General Information
People can get sick from a variety of sources anywhere in the word. Polluted air, exposure to others who have infectious illnesses, accidents, smoking, excessive alcohol consumption, exposure to infected insects and contaminated food, and water all play rolls in making us ill. Southeast Asia including Vietnam has Hepatitis A and B, Dengue, Malaria, Rabies, Plague, Japanese encephalitis, Tetanus, Tuberculosis, Typhoid, and others. Amoebas: Amoebic dysentery is caused by ingesting cysts (eggs) of pathogenic ameba in water. These amoebas can also be found on raw vegetables and in food contaminated by infected food handlers. The onset of symptoms may be abrupt or slow to develop after infection. Symptoms which may be absent or difficult to describe are usually: fatigue, lower abdominal pain, and alteration of bowel habits. More serious infections are characterized by stools, which contain blood and mucus, fever, moderate to severe and abdominal pain and an enlarged liver.

Avian Bird Flu: It is believed that most cases of bird flu infection in humans have resulted from contact with infected chicken or contaminated surfaces. Infected birds shed flu virus in their saliva, nasal secretions, and feces. Precaution: The following recommendations are directed to expats living abroad. To minimize the possibility of infection, observe precautions to safeguard your health. Specifically, travelers should avoid contact with live poultry. Do not eat uncooked or undercooked poultry or poultry products. As with other infectious illnesses, one of the most important preventive practices is careful and frequent hand washing.

When Preparing Food
Separate raw meat from cooked foods. Do not use the same knife for preparing raw meat and cooked foods. Ensure thorough cleaning of chopping boards and knife after preparing chicken. Do not handle either raw or cooked foods without washing your hands in between. Do not place cooked meat back on the same plate or surface it was on before it was cooked. All foods from poultry should be cooked thoroughly, including eggs. Egg folks should not be runny or liquid. Before influenza viruses are destroyed by heat, the cooking temperature for poultry meat should reach 700C (1580F). Wash egg shells in soapy water before handling and cooking, and wash your hands afterwards. Do not use raw or soft-boiled eggs in foods that will not be cooked. After handling raw poultry or eggs, wash your hands and all surfaces and utensils thoroughly with soap and water.

Avoiding Bugs
Cockroaches and ants are very common in Vietnam. Some cockroaches in Vietnam can fly. They preferred haunts are kitchens and bathrooms. The small brown ants search for food or sugar; the bigger ones eat wool or clothing. There are pest control companies in HCMC who can treat your home for pests. Lice are gray or brown insects that live only on humans. A male louse is smaller than a female louse. Most of the time, they live in scalps but they can also live elsewhere on your body where there is hair. Lice are parasites and feed on blood. A female produces 8 eggs a night, which small and white. They stick to hair. It takes 7 days for eggs to hatch and 10 days to reach maturity. Itching of the head, (usually behind the ears) is caused by the saliva of the louse and is the first warning sign. Lice walk from head to head. They cannot fly or jump. After contraction of lice, use a Permetrine and Isopropanol combination shampoo to kill the lice and their eggs. Although dead, they will still stick to the hair. Wash all the infested areas thoroughly. Wash the clothes, blankets, and sheets of the infested person as well. Another suggestion is to put your laundry in a tightly sealed plastic bag for one week because without a fresh supply of blood, the lice will die.

There are numerous species of mosquitoes in Vietnam many of which transmit diseases such as malaria, dengue fever, and hemorrhagic fever. A mosquito net comes in handy when traveling. Wear protective clothing and use repellents.

In the daytime, you are not generally at risk; however a few precautionary measures can reduce the number of insect bites.

  • Put mosquito netting on windows as screening.
  • Close the windows and doors at dusk
  • Use plug in repellents
  • Sleep under mosquito nets
  • Wearing long sleeves and trousers is advisable

There is a lot of entertainment that takes place outdoors carry insect repellent in your bag or car as the dark depths of the car around your feet often have mosquitoes lurking.

Giardia infection is characterized by explosive watery diarrhea without blood or pus in the stool. The odor of the stool and the accompanying gas foul smell. Other symptoms include abdominal bloating or swelling, nausea, belching, loss of appetite, headache, and even some weight loss. Fat and fat soluble vitamin absorption is blocked so stools may appear greasy of frothy. It is not uncommon for patients to complain of worse symptoms after drinking milk. The cysts of Giardia are usually found in contaminated water and on dishes or utensils rinsed with contaminated water. The cysts are killed by boiling water for five minutes and by washing dishes with soap or detergent. Giardia infections are often chronic; symptoms appear last 24 to 48 hours, disappear, and reappear several times. At other times the individual may be heavily infected and pass it on to the family members while showing no symptoms hat so ever. The diagnosis is made by examining the patients stool specimens. Hepatitis, Viral Type A: Transmission can occur by direct person to person contact, contaminated water, ice, or shellfish harvested from sewage, contaminated water, or vegetables or fruit. Symptoms are fever, malaise, nausea, and abdominal discomfort, followed within a few days by jaundice. Symptoms vary and the illness lasts from 1 or 2 weeks to several disabling months.

By teaching children to wash their hands much more frequently then they have been used to, you can avoid a lot of problems. Ever time that they have been shopping played outside of your home or come back from school promote a habit of removing their shoes at the door (commonplace in Asia), to avoid bringing the  dirt inside, and marching straight in to the bathroom to wash their hands, you will find that tummy trouble will be rare.

Injections against Hepatitis, Japanese encephalitis, Tetanus, Tuberculosis and Typhoid are recommended but not required. Most doctors advise you not to take the everyday malaria pills if you have to stay a long time in this country. In the Vietnamese Central Highlands, however, this risk is higher, so you should consider taking precautions. Check with your doctor for relevant immunization before going to Vietnam.

Newcomers here tend to be alarmist about Malaria. This must obviously be a personal choice, but most expatriates do not take malaria pills. It was explained to us that in Asia our pediatrician would be “looking” at malaria as a possibility if you have a fever for three days and that the preventive pills may even mask the symptoms. In Saigon itself, cases have been infrequent among the foreign community.

Monosodium glutamate (MSG, Ajinomoto or “bot ngot”) is widely used in Vietnam. For some people the consumption of MSG causes discomfort. Symptoms include burning sensations, which begin in the chest and spread to the neck, shoulders, forearms, and or abdomen, tearing of the eyes, and sweating often follow. Some diners experience tightness and a sense of pressure in the face and behind the yes. Others report hives, headaches, thirst, or chest pressure, which mimics a heart attack. Stress: Living abroad is a stressful experience even to families who make careful preparations for the transition. Some of the most common stress warning signs are:

  • Anger which is difficult to control
  • Excesses, of drinking eating or smoking without control
  • Nervous tension, losing the ability to concentrate, inability to sleep
  • Physical illnesses
  • Withdrawal or denial or spending too much time alone at home
  • Depression, malice, crying
  • To combat stress, we recommend:
  • Work on control; there are many things that we cannot control, but there are also things that you can control, such as your diet, exercise, etc. set goals rather than letting life control you.
  • Learn your way around; this includes physically, culturally and linguistically learning your way around the new environment. The more familiar you are with your new environment, the more you will gain from the experience
  • Move with the rhythms of the country and relax.
  • Seek a support group and work to maintain it. Take advantage of what we have to offer
  • Take a break. Take time off for weekends in the Highlands or at the beaches. Take vacations.
  • Maintain a sense of humor. Laughter is one of the world’s best medicines.
  • Pursue a hobby
  • Exercise
  • Pamper yourself; have a facial, manicure or a full body massage. Make an appointment with a hair stylist, reflexologies, or acupuncturist
  • Keep a regular diary for the first few months. It is  very therapeutic
  • Ask for help

Tu\typhoid Fever

This is a generalized infection caused by Salmonella typhus. Transmission of the infection in the expatriated community most commonly occurring thorough food contaminated by food-handlers, but flies may also spread the organism to food. Symptoms of the disease vary greatly between individual patients. The onset of the infection is very suggestive of influenza like illness and there is usually fever, loss of appetite and constipation. Water: All water consumed in Vietnam should be boiled or otherwise treated to make it free of any pathogens. Freezing water does not make it free of any pathogens. The best advice when eating out is to avoid drinks unless they are bottled, canned, or boiled (such as tea and coffee). Bottled water is considered safe. Keep in mind that the ice served with drinks may not be safe. A five-minute boil with effectively kill Hepatitis A. Water purifying systems are available for purchase in Vietnam.

  • Water Dehydration can occur easily here in Vietnam especially when you are unaccustomed to the rapid rate of water loss through perspiration. Most doctors recommend drinking 8 glasses of water a day. Fortunately today safe and inexpensive bottled water is readily available most everywhere in Vietnam.
  • Slight headaches, lethargy, and irritability, can all be symptoms of dehydration

Most people’s gardens do have snakes, but you usually do not see them. Your gardener, security, or household staff can usually dispose of snakes, but children should be warned against running barefoot in long grass or venturing into the undergrowth. Neither adults nor children should attempt to catch anything, especially if you are unfamiliar with safe capturing methods. Hairy caterpillars can cause a violent reaction if you come in contact with them and a scorpion or a wasp sting can be pretty painful.

Dogs and cats are often found hanging around gates to houses. They usually do not have rabies, but are likely to be covered in ticks and fleas, and as in any country, children should be taught to avoid them rather than encourage them. On the positive side, dogs and cats are readily available for purchase as pets and it is not difficult to find a vet. Dogs may also discourage rats and mice from entering you home.