with aspirin allergy, kidney disease, or gout, and should not be taken for more than three weeks. Quinolone antibiotics may bind to metallic cations such as bismuth; they should not be taken concurrently.
The standard recommendation is for travelers at risk to bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: eitherciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin)(PDF) 500 mg once daily for a total of three days. Quinolones should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12.
Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. For children, the dosage of azithromycin is 10 mg/kg on day 1, up to 500 mg, and 5 mg/kg on days 2 and 3, up to 250 mg. Another option is trimethoprim/sulfamethoxazole (Bactrim), which is used less often today because of increasing bacterial resistance but may be appropriate for children or those unable to tolerate other antibiotics. The dosage is one double-strenth tablet twice daily for adults and 5 mg/kg trimethoprim/25 mg/kg sulfa twice daily for children. Trimethoprim-sulfamethoxazole should not be given to pregnant women or those with a history of sulfa allergy. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.
Most cases of travelers’ diarrhea are mild and do not require either antibiotics or antidiarrheal drugs.
Adequate fluid intake is essential. Oral rehydration solutions, which are rich in salt and sugar, are widely available and highly effective. If fluids that do not contain salt are used, plain salted foods, such as crackers, are recommended. Dairy products should be avoided until diarrhea has subsided, as these are often difficult to digest while the intestine is inflamed.
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 obtained, if possible.
The following are the recommended vaccinations for Thailand:
Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, an