Hi All,

I am considering a trip to Thailand (Koh Samui, Ko Tao, Chiang Mai and potentially another island) with my girlfriend in about 10 days. She is EXTREMELY allergic to shellfish (shrimp, lobster, clams, oysters, mussels, etc).

I understand most thai dishes are made with fish sauce (usually including shrimp and other shellfish). We will obviously bring language cards noting her allergies, epi pen, etc - do you think this shellfish allergy will be a big problem?

I look forward to your responses.

There are a ton of different types and styles of fish sauce.

From the simple Tiparos to the stinky Pla Ra - it is best not to ever see how Pla Ra is made, trust me. Protesters have been known to put Pla Ra in thin plastic bags and throw them at enemies, as a sort of stink bomb.

They are typically added to preparations as the salt component, but also add some extra flavor profiles.

Most are made from, amazingly, fish, like Anchovy and salt.

http://www.tiparos.com/process1.php?lang=en

There are also an amazing array of other sauces added to preparations here, Oyster Sauce is one such sauce, and it also comes in a wide variety of "flavors". Not sure if this would trigger a reaction?

I think the biggest challenge might be avoiding cross-contamination - not sure if that's the correct word - but by that I mean cooking/serving utensils used to prepare shellfish dishes, which are then used to prepare your non-shellfish dish.

How many epi pens can you bring?

These. If you have smart phones, you may want to have those words and phrases programmed into them. Make sure you also have something written in Thai explaining that she has allergic anaphylaxis in case you need to communicate with emergency responders. I.e., get her medic-alert card translated into Thai. Also, bring extra EpiPens as they are pretty expensive in Thailand. You may be able to get them OTC, but better to bring an Rx just in case.

Will you be staying at major, international resorts? If so, this is something they should know how to handle. You may wish to limit most of your eating to the major international hotels for things other than fruits, and possibly places that specialize in vegetarian food. Even if you successfully convey the danger to a street food vendor, the risk of cross-contamination is great.

I'd also alert your own hotel(s) in advance of arrival via email, and then also communicate face-to-face with the chef and the F&B manager once on site.

Learn to recognize the written Thai words for shrimp, lobster, etc. (assuming her allergy is to crustaceans rather than mollusks), and look for that on condiment bottles, etc.

Finally, you should make sure you know how to call emergency services from your cell, and also be able to communicate to bystanders that you need emergency assistance, just in case.

Try not to worry too much. Be safe and have a great visit!

A Rx from a non Thai doc won't mean anything.

It's can be very useful in specifying exactly what is required in terms of compound and dose. The traveller may be able to give coherent and accurate description, but the pharmacist and/or doctor will be reassured by a written prescription.

This is particularly important in situations where drugs not available off the shelf can be dispensed on a discretionary basis by a pharmacist. (I've got to admit I have no idea if this situation holds in Thailand).

The prescription could also be useful in validating the traveller's entitlement to carry pills/syringes/liquids at customs/security.

I have found that many medications which require a prescription in the U.S. are available over the counter in Thailand. I recall specifically that last year when I had a tooth infection, my dentist at home told me to go to a local dentist and get a prescription for a particular antibiotic in a particular strength. She offered to speak with the local dentist on the phone if necessary. I went to a pharmacy first and got what I needed. And at an incredibly small fraction of the U.S. cost, too!!

All, thanks for your replies. This is all very helpful information.

We have decided against a trip to Thailand for now and are heading to Mexico and Southern California instead. We are spanish speaking so have no issues with the language barrier.

The cross contamination was what I was mostly worried about, we were going to bring the cards noting the deadly allergies, etc.

Appreciate all the help. We will, however, visit Thailand at some point - please keep the recommendations coming!