Burma
Avoid dental treatment as the standards of care and hygiene cannot be guaranteed.
Generally the quality of medication cannot be guaranteed in Myanmar, as heat damaged and out of date supplies may be stocked
Blood supplies should be considered as unsafe in Myanmar
Medical facilities in Burma are inadequate for even routine medical care. There are few trained medical personnel because the universities were closed for several years and have recently reopened. Common drugs for sale, such as insulin, are often adulterated products and unsafe to use. HIV/AIDS is rampant in the country, as is malaria and hepatitis. Hospital and medical services are available in Rangoon; elsewhere, medical care is limited.
Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.
Drink only bottled beverages (including water) or beverages made with boiled water. Do not use ice cubes or eat raw seafood, rare meat or dairy products. Eat well-cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors.
Swim only in well-maintained, chlorinated pools or ocean water known to be free from pollution. Wear clothing which reduces exposed skin and apply repellents containing DEET to remaining areas. Sleep in well-screened accommodations. Carry anti-diarrheal medication. Reduce problems related to sun exposure by using sunglasses, wide-brimmed hats, sunscreen lotions and lip protection.
A new strain of cholera (Bengal cholera) has appeared in Myanmar. Disease caused by this new strain is characterized by extremely rapid onset of severe symptoms. The current cholera vaccine affords no protection against this new strain; therefore, particular caution should be taken with food, beverages and personal hygiene. Persons becoming ill should seek immediate medical care and rehydration therapy.
AIDS occurs. Blood supply may not be adequately screened and/or single-use, disposable needles and syringes may be unavailable. When possible, travelers should defer medical treatment until reaching a facility where safety can be assured.
Cholera: Although limited in effectiveness, vaccination may be appropriate for persons living and/or working in less than sanitary conditions for more than 3 months where medical facilities are unavailable. Vaccination may also be appropriate for travelers with impaired gastric defenses who are planning an extended visit or being exposed to unsanitary conditions. Vaccination is not advised for pregnant women, infants younger than 6 months old, or persons with a history of severe reaction to the vaccine.
Hepatitis A: Consider active immunization with hepatitis A vaccine or passive immunization with immune globulin (IG) for all susceptible travelers. Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. It is particularly important for persons who will be living in or visiting rural areas, eating or drinking in settings of poor or uncertain sanitation, or who will have close contact with local persons (especially young children) in settings with poor sanitary conditions.
Hepatitis B: Vaccination is advised for health care workers, persons anticipating direct contact with blood from or sexual contact with inhabitants, and persons planning extended stays of 6 months or greater (especially those who anticipate using local health care facilities, staying in rural areas, or having intimate contact with the local population).
Japanese Encephalitis: Consider vaccination if staying a month or more from May to October when transmission is presumed to occur, especially if travel includes rural areas. Also consider if staying less than 30 days during that period and at high risk (in case of epidemic outbreak or extensive outdoor exposure in rural areas). Repeated outbreaks are reported from Shan State in the Chiang Mai Valley.
Polio: A one-time booster dose is recommended for travelers who have previously completed a standard course of polio immunization. Refer to CDC guidelines for vaccinating unimmunized or incompletely immunized persons. Pregnancy is a relative contraindication to vaccination; however, if protection is needed, either IPV or OPV may be used, depending on preference and time available.
Rabies: Preexposure vaccination should be considered for persons staying longer than 30 days who are expected to be at risk to bites from domestic and/or wild animals (particularly dogs), or for persons engaged in high risk activities such as spelunking or animal handling. Need for vaccination is more important if potential exposure is in rural areas and if adequate postexposure care is not readily available.
Typhoid: Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited. Contraindications depend on vaccine type.
Note: All routine vaccines (such as DTP or Td, Hib, MMR, polio, varicella, influenza and pneumococcal) should be kept up-to-date as a matter of good health practice unrelated to travel.
Insect-borne illness: considered an important cause of disease in this area.
Chikungunya fever - occurs
Dengue fever - occurs
Dengue Hemorrhagic fever - occurs
Encephalitis (Japanese type) - common (endemic/hyperendemic countrywide)
Filariasis - prevalent in rural areas
Leishmaniasis (visceral) - common
Malaria - common
Plague - occurs
Typhus (mite-borne) - occurs in deforested areas
Food-borne and water-borne illness: these diseases are common.
Cholera - occurs
Dysentery (amoebic and bacillary) - occurs
Fasciolopsiasis (giant intestinal fluke) - occurs
Hepatitis - occurs
Melioidosis - occurs
Trachoma - occurs
Typhoid fever - occurs
Other hazards:
Diseases such as measles and diphtheria are commonly reported, and cases of polio still occur regularly.
Influenza risk extends throughout the year.
Rabies - occurs
Yellow fever: A yellow fever vaccination certificate is required from travelers coming from infected areas. Nationals and residents of Myanmar are required to possess certificates of vaccination on their departure to an infected area.
