Cold or flu? Respiratory issues in thailand

[Elkski]

This is my 8th trip to LOS. About 7 months total. 2 previous trips I lost 4-5 days due to a respiratory issue.  One time I think I got something in bkk while on a tuk tuk in the rain or was it the mouldy smelling room aircon?.  One time I ruined 4 days on koh samui.  Missed out on diving.   Just layed around resort for 3 days.  Both times  much fluid from sinus and lungs.  Green and yellow.   Both times a zpack cured me.  Results dramatic by day 2. Azitheomycin 500 mg day 1 then 250 mg for 4 days. 

This trip I waa in bkk.   Got the scratchy throat feel then swollen glands. Not much sinus  drainage at first.  Did get a cough.  Some fever and muscle aches and Tired. Clear fluid so far.  Not coughing up much and fluids clear this time.  Seems to be getting  better.

Why do I get these? I travel with a zpack  now but didnt use it this time.

I had the flu shot in USA a month ago.  Is this flu or did I get a cold in Thailand?  Haha 

 

Edited January 6, 2020 by Elkski

[Nyezhov]

Overcomsumption of Antiobitcs to cure a viral infection is not quite reccomended to put it mildly. If you dont havce a bacterial infection (nasty green sinus snot or lung butter), just let it run its course and lay off the Zpaks. It is quite [ossible to catch a cold here in Thailand, however, proper handwashing like in the West goes a long way to keeping you healthy.

 

 

[Elkski]

Yes I am aware of a antibiotic overuse.  That's why I held off.  One time I was coughing up much green fluid I could hardly  breath.  

Maybe its the sweating then going on cold bts rides  or into cold malls.  I will wash my hands more.  Cleanliness, proper storage temperatures and clean hands and surfaces in Thailand  are scary.  

[impulse]

I found it to be allergies.  I'm allergic to mold, mildew and lots of other stuff that grows in the tropics.  Sinus drainage eventually caused infections and it turned into bronchitis.  I'd leave for the cold, clean air of northern China and it would clear up after a week or so.  (Yes, that's sarcasm.  It's cold in N China, but the air ain't clean)

 

I got to love my Neti pot when I lived in BKK.

 

[Nyezhov]

1 hour ago, Elkski said:

clean hands

Thats the only thing you can actually control. Keep your hands clean and order extra chili. You will live.

[Elkski]

Thailand  is unique.  Clean hands you  say.   3 nights in the village.   Nice to have cooler weather.  Knock on wood but I appear to have survived the food.  But gf and of course me avoids the rotten fish in her somtom at advice from  bkk doctor.  How do these people survive eating the raw whole shrimp and squid and shell snail things.  I understand cooking finely diced seafood in line juice  aka ceviche like in Mexico.     

[xylophone]

2 hours ago, Nyezhov said:

Overcomsumption of Antiobitcs to cure a viral infection is not quite reccomended to put it mildly. If you dont havce a bacterial infection (nasty green sinus snot or lung butter), just let it run its course and lay off the Zpaks. It is quite [ossible to catch a cold here in Thailand, however, proper handwashing like in the West goes a long way to keeping you healthy.

 

 

Agree that it is of no use whatsoever, and can be dangerous, to take antibiotics for a viral infection, so I stick by that.

 

Not unlike the OP, I had a scratchy throat, sinus problems, constant headaches and felt lousy and sometimes very tired, and thought it to be viral, so just left it and took plenty of fluids and the occasional paracetamol.

 

This went on for a few weeks until the phlegm became gross and dark grey, and I also lost my voice and thought that I might have a low level bacterial infection, so I got onto the amoxicillin for seven days, and after three days felt a lot better and now the symptoms have gone completely.

 

So it's sometimes hard to differentiate between what is viral and what isn't, but leaving something for a few weeks and not getting any respite, I felt I had to take some other action, which fortunately worked.

 

Like another poster has said, I am a great believer in azithromycin, however only turn to it when I feel it's really necessary.

And just to add to that I, have noticed there have been a lot of people suffering from this sort of thing over the past couple of months, both Thai and tourists alike, and I wondered if it initially is triggered by some sort of allergic reaction which then irritates nasal and throat passages, and can leave one susceptible to an infection.

[Elkski]

I agree with the last post.  I was going to suffer for 4-5 days and wait for off color fluid or worsening of sinus or lung issues before antibiotics.  I guess you can go to a hospital for a swab test?  This time I seem to have improved.    It is no fun to wait when you have had the miracle improvements  like I have With a zpack. 

[Sheryl]

It is quite common for newcomers to Thailand (or anywhere else in Asia) to get a lot of respiratory viruses, this is because you have no immunity to local bugs. People who move here full time are often sick quite a  lot for the first few years for this reason.

 

Think of all the colds and flu you had in your life back home, from childhood onward. Each of these left you with immunity to that particular viral strain. Now you come here where are the strains are at least a little different and you have to start to acquire immunity all over again.

 

Flu is an altogether different strain and season here than in the US.

 

In addition air pollution in some parts of Thailand (including Bangkok and Chiang Mai) is quite bad and this can irritate the respiratory tract and predispose to infection.

 

In addition to careful and frequent handwashing I suggest:

 

1- avoid tuk tuks and motorcylce taxis, exposes you directly to a lot of fumes. take taxis. Grab works here or you can flag one down.

 

2- take Redoxan (Vitamin C plus zinc, effervescent orange tablets you put in water) daily while here. Any pharmacy has it. Alos, bring some Zinc throat lozenges with you from US, they are hard to come by here.

 

3- Get flu shot if you are here between May - November which is the local flu season. It is a different vaccine than in the US, it is "Southern Hemisphere". You may be able to get it at a travel clinic in US, be sure to specify Southern Hemisphere. Otherwise get as soon as you arrive.

 

4- Anywhere you stay, immediately on checking in remove the a/c filter and clean it. Maintainence is poor here and you will often find the filter is filthy.

 

5- consider wearing a face mask if walking much in Bangkok or Chiang Mai or other congested areas.

[stephenterry]

If you're suffering, and consuming meat, fish, dairy and eggs, you're at risk of bacterial and viral diseases more often than being on a WFPB nutrition regime. That's a scientific fact established for decades, because your immune system is not at its optimum strength.

 

However, I would also take antibiotics in the event I was spewing up green globs as it would be clear that the body's natural defences need help to destroy the harmful gut bacteria. As for viruses like flu, antibiotics don't work and are unnecessary.  

[Elkski]

Thanks Sheryl 

I have banned tuk tuks.  It was stupid to use a tuk tuk during  a first rain in bkk in weeks.  Just imagine what was airborne off the streets.  I will wear my  n95 masks more in bkk

Edited January 6, 2020 by Elkski

[Sheryl]

WFPB (whole -foods, plant-based) diets, if done properly (enough balanced proteins)  are certainly healthful.  No question there. But many people are not prepared to follow this. And it is possible to eat a balanced diet otherwise.

 

I do not think OP's problem -- which is quite common to newcomers here -- is related to diet unless he is seriously run down from lack of nutrients.

 

The problem is not what is being ingested as food. It is what is being breathed in -- virus he has no prior exposure to, pollution particles etc.

[OneMoreFarang]

I have sometimes problems with the air pollution mostly when I lay down or sleep. Then my throat hurts and I have to cough many times.

I visited the doctor and he prescribed NAC Long 600mg. That seems to make this a lot better.

As far as I know that medicine is available without prescription. 

 

[Speedo1968]

If you travel by minibus you will often notice the roofs are black inside.    Such buses can have a distinct smell.    This is from protein dust and can be loaded with bacteria.    On larger buses this may not be noticeable but that does not mean it is not there.     Rainy season travel can add to such problems.

When ever I travel by local buses or minibus I chew a High C tablet beforehand.    

Alternatively, where possible I travel by train, normal or third class, cheaper and the air fresher !

[ehs818]

I have chronic Bronchitis and use AMK whenever I feel symptoms. It's Amoxicillin and Clauvulanic Acid. For a variety of respiratory ailments. Check it out, Google first and you can them find it at any pharmacy.

[Laza 45]

5 hours ago, Elkski said:

Yes I am aware of a antibiotic overuse.  That's why I held off.  One time I was coughing up much green fluid I could hardly  breath.  

Maybe its the sweating then going on cold bts rides  or into cold malls.  I will wash my hands more.  Cleanliness, proper storage temperatures and clean hands and surfaces in Thailand  are scary.  

If you are coughing up green phlegm that is a sign of secondary bacterial infection.. the right antibiotic should help clear that.. antibiotics don't work on viruses..  I think we get these things while traveling on airplanes.. Incubation & treatment of symptoms..

https://www.healthline.com/health/incubation-period-for-cold#early-treatments

 

[Elkski]

I'm pretty sure my diet is fine. I did have a few late nights , 1 was NYE,  prior to the onset of first symptoms.  I find it hard to sleep in late so I was probably tired. 

 

 

This time fluid stayed clear. And sinus are open again. 

But 2 times before an amazing color of green.  

Edited January 6, 2020 by Elkski

[justin case]

look up, the effects of 3-5 flu shots (in a row, one per year) and your risks for getting more C.

[NoBrainer]

6 hours ago, Elkski said:

Yes I am aware of a antibiotic overuse.  That's why I held off.  One time I was coughing up much green fluid I could hardly  breath.  

Maybe its the sweating then going on cold bts rides  or into cold malls.  I will wash my hands more.  Cleanliness, proper storage temperatures and clean hands and surfaces in Thailand  are scary.  

 

It's probably just your body shocked by the high levels of pollutants in the air when you arrive.

 

Takes a few days to get used to breathing the particles that are mixed with the air.

[4MyEgo]

4 hours ago, xylophone said:

so I got onto the amoxicillin for seven days, and after three days felt a lot better and now the symptoms have gone completely.

You have to have your wits about you, and keep an eye on how things are going, too long is not good, as ended up with a severe chest infection last time I got this, and thought I could beat it, no chance, learnt fast as I was nearly on my deathbed, as two doses of antibiotics didn't do Jack, in then came the heavy duty stuff and steroid puffer, sorted.

 

4 hours ago, xylophone said:

And just to add to that I, have noticed there have been a lot of people suffering from this sort of thing over the past couple of months, both Thai and tourists alike, and I wondered if it initially is triggered by some sort of allergic reaction which then irritates nasal and throat passages, and can leave one susceptible to an infection.

Yes it's getting around at the moment, littles ones had it, I have had it, wife has had it, we still have the cough and I hear one of the boys at the moment. I suspect the PM2.5 levels have been higher than normal post New Year and we all being exposed to it end up with some kind of bronchitis as it lingers, but we are all clear phlegm at the moment and feel ok apart from bouts of that spider web in the mouth feeling, fortunately no antibiotics, just rest, and keeping clean and away from smoke.

Edited January 6, 2020 by 4MyEgo

[orchis]

was riding the bts and mrt around christmas, got a very bad cold, every country's tourists seemed to bring their own strand of virus. i think that particularly adds to the situation in bangkok.

[30la]

Well there are many possibilities, the air conditioning is too high, walking in the rain without adequate clothing, swimming in the sea and you do not notice the cool breeze that occasionally pulls and many others.
You seem delicate and inclined to take these ailments, pay more attention!

[DogNo1]

I think that our hotel air conditioners probably have mold, mildew and fungi lurking in their dark recesses.  I have my air filters changed frequently but they are not HEPA filters.  I've never seen anyone crawl into the spaces where the cool air emanates from and clean them.  To kill the mold and mildew, I spray my rooms thoroughly with isopropyl alcohol every night.  I wish my bedroom didn't have a carpet!  When I get a persistent cough, I don't take an antibiotic until the mucus turns yellow.  When it does, I take a ten-day course of Avelox.  I usually feel better in three days but I take the full ten-day course.  At my advanced age, I don't want to risk pneumonia.  It doesn't seem possible to escape allergens unless you live in a clean room like Howard Hughes did.

[Captain 776]

I just had 13 days of the worst chest cold / lung infection of my life.

Usually the air quality doesn’t bother me and I have never smoked.

When I had before I took Azithromycin and Prednisone and 2-4 das back to OK.

Noth this time.......I ended up in E R because I couldn’t breathe

[DogNo1]

If you read the enclosure in the Avelox box, it claims to be more effective than Aizithromycin.  It's also more expensive and made by Bayer.

[Mangkhut]

I have travelled quite a lot around in Thailand and in other SEAsian contries. And damned you almost on every of my first trips I got this cold/flu-ish symptoms. Coughing in the mornings, sore throat, a tiny bit of fever, reduced general condition/not well being, feeling fatigued etc etc. Not really very sick but still far from 100 %. And this went on and on forever. It usually took 3-4 weeks to get back to normal. 
At one stage when getting back to Europe after a several weeks trip in SEAsia and with symptoms almost the same length (and I tried normal penicillin for a few days but I did not respond at all to that) I researched a bit and found out about «atypical pneumonia» https://www.medicalnewstoday.com/articles/317957.php

This infection is caused by other bacterias than the normal ones, often Mycoplasma or Chlamydia species.

I went to my GP and told him about my experiences and symptoms and suggested that I might had this atypical pneumonia. He agreed and since I have had symptoms for 3-4 weeks he prescribed me a macrolipid antibiotica (Azithromycin) And after just a few hours after the first pill I felt better. After 2-3 days I was 99,5 % well. 
So nowadays if I get similar symptoms when travelling or staying in Asia and if it lasts more than 4-5 days I have no doubt what do. Get the right antibiotics and take them. 
 

Now I dont say or advice others to the same if you have the same symptoms - but go to see a doctor if possible and if you have these same symptoms that just keep on appearing and you dont get any better - it could be atypical pneumonia. Mention that for your doctor, and he or she will hopefully consider that. 

[xylophone]

6 minutes ago, DogNo1 said:

If you read the enclosure in the Avelox box, it claims to be more effective than Aizithromycin.  It's also more expensive and made by Bayer.

It's also antibiotic which belongs to the quinolone range, and they have some nasty side-effects, especially as one gets older.

 

And some of these side effects are irreversible!! I've been on the receiving end of torn tendons because of this drug and it appears that in some cases it can affect the valves in the heart.

 

I would never take this or any other quinolone, no matter how much I was suffering, and anyway there are other comparable antibiotics out there which don't have these side effects.

 

2 hours ago, NoBrainer said:

It's probably just your body shocked by the high levels of pollutants in the air when you arrive.

 

Well I have lived here full time almost 13 years now and for the past few years have been getting the same thing, with headache, sinus problems, tickly throat and a chesty cough, not to mention the fact that I feel like <deleted>. 

 

In fact I ended up in hospital with pneumonia as a result of this "affliction" getting the best of me, so five days flat on my back and on a drip, plus the awful hospital food, made me take more positive action this time and I took amoxicillin before I felt too rough with it. So far so good.

 

Whatever it is, it hasn't allowed me to build up any immunity to it whatsoever!

 

One thing I forgot to mention in another post was that as well as the Aerius antihistamines, and the amoxicillin, I also used Nasonex on a regular basis and the combination seems to have done the trick.

[The Theory]

It is all about immunity. If you drink alcohol everyday then it is the time to  reduce it. 

[Onrai]

I got Bronchitis in Africa 45 years ago. Apparently it is very common when you go from 0% humidity ( Sahara desert) to 90-100% humidity (Mali). I had a bout of bronchitis every year for the next 20 years and then it miraculously cured itself. No bronchial issues for years. 

Then I come to South East Asia and I am plagued by bronchial/ lung problems. I attribute it to going from very hot air outside to ,say a 7-11, where they blast the air conditioning just above the door. My throat almost instantaneously fills with a large glob of phlegm. It so unsettling to suddenly being choked with phlegm. My guess is it a mechanism to protect my bronchial passages. I have been sick half a dozen times and have been taking Acetin (Mucolytic) to break up the congestion. I  wear something around my neck almost constantly to avoid any draft or cold air on my neck. I can’t speak for others but the hot air to cold air conditioning is a killer for me.

[DogNo1]

Thanks for the warning about Avelox.  I certainly don't want a torn ligament or tendon.  I'll try Aizithromycin the next time I need an antibiotic.

 

Just curious - did you do anything special to get the torn ligament?