Bangladesh Medical Travel Information

Medical Facilities and Health Information The general level of sanitation and health care in Bangladesh are far below U.S. and European standards. There is limited ambulance service in Bangladesh and attendants seldom are trained to provide the level of care seen in the United States. Traffic congestion and lack of modern centralized emergency services system (on par with 911 in the U.S.) makes patient transport slow and inefficient. Several hospitals in Dhaka (e.g., United, Apollo, and Square Hospitals) have emergency rooms that are equipped at the level of a community hospital, but most expatriates leave the country for all but the simplest medical procedures. Hospitals in the provinces are less well-equipped and supplied. Psychological and psychiatric services are limited throughout Bangladesh. There have been reports of counterfeit medications within the country, but medication from major pharmacies and hospitals is generally reliable. Medical evacuations to Bangkok or Singapore are often necessary for serious conditions or surgical procedures and can cost thousands of dollars. See the Medical Insurance section below for useful information.

Despite government efforts, community sanitation and public health programs are inadequate in Bangladesh. Water supplies in Bangladesh are generally not potable. Typhoid fever, cholera, infectious hepatitis, giardia, cyclospora, and bacillary and amebic dysentery are only a few of the serious diseases transmitted by impure drinking water. Bottled drinking water, especially major brands, is generally safe for consumption. Fecal-oral contamination is common; improperly prepared meat and improperly cleaned vegetables can lead to food-borne illnesses such as cysticercosis, meurocysticercosis, and campylobacteriosis plus hepatitis A, B, C, and E. Press reports indicate that fish and other raw foods are frequently treated with formalin to slow decomposition, that fruits, particularly bananas, are generally treated with chemicals to speed ripening, that milk products are adulterated with melamine, and vegetables tend to show elevated levels of arsenic due to contaminated groundwater. Washing, soaking, peeling, and thoroughly cooking food are mandatory procedures to minimize chemical, insecticide, bacterial, and parasitic contamination.

Multiple strains of influenza continue to circulate annually in Bangladesh including H1N1 influenza A pandemic strain. Peak influenza circulation occurs during the rainy season, approximately May through October. CDC recommends a yearly flu vaccine as the first and most important step in protecting against the most common influenza viruses (seasonal flu). For more information about seasonal influenza, please refer to the CDC’s seasonal Flu website.

Highly pathogenic avian influenza A virus H5N1 (Bird flu) has been circulating among poultry in the country since 2007 and outbreaks continue to occur nationwide. The most recent outbreak occurred in October 2012. In response to the ongoing circulation of H5N1 in the country, the government has planned to start a pilot H5N1 vaccination program among domestic poultry. There are concerns from a human health perspective about the use of poultry vaccine which minimizes signs of illness in the birds but does not confer sterilizing immunity, as we could have silent circulation of the virus in the birds, with continued human exposure. The US Center for Disease Control (CDC) is reviewing its current surveillance platforms with a plan to increase its monitoring of H5N1 circulation among healthy looking birds sold in markets. Although avian influenza A viruses usually do not infect humans, rare cases of human infection with avian influenza A viruses have been reported, most often following direct or close contact with infected poultry. As Bangladesh continues to be affected by H5N1, it is recommended to avoid poultry farms, contact with birds in live food markets, and to avoid consumption of poultry products that are not thoroughly cooked. For information on avian influenza (bird flu), please refer to the Department of State's Avian Influenza Fact Sheet.

Any questions or concerns about influenza or other illnesses should be directed to a medical professional. Although the Embassy cannot provide medical advice or provide medical services to the public, a list of hospitals and doctors in Dhaka can be found on the Embassy website.

Dengue fever, a mosquito-borne illness, is prevalent in Dhaka and surrounding areas, in particular from October through March, but can happen at any time of year. Prevention is key, as there is no vaccine or treatment once infected. Malaria is a problem in the surrounding areas outside Dhaka. If you are planning to travel outside Dhaka, consider starting prophylaxis medication prior to travel. Japanese B encephalitis, also a mosquito-borne disease, is a problem throughout Bangladesh, although less so in Dhaka. While there is no specific treatment for Japanese encephalitis, there is a recommended vaccine available. Chikungunya was found in Bangladesh in 2008, and this mosquito-borne illness is slowly making headway throughout the country, including in Dhaka. No vaccine or specific treatment exists for Chikungunya. In all areas, use of mosquito repellent and bed nets are strongly recommended to help prevent mosquito-borne diseases.

In 2009 and 2010, there were multiple outbreaks of anthrax in rural communities in Bangladesh among persons who slaughtered sick animals. Individuals who avoid this activity are not at risk. Though a small risk still exists of consuming anthrax-infected meat, human vaccination against anthrax is not recommended. Rabies is a more serious problem, with several thousand dying yearly in Bangladesh from this endemic disease, generally passed on via bites from infected dogs. Seek prophylactic advice from your health-care practitioner before coming to Bangladesh, and seek immediate medical attention if bitten by any animal.

According to the World Health Organization, Bangladesh has also seen cases of polio, nipah virus, and Kala-Azar, (visceral leishmaniasis). Kala-Azar is a deadly disease caused by a parasitic protozoa, leishmaniadonovani, transmitted to humans by the bite of infected female sandflies, phlebotomusargentipes, which lowers immunity, causes persistent fever, anemia, liver and spleen enlargement, loss of body weight and if left untreated, kills.

Tuberculosis (TB) is a major public health problem and endemic in Bangladesh. In 2012, the World Health Organization (WHO) ranked Bangladesh seventh among the world’s 22 high-burden TB countries. The prevalence of multi-drug resistant tuberculosis is relatively low, but a recent WHO report suggests the rate of MDR-TB is increasing in the country.
Drinking Water Source - percent of rural population improved 84.4%
Drinking Water Source - percent of total population unimproved 15.2%
Drinking Water Source - percent of urban population improved 85.8%
HIV/AIDS - adult prevalence rate 0.1%
Hospital Bed Density - beds/1,000 population .6
People Living with HIV/AIDS 6,300
Physicians Density - physicians/1,000 population .36
Diseases - note highly pathogenic H5N1 avian influenza has been identified in this country; it poses a negligible risk with extremely rare cases possible among US citizens who have close contact with birds
Sanitation Facility Access - percent of total population unimproved 43%
Sanitation Facility Access - percent of urban population improved 55.2%
Sanitation Facitlity Access - percent of rural population improved 57.8%
Major Infectious Diseases - degree of risk high
Animal Contact Disease (s) rabies
Food or Waterborne Disease (s) bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever
Vectorborne Disease (s) dengue fever and malaria are high risks in some locations
Water contact disease (s) leptospirosis

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