Health Information for Travelers to Angeles

Thanks to JC, owner of Margarita Station in Angeles City -   for sending me this good information for use on this report. JC says:

For what it's worth, here is my revision after living here over 10 years and having worked with the medical staffs on Clark for years:

Food and waterborne diseases are the number one cause of illness in travelers. Travelers' diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout the region and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe.

Malaria is not a concern in Angeles City, Subic/Olongapao, Iba, San Fernando (La Union), or Manila. If you are planning on visiting some areas of the provinces, it is better to be safe and take mefloquine in advance. Prevent infection by taking prescription antimalaria drugs and protecting yourself against mosquito bites. Malaria risk exists all year in some remote cities and rural areas of the country.

Filariasis, Japanese encephalitis, and plague are diseases carried by insects that also occur in this region, but the risk to travelers is low. Protecting yourself against insect bites will help to prevent these diseases.

Do not swim in fresh water (except in well-chlorinated swimming pools ) in certain areas of the Philippines, to avoid infection with schistosomiasis.

Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively. Avoid travel at night if possible and always use seat belts.

To Stay Healthy, Do:
Wash hands often with soap and water.

Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks. The tube ice type ice cubes used in most bars are safe. Beware of low budget bars that use tap water in plastic bags to make ice. This is obvious when watching the bartender breaking ice with an ice pick for your drink. Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself.

Remember: boil it, cook it, peel it, or forget it. To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot. Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.

To Avoid Getting Sick:
Donít eat chicken feet, goat intestines, and other tempting street delicacies. Donít share needles with anyone. Donít play with monkeys (except the ones in bikinis). Donít swim in fresh water. Salt water is usually safer (warnings about La Union and Boracay).

What You Need To Bring with You:
Insect repellent containing DEET (diethylmethyltoluamide), in 30%-;35% strength for adults and 6%-10% for children. Over-the-counter antidiarrheal medicine to take if you have diarrhea. In Angeles at any pharmacy buy Fasigyn 2 grams, take as a single dose. Sunblock, sunglasses, hat.

Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).

After You Return Home:
If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area.

If you become ill after travel - even as long as a year after your trip - tell your doctor the areas you have visited.

Get a TB test within 4-6 months. TB rate is 10-25% in most areas of the Philippines.

Additional Health Comments By Dave
My biggest concern was be careful not to drink local water since I've read reports that until you get use to the bacteria you have a high risk of getting sick for a few days from it.  Even the bottled water from one of the local Angeles City water companies tested "Too Numerous to Count" in bacterial tests.  The local tap water is much worse.

I also knew that some of the better bars and places like Margarita Station and Kokomo's bought much higher cost premium water that was quite safe. Margarita Station even meets American standards for their kitchen area.

In bars I only had diet cokes and bottled water.  If a bar didn't have canned cokes I ordered without ice. I avoided all tap water, even brushing my teeth with bottled water from which all the hotels had plenty of in their minibars. 

In bars I tried to be cautious but not paranoid.  For example in some of the Makati bars the bargirls played the kiss and pass the ice in your mouth game which I did enjoy.

I avoided all street vender food, and never had any health problems.

As JC says if you do get sick from bad food or water the likely result is "tourist diarrhea", the drug of choice is Fasigyn taken 2 grams at a time (500mg pills x4). It works within hours and does not result in cramps and other problems often associated with Imodium or Lomitil. It is available in most drug stores in the Philippines or Thailand.

If you come down with something more severe (bleeding etc.), Cipro is the drug of choice. It is an antibiotic but will do nothing for just common diarrhea or upset stomach.

If you should need a physician or have a medical crisis, I understand Makati Medical Center is an outstanding hospital with private rooms and food service comparable to at least a four star hotel.  It has been reported that the medical care is outstanding and it has the latest sophisticated medical technology.

It has been reported that the "pits for medical care" is PGH in downtown Manila. Crowds of patients and lack of privacy yet a high quality of medical care.

Hopefully you will never need to know about the hospitals!

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