How not to get sick on holiday in Thailand

[uncle tom]

When I first visited Thailand I would consider it an achievement if I went fourteen days without going down with some form of sickness. This year however, I went eleven weeks without getting ill once, and a trip of similar length last year was equally successful.

So I thought I'd share my personal dos and donts on the gastronomic front:

1) I trust Thai food. Don't assume that all Thai dishes are extremely spicy. There is a huge variation in tastes across the country and a Thai chef expects to receive instruction from his customers as to how spicy they want their food. You are not committing some heinous faux pas against Thai culture if you specify 'no spicy'.

2) I don't trust burgers - and the biggest burger chains are amongst the worst offenders. Thais achieve food hygiene their own way, and it doesn't fit well with western cooking requirements.

3) I do trust street vendors. Their carts may look a bit grimy, but they buy their food fresh from the market every day and then tour the streets until they've sold out. Stuff doesn't have time to go bad.

4) I avoid eggs unless very fully cooked. It's a theoretical salmonella hazard, I may be over cautious.

5) I enjoy the fruit. Buy from the street vendors, but stand clear as they wield the small machetes they use to prepare it. The vitamin C you get from eating it may well enhance your body's defences.

6) From bitter past experience, pies are to be avoided, but sausages can be indulged with caution - make sure they are really well cooked though.

7) Indian restaurants do not have a very good reputation. It may be that with a through flow of tourists who rarely become regulars, some of them don't take as much care as they should. And besides, why go for a ruby when there's ethnic Thai to be had?

[oakdale160]

There is no doubt that after long stays here you develop resistance against local bugs but the tourist and short time stayers have more problems.
Extra tips--- When buying street food go to a BUSY vendor, you may have to wait in a line-up but the food is likely to be fresher as there is a quick turnover.
MIcrowave is great for killing bacteria, they just explode. Even if you are cooking chicken other ways, wash and give it at least 90 secs in the MW first. then wash again.

[uncle tom]

There is no doubt that after long stays here you develop resistance against local bugs but the tourist and short time stayers have more problems.

Has anyone ever done a proper medical study of the 'Delhi belly' experience? - is it just that visitors are a bit careless and not wised up - or are there really local bugs in local places..?

[caller]

1) I trust Thai food. Don't assume that all Thai dishes are extremely spicy.

I like spicy!

2) I don't trust burgers - and the biggest burger chains are amongst the worst offenders.

I have never had an issue with a burger here - whether from a western chain, a Thai chain, local chains, ordered in local restaurants or bought frozen. You say you don't trust them, but have you experienced problems?


5) I enjoy the fruit. Buy from the street vendors, but stand clear as they wield the small machetes they use to prepare it. The vitamin C you get from eating it may well enhance your body's defences.

Something I leave to the other half, apart from local farmers selling direct, pineapple for example.

6) From bitter past experience, pies are to be avoided, but sausages can be indulged with caution - make sure they are really well cooked though.

I never eat such food out, but I buy pies and sausages from HHH&B and other sources (for pies) and never had any issues. I think it's something I would generally avoid from Thai places and would want to know the source from Western places.

7) Indian restaurants do not have a very good reputation.

Is that right? I have been to two. The place opposite the Hilton that was pricey but excellent and another place in Poonsuk that wasn't, but no problems health wise. I far prefer Indian curries to Thai one's and there are folk on here who are real devotees of some of the local curry houses.

Still, interesting to see what works for you. But I really feel it will be a horses for courses type of thing!

[HHTel]

There is no doubt that after long stays here you develop resistance against local bugs but the tourist and short time stayers have more problems.

Has anyone ever done a proper medical study of the 'Delhi belly' experience? - is it just that visitors are a bit careless and not wised up - or are there really local bugs in local places..?

It's not restricted to foreign visitors. Local Thais get 'Delhi Belly' probably just as much as we do. They come to expect it once in a while.

[Takiap]

Well, ever since I first set foot in Thailand back in 1997, I have only had food poisoning once, and I'm inclined to think it was caused by seafood at a Japanese restaurant in Bangkok.

Diarrhea I've had a few times, probably once a year in general, but of course that can be caused by any number of thing rather than from food alone. I very rarely eat out. I do all the cooking at home, which mean my kids and I are eating the exact same thing. There have been times when I get the runs, whereas my kids don't, or one of them do, but the rest of us don't. This obviously suggests that the runs can be cause by other things, including a dirty glass in a bar, or perhaps a contaminated beer bottle if drinking straight from the bottle.

During my first ten or so years here I ate out all the time and never had any more issues than I have now. Maybe I just have a strong stomach, but to be honest, I am inclined to think that many from the West are a bit paranoid about food hygiene.


Uncle Tom, I think you worry too much about salmonella from eggs lol. I've been eating carbonara for years, the authentic Italian way which calls for raw eggs and I have never had a problem.

[handdrummer]

Everything depends on the quantity and quality of the bacteria in your gut. If you're healthy and producing a sufficient quantity of good bacteria, unless the food is contaminated, chances are you won't get sick. I no longer eat raw animals: meat, fish, seafood, eggs. They aren't safe anywhere these days. There's too much pollution in the water and chemicals in the feed. Once you've cooked the food it will be safe to eat. You can eat a cup of yoghurt a day to grow bacteria &/or you can take digestive enzymes. Beware of salads in restaurants. They wash the vegetables in tap water and sometimes the vegetables aren't fresh. My wife had some cucumber that was off and has been ill for 2 days.

[MLS]

oakdale160, I understood the current food safety thinking is not to wash raw chicken.
Also I find that chain breast meat, even if only initially zapped in a microwave oven, tends to go rubbery. (I’m seeing Benny Hill say that now.)

[uncle tom]

Caller said:

I have never had an issue with a burger here - whether from a western chain, a Thai chain, local chains, ordered in local restaurants or bought frozen. You say you don't trust them, but have you experienced problems?

I certainly have had problems with burgers in the past and many others have too - I regard it as the riskiest thing to eat in the LoS.

Takiap said:

I think you worry too much about salmonella from eggs lol. I've been eating carbonara for years, the authentic Italian way which calls for raw eggs and I have never had a problem

It's one of those areas where you just don't know. It might be that the yard reared hens in Thailand are completely safe, but the only eggs I've seen eaten by Thais are very well cooked, so it seems prudent to be cautious.

[caller]

Caller said:

I have never had an issue with a burger here - whether from a western chain, a Thai chain, local chains, ordered in local restaurants or bought frozen. You say you don't trust them, but have you experienced problems?

I certainly have had problems with burgers in the past and many others have too - I regard it as the riskiest thing to eat in the LoS.

First I have heard of it. How do you and they know it was a burger? Care to name and shame?

[uncle tom]

Care to name and shame?

Worst offender, both from personal experience and anecdotally in HH, is Burger King..

[MDMK]

Years ago I had to go to hospital in Pattaya and the doc treating me said the biggest risk to tourists in Thailand were scooters, alcohol and bitey grabby monkeys. I don't know though if he was quoting serious statistics or just making polite conversation and flippant remarks. I could believe alcohol related injuries and scooter injuries are very high up the list though, and they have the potential to be a lot more serious than 48 hrs on the shits. Though granted the shits sure ain't fun either. I've also seen some hideous cases of sunburn that even half an ounce of common sense would have prevented.

One thing I would add to the list above is hand sanitizer gel, the money has got better (cleaner, more new notes, not so many old decrepit notes) over the last 2 and half decades, it used to scream DISEASE at me it was so dirty, and it smelled awful. But I still wipe my hands with santizer after I have handled notes and go to eat or drink something.

[J.J.B.]

Caller said:

I have never had an issue with a burger here - whether from a western chain, a Thai chain, local chains, ordered in local restaurants or bought frozen. You say you don't trust them, but have you experienced problems?

I certainly have had problems with burgers in the past and many others have too - I regard it as the riskiest thing to eat in the LoS.

First I have heard of it. How do you and they know it was a burger? Care to name and shame?

Burgers are a surprise to me too. Steak tartare/‘filet Américain’ are firm favourites and much more common than raw chicken. Burgers are generally cooked through and provided they reach over 45°C for a minute or so should be devoid of any bugs that would bother us. Could it be a poorly-washed lettuce leaf or weeks old mayonnaise that’s a more likely culprit? Personally, a BintaBurger is amongst the best I’ve tasted and always cooked with great care.

[egiljohann]

I have been sick of food poisoning two times in my time in Thailand since 1991. Both times as a tourist. First time on a buffet in Shangri La hotel in Bangkok. I was there with the tour company and ate chusie. Number two was in Hua Hin on a T-bone steak that's probably been in the fridge way too long before cooking. After moving here in 2003 I'd never had a problem. I guess as other have stated my stomach's changed over the time here in Thailand, and now I can eat like a dog with no problems.

[RCer]

I tend to go places filled with Thai's and few farangs.