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    Influenza exhibits a seasonal pattern with peaks occurring from June through September, overlapping with the typical rainy season. Based on data from US-bound refugees, the prevalence of hepatitis B infection in Burma is high. Hepatitis B vaccination is recommended for most travelers before departure, especially those who might engage in activities that increase risk to body fluid exposure, such as unprotected sexual contact, injection drug use, tattooing, or providing medical care. Typhoid and other diseases transmitted by contaminated food and water are common, and typhoid vaccine is recommended. Rabies vaccination is recommended for travelers participating in extensive outdoor activities, such as camping or caving, that could increase their risk of animal bites. Vaccination is also recommended for travelers working with animals, such as veterinarians, and for young children, for whom it can be difficult to prevent interaction with dogs or other animals. Malaria and Other Vectorborne Diseases Malaria is present in all areas of Burma below altitudes of 3, ft 1, m , including Bagan, and the risk to travelers is considered moderate. The incidence of malaria in Burma is higher than that of neighboring countries in the Greater Mekong Subregion and is concentrated in and around forested areas. Drug-resistant malaria has been and continues to be a concern in Burma, and chemoprophylaxis recommendations vary accordingly. For travelers to Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi, atovaquone-proguanil or doxycycline is recommended but not mefloquine; for other malaria risk areas, atovaquone-proguanil, doxycycline, or mefloquine can be used.

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    Very thanks you all. My main purpose is just to help all our students. Log In. Leptospirosis Leptospirosis is a bacterial disease usually transmitted through contact with water contaminated with the urine of infected animals see Chapter 3, Leptospirosis. It occurs most commonly during the rainy season. Travelers should avoid contact with soil and water that could be contaminated, and cover any open wounds to prevent exposure. Skin wounds that have been contaminated with soil or water should be immediately and thoroughly cleaned.

    Travelers should follow safe food and water recommendations, including eating food that is cooked and served hot and drinking only bottled water. Oral rehydration solution is helpful in severe cases of diarrhea and is usually available in pharmacies.

    Visitors should use only reputable taxi or public transportation companies and always wear seat belts. Motorcycles account for a high percentage of road traffic deaths and should be avoided.

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    Pedestrians and bicyclists are also commonly victims of road traffic deaths and should exercise caution; right-of-way rules and infrastructure improvements such as crosswalks or bike lanes to protect these groups are often not followed or not in place. Prolonged heat exposure, especially for travelers in poor physical condition, elderly or very young travelers, and those not accustomed to heat, poses a risk for heat-related illnesses such as heat exhaustion or heat stroke.

    International-standard medical care is rarely available, so treatment of chronic disease exacerbations or severe injuries can be suboptimal. Travelers should strongly consider medical evacuation insurance. The World FactBook: Burma. Central Intelligence Agency; [updated Sep. Melioidosis: epidemiology, pathophysiology, and management.

    Clin Microbiol Rev. Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop. Epidemiology of human influenza A and B viruses in Myanmar from to Intervirology ;52 6 — Infectious diseases related to travel.

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