The information's in this page are general information's about health in Vietnam (Asia) to help you to prepare your trip or your expatriation; the diseases mentioned on this page are not specific to Vietnam and many of them are widespread all over the world more or less according each disease and each country.
The information are not comprehensive and does not replace a specific medical advice or medical consultation that takes in account your medical condition which is at least as important as the environment in the country is. For children, elderly, pregnancy and people with chronic disease or/and taking regular medication, a specific medical advice is necessary either for prevention, diagnosis or treatment.

BEFORE TO TRAVEL

       1. Vaccinations

A - Routine Vaccinations

Before travel, be sure you and your children are up to date on all routine immunizations according to schedules approved by the Advisory Committee on Immunization Practice (ACIP). Some schedules can be accelerated for travel.

See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect. If it is less than 4 weeks before you leave, you should still see your doctor. It might not be too late to get your shots or medications as well as other information about how to protect yourself from illness and injury while traveling.

B - Recommended Vaccinations and Preventive Medications

The following vaccines may be recommended for your travel to Southeast Asia . Discuss your travel plans and personal health with a health-care provider to determine which vaccines you will need.

• Hepatitis A Transmission of hepatitis A virus can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested in contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling.
• Hepatitis B , especially if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not receive the series as infants.
• Japanese encephalitis , if you plan to visit or work rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis especially during the monsoon.
• Malaria, there is no malaria in the big cities and it is not recommended to take preventive medication for the expatriates who will live in the country (except under special circumstances or living in an endemic rural area). But in some circumstances like a trip in the mountains or in contaminated areas or a round trip through Vietnam it is recommended to take preventive drug. Prevent this serious disease by seeing your health care provider for a prescription ant malarial drug and by protecting yourself against mosquito bites.
• Rabies , if you work in contact with animals, or if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities. Generally not recommended for normal travelers.
• Typhoid , Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected.

As needed, booster doses for tetanus-diphtheria-polio and measles

C - Required Vaccinations

None.

D - Yellow Fever

There is no risk for yellow fever in Southeast Asia . A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from countries in South America or sub-Saharan Africa .

       2. What You Need To Bring With You

• Long-sleeved shirt, long pants, and a hat to wear whenever possible while outside, to prevent illnesses carried by insects.
• Insect repellent containing DEET
• Bed nets treated with permethrin. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.
• Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
• Iodine tablets and portable water filters to purify water if bottled water is not available.
• Sun block, sunglasses, and a hat for protection from harmful effects of UV sun rays.
• Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s) or letter from your health-care provider on office stationery explaining that the medication has been prescribed for you.
• Always carry medications in their original containers, in your carry-on luggage.
• Be sure to bring along over-the-counter antidiarrheal medication (e.g., bismuth subsalicylate, loperamide) and an antibiotic prescribed by your doctor to self-treat moderate to severe diarrhea.
• Bring your Vaccinations booklet
• Provide yourself with your blood group card.
• Underwrite a sanitary repatriation insurance.

WHEN TRAVELING

       1. To stay healthy, do...

• Wash your hands often with soap and water or, if hands are not visibly soiled, use a waterless, alcohol-based hand rub to remove potentially infectious materials from your skin and help prevent disease transmission.
• In developing countries, drink only bottled or boiled water or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes.
• Take your malaria prevention medication before, during, and after travel, as directed. (See your health care provider for a prescription.)
• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot, even on beaches.
• Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
• Protect yourself from mosquito insect bites:

• Wear long-sleeved shirts, long pants, and hats when outdoors.
• Wear long-sleeved shirts, long pants, and hats.
• Use insect repellents that contain DEET (N, N-diethylmethyltoluamide)...
• If no screening or air conditioning is available: use a pyrethroid-containing spray in living and sleeping areas during evening and night-time hours; sleep under bed nets, preferably insecticide-treated ones.

       2. Do not

• Do not eat food that is not well cooked to reduce risk of infection (i.e., hepatitis A and typhoid fever).
• Do not drink beverages with ice.
• Avoid dairy products, unless you know they have been pasteurized.
• Do not swim in fresh water to avoid exposure to certain water-borne diseases such as schistosomiasis.
• Do not handle animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). Consider pre-exposure rabies vaccination if you might have extensive unprotected outdoor exposure in rural areas.
• Do not touch dead animals or surfaces spoiled with animals dejections.
• Do not share brush teeth, razors, needles for tattoos, body piercing or injections to prevent infections such as HIV and hepatitis B.

       3. Information for tourists

A - Environmental hazards

• Climate & air pollution : heat, humidity, dust and motor fumes (especially in Saigon and Hanoi ) combine their effects that can worsen a lung disease, in particular asthma, emphysema or chronic obstructive chronic disease. It can also aggravate coughs, colds and sinus problems. The use of air conditioned too cold and directed on the face or the chest should be avoided. If you have sinus or lung disease, take your usual medication (inhaler…) for exacerbation of the symptoms.
• Heat : heat can cause dehydration and heatstroke. Drink more water and if you do not have to follow a low salt diet for your health condition (high blood pressure, heart failure, chronic edema, cirrhosis), increase a little your salt intake.
  Prickly heat which an itchy skin rash due to excessive perspiration can be prevented: wear ample clothes made with natural fibers, shower often, dry your skin well and put mild talcum or heat powder.
• Sunburn : in the tropics, even you do not feel very hot especially on the beach or under the clouds you can get sunburn quickly. Protect your skin with a sun cream with a strength adapted to your skin sensitivity, wear a hat and protect your eyes with sunglasses.

B - Infectious diseases

Diarrhea
Diarrhea is a common symptom among the travelers often call “tourista”; but it can be just the sign of diet changes until the sign of a very severe disease that needs a hospitalization.
When should you see a doctor?

• If you have bloody stool or/and mucus
• if you have fever
• if you have severe abdominal pain
• if you have very often watery stool and you loose a lot of water and weight
• if you are vomiting

• fluid replacement: drink at least equal to the volume being lost; take the World Health Organization ORS solutions but if you cannot find it you can drink Coca-Cola or Pepsi-Cola; take away the gas by adding 1 teaspoon of sugar into each glass.
• Bland diet: eat only white steam rice with boiled carrot, porridge (“chao” in Vietnamese) and soups (“pho” in Vietnamese).

• severe diarrhea persistent after 48H of good diet, diarrhea with blood and mucus in stools, any diarrhea with fever, profuse watery diarrhea; in these cases a culture of stools are necessary to find out which bacteria is responsible of your symptoms. If you are in remote area with no chance to be able to see a doctor, a 5 days course of Ciprofloxacine 500mg twice daily is indicated. Children and pregnant women cannot take this treatment.
• Amoebic dysentery often begins by a low-grade diarrhea and progressive intermittent abdominal pain with blood and mucus in stools. If you are in remote area with no chance to be able to see a doctor, the treatment is secnidazole 2g as a single dose or metronidazole 500mg 3 times a day for 10 days.
• Giardiasis is another parasite that cause diarrhea with cramps, nausea, a bloated stomach, foul-smelling diarrhea and frequents gas. The treatment is the same as amibiasis.

Hepatitis
5 types of hepatitis are known: A, B, C, D and E. The most common are the types A, B and C. They are all widespread worldwide but hepatitis B and C are more common in Asia than they are in Western countries.

Hepatitis A is transmitted by contaminated food and water or through direct person-to-person contact. You can be protected by a vaccine. If not vaccinated wash your hands often and more before eating or drinking.

Hepatitis B is transmitted through contact with infected blood, blood products or body fluids: sexual contact, unsterilised needles, blood transfusions or some breaks of the skin (shaver, body piercing, tattoo); it is very common in all Vietnam particularly in some areas. Now the Vietnamese health program includes the systematic vaccination of the newborns and also vaccination during the pregnancy to give immunization to the fetus and prevent the contamination from the infected mother at birth. There is a very effective vaccine recommended to have before to come to Asia . If not yet done, avoid any blood exposure; in the clinics and hospitals they use disposable needles and syringes; use condom can prevent sexual exposure.

Hepatitis C is mostly spread through infected blood contact and blood products (unsterilised needles and blood transfusion) and rarely by sexual contact; it is widespread in Vietnam and there is no preventive vaccine. The only prevention is to avoid risk situations.

Hepatitis D is usually a co infection that contaminates the people already infected with hepatitis B virus or also with hepatitis C virus and HIV. We do not have much data about this hepatitis in Vietnam .

Hepatitis E is transmitted by contaminated food and water; it is not common in Vietnam , just sporadic cases are found. Prevention is the same as Hepatitis A by having a good hygiene but there is no vaccine. It is particularly serious for the pregnant women during the third trimester.

HIV and AIDS
An infection with the human immunodeficiency virus may lead to immune deficiency syndrome (AIDS), which is a very severe chronic disease that leads to many others complications. We have now some good medications to prevent most of the complications and to live in good condition but not to cure the disease.

The people are infected through the blood or blood products from infected people or sexual contact.

The only prevention is to avoid risk situations and use condom to prevent sexual exposure.

Parasites
The tropical zone is known to have much kind of parasites.

You can be contaminated through: food (raw or not enough cooked), drinking water, fresh water when swimming, the soil and contacts with animals by skin bites. They can give no symptoms or various symptoms including but not limited to: skin rash and itching, abdominal pain, diarrhea, hematuria for the most common.

If you are experiencing some symptoms, better to seek doctor advice.

Bird Flu
The Bird Flu has been spreading to some countries in the world and there are cases in Vietnam among the poultry mostly the chickens, but also the ducks and the pork. Some people are affected but they are all people who work in the farms and take care directly of the affected animals; they have been infected by dejections of affected animals or dead affected animals.

Some people from people contamination (12 cases in Thailand ) have been supposed inside the same family with permanent or repetitive contact but without spreading outside the family.

No case has been reported from eating cooked animals.

It is advisable not to go to the areas where they grow poultry but there is no or very minimal risk in the normal tourist areas.

No vaccine has been recommended and the normal flu vaccine does not protect against the H5N1 virus responsible of the bird flu. There is one antiviral drug that reduces the symptoms of the affected people: oseltamivir (Tamiflu®).

No restriction for traveling has been making by the WHO but avoid the animal farms. Just do not touch dead animals even in the market or surfaces spoiled with animal's dejections, wash your hands often with hydro alcoholic solution, and cook the food at more than 70 C.

THE TRAVELER FIRST-AID KIT

Bandages and first-aid materials

• elastoplasts, adhesives bandages ;
• strapping ;
• sterile compresses ;
• hypoallergenic dressings ;
• tourniquet, scissors, tweezers ;
• Disposable syringes and needles ;
• cotton wool, surgical spirit, antiseptics... ;
• antibiotic cream (Fucidine) ;
• antiseptic solution (Bétadine, Chlorexidine)
• thermometer (digital) ;
• safety pins ;
• adhesives sutures ;
• antiseptic gauze ;
• anti-pruruginous ointment.

Cosmetic and hygienic products :

• condoms ;
• total sun block ;
• mosquito repellent ;
• hydroclonazone (disinfectant for drinking water) ;
• 2 pairs of sunglasses ;
• hat (broad-brimmed) ;
• toilet paper (a rare commodity in third-world countries) ;
• wristwatch (a second one may be useful for diabetics) ;
• ear plugs.
• sanitary towels - sanitary napkins

Medication (to be discussed with your doctor)

• mild sleeping pills (Lexomil);
• urinary antiseptics (Noroxine);
• antidiarrhoeics (Tiorfan, Smecta);
• laxatives (Forlax);
• antalgics (Paracetamol) ;
• antispasmodics (Spasfon, Debridat);
• antipyretics (Paracetamol);
• antihistaminic (Cetirizine);
• antimalarials ;
• antibiotics (Augmentin);
• eye-drops (antiseptic, antiallergic) ;
• antiemetics (travel sickness) Primperan ;
• oral rehydration salts (WHO recommendation ; can be prepared by yourself: 6 level coffee spoons of sugar and 1/2 coffee spoon of salt in 1 liter of drinking water) ;
• ear drops.

USEFUL ADDRESSES

Hanoi

Hanoi Family Medical Practice
A1 Van Phuc, Kim Ma
Tel : 84.4.846.17.48/49 or 843.07.48, emergency 24h/24h : 09.03.40.19.19

International SOS
31 Hai Ba Trung
Tel : 84.4.9340555 (emergency), 9340666

Hôpital français de Hanoi
1 Phuong Mai
Tel 84.4.5740740

Hochiminh City

Franco-Vietnamese Hospital
6 Nguyen Luong Bang, Tan Phu Ward, District 7
Tel : 84.8.4113333
200 beds International Standard Hospital.
Emergency 24h/24h Tel: 411 35 00
Website: www.fvhospital.com

Columbia Asia Medical Center Saigon
08 Alexandre de Rhodes St., District 1
Tel : 84.8.8238888

Columbia Asia Medical Center, Gia Dinh
01 No Trang Long St., Binh Thanh Dist
Tel : 84.8.8030678
Website: www.columbiaasia.com

International Medical Center
1 Han Thuyen Street , district 1
Tel : 84.8.8654025 (emergency 24h/24h), 8272366

SOS international
65 Nguyen Du, District 1
Tel : 84.8.8298520

Family Medical Practice
Diamond Plaza, 34 Le Duan, District 1
Tel: 84.8.8227848

Vung Tau

International SOS clinic (clinique)
1 Le Ngoc Han
Tel : 84.6.4858776

Outside Hanoi and Ho Chi Minh City

You should go as soon as possible to the closest big city where the primary care, if it is a vital emergency, can be done in the local hospital, avoiding as much as possible blood transfusion and requesting the use of disposable syringes and needles .

Call your insurance immediately.