The heat, the sunshine, a multitude of food outlets, large numbers of visitors and cultural differences make the threat of food poisoning in Thailand a reality

A lot of western doctors who advocate for restricted use of antibiotics may raise their eyebrows when they hear this, but foreign tourists are advised to use antibiotics, and even charcoals, when traveling in Thailand as there is a real threat of food poisoning. The level of the threat can be gauged from a news report in Thailand from February this year when twenty nine public health officials attending a seminar at a Pattaya hotel suffered food poisoning symptoms and nine had to to be hospitalised.

risk of food poisoning in Thailand
Rex Tickell with his family on their first overseas visit to Thailand in June/July 2016. Mr. Tickell and his family developed food poisoning symptoms but his convulsions became so strong that he became unconscious and died 30 minutes after being removed to hospital. While many veteran visitors to Thailand and the many fans of Thai cuisine suggest that it is a matter of common sense precautions, a different climate and change of cuisine which is bound to have some effect on a western stomach, there are consistent reports of severe food poisoning among western visitors. There are also regular scares involving Thai citizens including fatalities. Thailand is a country where nearly all people eat out regularly. The huge numbers and variety of food outlets, hot weather and extreme sunshine has created a health risk. Thai authorities have begun a food traceability programme and hygiene regulation but it will be some time before Thailand achieves the same hygiene standards as western countries across all food outlets operating in the country. The situation can be managed by taking vaccinations, using common sense and being selective about food venues.

The officials were attending the event having gathered from all parts of Thailand. The nine transferred to a Pattaya hospital were suffering dizziness, chest pains, vomiting and extreme dehydration. Twenty other officials were treated on the spot with antibiotics and saline solution for dehydration after suffering chronic diarrhea.

Australian dies 30 minutes after been hospitalised in Thailand from severe food poisoning

Rex Tickell, an Australian 55-year-old man, is seen in a photograph enjoying dinner with family during his trip to Thailand in June and July 2016. He was described by his family as ‘loving’ and ‘hard working.’ Later on, the Aussie husband and father of three developed food poisoning symptoms along with other family members who also came down with an infection. At some point, Mr. Tickell began to vomit so violently and strenuously that he fell unconscious. The family tried CPR but they were unable to revive him. Despite being immediately rushed to the hospital, he was pronounced dead no more than 30 minutes later. The cause of his death was severe food poisoning and his case is a warning to visitors who want to enjoy one of the world’s celebrated cuisines and holiday locations that it must be done with care and vigilance to the threat of food poisoning. The extended Tickell family from Queensland in Australia had been on a the family’s first overseas holiday to Thailand. The tragedy was underscored further when it emerged that Rex was the only bread winner in the family and his death left his wife and children in challenging financial straits. The only consolation for the family was that they had taken out travel insurance which allows for the repatriation  of his body without further loss.

Persistent reports of food poisoning in Thailand

While cases like Rex Tickell are thankfully rare enough, there are persistent reports of foreigners coming down with severe food poisoning in Thailand. And it’s not just street food, many of those who have succumbed have reported being poisoned by western food or food prepared at resorts and hotels catering primarily for foreigners. One man reported staying at a resort in northern Thailand and getting food poisoning after eating a western style breakfast. Hospitalised with a bacterial infection the situation became even more critical when the bacteria moved to his heart. Another foreigner reporting getting a serious e-coli infection from a salad!

Western doctors have warned about street food in Thailand – but foreigners should be be more wary of vendors selling western food

Street food has been always hailed as a highlight of Thailand, but the sheer size of the industry plus a lack of effective oversight makes it very difficult to ensure food hygiene. Many doctors in western countries, while warning travellers to be vaccinated, also warn about a casual attitude towards food hygiene by westerners and in particular eating at Thai street food locations often savouring exotic dishes for shock selfies to send home. Coupled with the hot weather that accelerates bacterial growth, it is a truth that tourists and travelers are more likely to consume unsafely prepared food in the country. It is not hard in Thailand to catch the sight of mom-and-pop food stalls that sell mouth-watering food cooked hours ago and left uncovered, attracting both tourists and swarms of flies. However, even restaurants that offer western dishes can be a particular and even more dangerous source of food poisoning as some Thais lack expertise in cooking those dishes and are prone to make mistakes. Travel forums like TripAdvisor are full of accounts in which some tourists eat nothing other than bacon, eggs and bread at the hotel, yet they end up in the hospital for stomach sickness and nausea.

Sheer numbers of Thai food outlets make caution necessary for for foreigners

Although it is a government priority in Thailand to improve food traceability and security, it is not yet up to western standards. Even when standards have improved, it will still be difficult to police the sheer numbers of Thai food vendors. Thailand is a unique country where most people eat out regularly and there are huge numbers of food outlets. The many food stalls and restaurants selling unsafe food are not held accountable yet, tourists take the matter of protecting themselves from food poisoning into their own hands. News of places that attract a lot of locals spread fast from one online travel forum to the next as their popularity guarantees their food safety. This is how some western foreigners combat the threat. Flies also become an indicator of food hygiene. The more flies a food vendor has, the more likely it should be given a wide berth. Wet-wipes and hand sanitizers have become a valuable asset for street food lovers as they can be used to kill most of the harmful bacteria. While this may sound silly, western tourists are constantly reminding each other of washing their hands regularly, especially before eating. Although this is the ubiquitous sanity advice in the West, quite a lot travelers fail to follow it in Thailand, even after touching rubbish bins.

Supporters of Thai food fayre says western hygiene may be the real problem

Tourists who love Thailand (and they are many and an increasing number) and relish the Thai food experience tend to dismiss most self-described food poisoning cases as a temporary failure to get accustomed to the local food. Though famous, Thai cuisine is very different from that of the western world (remember how spicy it is?) so it may take some days and stomach aches to adjust but some tourists can easily mistake such mild symptoms for food poisoning. Some people even go further by criticizing western hygiene standards as draconian and weakening the body’s ability to fight bacteria and other harmful agents. Coming to Thailand from the sterile environment of the West, foreigners are understandably more prone to be affected by health conditions that the local population are immune to. Some expats argue that exposure to Thai street food can put a beneficial stress on the digestive system, making it stronger and less susceptible to pathogens.

Thai school students struck by severe food poisoning

However, it still holds true that the danger is real, and even Thai people fall prey to food poisoning. Recently, 70 primary students in Pattaya had to be admitted to the hospital for food poisoning after having lunch at school. Unlike similar cases, the food was prepared by the school staff with the ingredients bought at a local Pattaya market. An investigation into the preparation process was ordered. It is not known yet whether the school board will be penalized for the incident or not.

Advice from a leading Thai hospital and resident expat

Bumrungrad International Hospital in Bangkok is one of Thailand’s most famous hospitals and visited by thousands of foreigners each year seeking premium medical treatment as well as expats living in the Bangkok area. The hospital describes the symptoms of food poisoning which kick in about seven to eight hours of ingesting contaminated food as abdominal cramps, diarrhea, nausea, severe headaches, dizziness and a loss of appetite. The hospital recommends that those experiencing the symptoms take fluids and eat simple food such a bread or crackers. They recommend seeking a doctor if the symptoms persist after two days. For foreigners visiting Thailand, a tip is to seek a pharmacy where special medication can be obtained that targets bacteria or pathogens in the gut. It is advisable to be sure that the pharmacy and the drugs purchased are reliable and safe. ‘I had a friend in Samui last weekend who bought this magic bottle and had it with a bottle of Singha beer while watching a football match on TV, somewhere before half time the food poisoning was long forgotten,’ say James Morris an international commentator in Bangkok.

If the food poisoning gets serious

Severe food poisoning is a life threatening medical emergency and caution should always be taken. Bumrungrad Hospital warns that if symptoms persist for three days then its critical to seek medical attention. Other aggravating system may include a very high temperature, extreme dizziness, inability to speak, hear or see properly as well as a inability to pass urine or digest foods. While many seasoned visitors to Thailand dismiss the threat as often simply a change of climate and cuisine causing an upset stomach, there are very real dangers from bacteria and viruses caused by poor hygiene in Thailand. It is advisable to be vaccinated against Hepatitis A and typhoid before visiting Thailand. There are also common sense precautions that foreigners can take such as being careful to observe how food is prepared and to be selective about food choices