Philippines
Good quality dental care is available in Manila. Avoid dental treatment elsewhere as the standards of care and hygiene cannot be guaranteed.
Some international medication is available from the larger pharmacies and hospitals in the larger towns and cities.
Blood supplies should be considered as unsafe. The exception is possibly the larger private hospitals in the capital, where some screen blood to international standards
Adequate medical care is available in major cities but is limited in rural and more remote areas.
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; avoid freshwater lakes, streams and rivers. 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.
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.
Fungus and ear infections, often due to swimming, are common in the hot, humid climate. Superficial skin infections are extremely common in the tropics. Carefully clean with an antibiotic disinfectant and cover even the smallest wounds.
Toward the end of the rainy season and as cooler weather begins, incidence of respiratory diseases rises. (Respiratory infections and irritations are very common because of atmospheric pollution and air-conditioning.)
Avoid over exertion and excessive fatigue. The tropical environment is enervating, and you may not recover from exercise as quickly here as in temperate areas.
Short exposure to the sun can result in serious burns.
Choose inter-island ferries carefully if traveling between islands by boat since some may be unsafe due to lax safety inspections and overcrowding.
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 during transmission periods, especially if travel includes rural areas. Also consider if staying less than 30 days during these periods and at high risk (in case of epidemic outbreak or extensive outdoor exposure in rural areas). Transmission in western Luzon, Mindoro and Negro Palowan likely occurs from April to November. It occurs throughout the year in other areas, with highest risk from April to January.
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 (widespread in some of the central islands; potential for spread is accentuated by the presence of a large group of susceptibles and the widespread presence of the vector, Aedes aegypti, particularly in large urban areas like Manila)
Dengue fever - occurs
Dengue hemorrhagic fever - occurs
Encephalitis (Japanese type) - occurs (endemic on all islands, with past outbreaks reported from Luzon, Manila and Nueva Ecija)
Filariasis - prevalent in rural areas
Malaria - prevalent
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
Opisthorchiasis (cat liver fluke) - occurs
Paragonimiasis (oriental lung fluke) - occurs
Schistosomiasis - prevalent
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.
Penicillinase-producing Neisseria gonorrhea (PPNG) is common in the Philippines. This type of gonorrhea is resistant to penicillin and must be treated by other means.
The Department of Health reports that a recent study of prostitutes in Manila and Cebu City found a gonorrhea strain resistant to ciprofloxacin and highly resistant to penicillin and tetracycline. The strain was present in 5% of all prostitutes surveyed and in 40% of prostitutes with gonorrhea.
Rabies - occurs
AIDS: According to the Department of State, testing is required for applicants for permanent resident visas as part of a general medical exam. Foreign test results are accepted under certain conditions. Contact Philippines' embassy for details.
Yellow fever: A yellow fever vaccination certificate is required from travelers over 1 year of age coming from infected areas.
