South Asia

Bhutan

Bhutan is a small land-locked Himalayan monarchy. By treaty, it accepts the guidance of India in foreign affairs. Facilities for tourism are limited.

CRIME: There is relatively little crime in Bhutan. Petty crime, such as pick-pocketing and purse snatching, is occasionally reported.

MEDICAL FACILITIES: Medical facilities in Bhutan are limited. Some medicine is in short supply. Doctors and hospitals often expect immediate cash payment for health services.

Arthropodborne diseases:

• Malaria
• Japanese encephalitis

We recommend:

• Usage of long-sleeved shirt and long pants to wear whenever possible while outside, to prevent illnesses carried by insects
• Usage of insect repellent containing DEET (diethylmethyltoluamide), in 30%–35% strength for adults and 6%–10% for children. Unless you are staying in air-conditioned or well-screened housing
• Usage of a bed net impregnated with the insecticide permethrin.
• Staying and sleeping in air-conditioned houses

Water- or food borne diseases:

• Amoebiasis
• Brucellosis
• Cholera
• Echinococcosis
• ETEC (E.coli)
• Giardiasis
• Hepatitis A
• Hepatitis E
• Typhoid fever

Other diseases:

• Hepatitis B
• Rabies

Vaccination recommended:

• Hepatitis A or Immune Globulin
• Hepatitis B or Immune Globulin
• Japanese encephalitis - only if you plan to visit rural areas for more than four weeks
• Typhoid fever - vaccination is particularly important because of the presence of S. typhi strains resistant to multiple antibiotics in this region
• Rabies - if risk for contact with wild or domestic animals
• A booster for tetanus/diphtheria - if not covered which indicates not vaccinated within th last 10 years.
• Yellow fever when entering from a yellow fever endemic region.

Stay healthy:

• Wash hands often with soap and water.
• Drink only boiled water, or water and carbonated (bubbly) drinks in cans
• Avoid tap water, fountain drinks, and ice cubes.
• Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it
• Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
• Prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot
• Do not travel at night
• Trafic accidents are frequent, be careful
• Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases
• Don’t eat food purchased from street vendors.
• Use chloroquine and proguanil as malaria prophylaxis in the districts of Chirang, Sarpang, Samchi, Samdrupjongkhar, and Shemgang (Chloroquine resistance)

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