I got diagnosed with Dengue fever on Koh Tao in Thailand. It took me out for about two weeks, with four nights spent in a hospital on Koh Samui. This article is a detailed account of what it was like, as well as some thoughts on assessing your risk and preparing when traveling to areas where Dengue fever is present. I also cover my experience with our travel medical insurance company, SafetyWing.

Disclaimer: This is not medical advice. I’m not a medical professional, and the information presented here simply recounts my personal experience. Always consult with qualified healthcare professionals for personalized medical advice tailored to your specific circumstances.

❓ Can I get Dengue Fever when going to Koh Tao, Koh Phangan, or Koh Samui?

The short answer is yes. You can get Dengue not only on Koh Tao, Koh Pha Ngan, and Koh Samui, but in most parts of Thailand and many other countries in Southeast Asia. While the chances of getting Dengue fever while traveling there are relatively low, and most people have no issues during their brief visits, it’s not that uncommon in the region.

On both Koh Tao and Koh Samui, locals and medical professionals treated my case of Dengue like an unfortunate but common occurrence. Many shared their own Dengue stories (have you ever swapped stories that featured platelet counts with strangers?).

Keep in mind that case counts have been rising (WHO stats) so what you know from the past year may not be applicable. The risk also varies greatly depending on location and season, with rainy and winter seasons being peak times, though it’s a year-round threat.

Before I dive into my experience, let’s have some fun and roughly calculate the odds of me winning the Dengue lottery*. Spoiler alert: they are much higher than winning the actual lottery.

66,041,780 was the population of Thailand in 2023 (Wikipedia)

28,042,131 people visited Thailand in 2023 (Wikipedia)

136,655 people got Dengue fever in Thailand in 2023 by 22 November 2023 (WHO). I’m not even in these numbers, as I was infected in December. I couldn’t find reliable data for the entire year.

66,041,780 + 28,042,131 = 94,083,911

136,655 / 94,083,911 = 0.00145248001

That’s roughly 0.145% of all people present in Thailand at some point in 2023, or one in 688 people. Ouch!

*These back-of-a-napkin numbers are very crude and don’t account for December cases, stay durations, unreported cases, or cases reported by visitors upon return home. A real statistician would likely include more factors. But I think this helps illustrate how common Dengue is in Thailand.

🦟 About Dengue fever and how to avoid it

This information applies to Thailand as well as any other countries where Dengue fever is present.

• Dengue can’t be passed from person to person directly, only through a mosquito bite.
  • In the areas where mosquitos carry infections avoid getting bitten to begin with. Cover-up, carry mosquito spray, use mosquito nets, etc.
• Symptoms may include sudden high fever, severe headaches, pain behind the eyes, joint and muscle pain, swollen glands, nausea and vomiting, fatigue, and a rash that appears three to four days after the fever starts.

Don’t delay seeking care if you feel something is off. Always get travel medical insurance when going abroad.

• A small percentage of infected people develop severe Dengue, which is life-threatening. That’s why it’s important to be monitored by medical professionals. They assess the risk by checking your vitals and monitoring the platelet count and other parameters that can only be seen with a blood test.
  • Do not delay seeing a medical professional with any health concerns. Having medical coverage helps make it an easy decision to seek care instead of putting it off over budget concerns.
  • A new Dengue vaccine (Qdenga) is now available. It’s possible to get it after arriving in Asia if it’s unavailable in your country (e.g. USA). Consult a medical professional regarding recommended vaccinations based on your travel destinations, personal medical history, length of stay, etc.
  • Always, always, always get insurance when traveling. My hospital stay cost USD 3,500+, but I didn’t have to pay a cent. We use SafetyWing.

🤒 What is it like to have Dengue fever – day-by-day experience

Day 0: Koh Tao, First signs

We arrived at Koh Tao from Koh Samui, and on our fourth day on Koh Tao, I started feeling a bit off. A headache, and some body aches. Symptoms were too weak to know one was sick, so I just thought I was tired from all the moving around. Getting sick on the 4th day after arrival means I could have got it on either Koh Samui or Koh Tao. The infection has a 3–14 day incubation period, so we’ll never know where that mosquito got me.

Day 1: Koh Tao, Dengue symptoms hit

I spent all day studying for a diving course and crammed some stressful work stuff in between. In the evening I got up from the desk exhausted and mentally fatigued but chucked it up to being tired from the day.

We went out to dinner and sat down in a restaurant, and this is where the first telling symptom hit. The restaurant wasn’t air-conditioned, so it was a bit hot. As soon as we sat down I felt super nauseous, like I was going to throw up. I tried to cool off by washing my face and spent some time near the bathroom worried I might puke. I felt so nauseous, there was no way I would make it through the dinner. We grabbed the food to go and returned to the hotel. After laying down under the AC for a bit the nausea went away and I had no problem eating. For now. 

I spent the rest of the evening in bed and at some point, I became aware of my body aching. I couldn’t get comfortable in any position. It finally occurred to me to measure my body temperature. Bingo! 38C (100.4 F) – now it made sense why I felt so lousy.

What didn’t make sense was the unfamiliar feeling of having a fever without any respiratory symptoms or major stomach issues.

Day 2: Koh Tao, Dengue fever becomes a suspect

I stayed in bed all day with a headache, brain fog, joint and muscle soreness, more nausea, and poor appetite. The fever continued and I lowered it with acetaminophen (Paracetamol in many places). It was a good call because NSAIDs, like ibuprofen, can increase the risk of bleeding if you have Dengue fever.  I also did lots of googling and that’s when Dengue first became a suspect. The 2 rapid COVID-19 tests I took were negative. I kept thinking back to a conversation with a friend telling us to be careful because someone they knew got Dengue fever in Thailand. At that moment I naively refused to believe it could happen to me.

In the evening, the fever jumped to 38.8 C so we decided to go to the hospital first thing in the morning. Looking back, it would have been prudent to see a doctor that day. Especially since I have insurance, which I cannot recommend enough to any traveler.

Day 3: Diagnosis and hospitalization

🏝️ Kao Tao Clinic and Dengue diagnosis

We went to the Koh Tao International clinic down the street. First, a mandatory Covid-19 test, and then, after talking to the doctor they gave me a rapid Dengue test. It’s a blood test, so you can’t do it yourself, but it only takes about 20 minutes in a clinic.

Tadaaaa, it’s positive. I got Type 3 Dengue fever (there are 4 types).

Koh Tao is a very small island. It does not have a lab to produce quick blood test results to monitor platelet count, which can drop severely with Dengue fever. Blood tests are crucial in evaluating your risks of developing severe Dengue. The doctor’s recommendation was to move me to a bigger hospital in Koh Samui on the very next ferry to be monitored by an infectious disease specialist there.

Things started developing fast from here. The clinic told us to go pack immediately and return ASAP to get started on fluids. Meanwhile the clinic organized tickets for the ferry. We went to our hotel (highly recommend them) and packed the bags. My husband ran to talk to the hotel owner and the scooter rental about us leaving early. They were beyond gracious and refunded us for all the days we didn’t stay.

After all that moving around, I was feeling extremely tired. Once everything was ready for our departure, one of the clinic employees picked us up and brought us back to the clinic. We had about 2 hours before the ferry so they started me on IV fluids, gave me acetaminophen for the fever, and anti-nausea pills so that I could eat. They also continued to check my temperature and blood pressure at frequent intervals. I didn’t know it then, but I would stay under this same regimen for the next 5 days. There is no special treatment for Dengue. It is about treating the pain symptoms and helping your body fight it through rest, hydration, and nutrition.

Many of you may be wondering how the medical facilities and care were. In Koh Tao, the clinic is quite simple but decent, with a very nice staff and English-speaking doctors who communicate very professionally. The Bangkok Hospital in Koh Samui was damn near luxurious with exceptional care, I’ll get to it next.

🛥️ Transfer to a hospital on Koh Samui

In the afternoon, the clinic gave us a ride to the ferry. A nurse from the clinic accompanied me during the transfer all the way to the hospital in Koh Samui, carrying the IV that was still connected to me, checking my temperature and blood pressure every 30-60 min. On the ferry, the IV bag was strapped to the pole – looked sketchy, but it worked.

The ferry personnel seemed to have been notified by the clinic and we got on and off ahead of the line, catching lots of inquisitive looks.

Once the ferry arrived at Koh Samui it all started to feel a bit too dramatic. While I felt really tired, I was capable of walking and moving around at least a moderate amount. Nevertheless, when we got out of the ferry, an ambulance crew was already waiting with a stretcher. They put me on it and awkwardly wheeled it along the wooden pier and into the back of an ambulance. The ambulance put the lights on during the 20-minute commute to the hospital. I for sure wasn’t dying so it felt a bit over the top. On the other hand, they had no way of assessing my condition before any tests so I guess better safe than having to fish me out of the sea if I fainted and fell off the pier.

🏨 Bangkok Hospital Samui

I spent the next couple of hours in the emergency room, waiting for my blood tests to come back and for the doctor to make an assessment. After looking at my platelet count (it was 100k) and other parameters the doctor told us that my condition was right on the threshold for recommending hospitalization or going home and coming for blood tests and monitoring every day, but ultimately she was recommending hospitalization.

At that point, I was feeling pretty crummy and a bit spooked. Since we had insurance it was a no-brainer to be on the safe side and ensure I got the best care possible.

After another half an hour or so, I got checked into my room. Honestly, it was nicer than many of the hotels we stayed in. It was a private room with a bathroom and a shower, a desk, and a nice TV across from a mechanical hospital bed. There also was a couch on which my husband could sleep so he stayed with me the entire time. I was pleasantly surprised but a bit worried – what if my insurance doesn’t pay? The hospital didn’t have a direct contract with our insurance, so they took a deposit of $1500 for my admittance (get no foreign fees and no ATM fee cards before you travel!).

Video of the hospital room interior:

Days 4-7: Koh Samui, The hospital stay

💵 Paying for the hospital stay in Thailand (my experience with Safety Wing)

In the morning, my husband called our insurance to figure out what the process would be. Normally you would pay your bills out of pocket (remember to get those no-foreign-fee cards!) and then submit the receipts for reimbursement. When we had to get medical care again just 2 weeks later, which is another story, that’s exactly what we did: paid at the clinic and got the reimbursement from SafetyWing later. But here I was staying in a hospital with around-the-clock care – we knew it would cost a pretty penny. So, we hoped SafetyWing would handle the payment directly. That way we wouldn’t have to carry a balance of thousands of dollars until the reimbursement is processed, which takes some time.

The insurance rep informed us that even though the company does not work with this hospital directly they will try to find a local partner through which they can send the payment to the hospital. We had to put the hospital and insurance in touch to receive all the doctor’s notes and other paperwork and fill out a few papers to get things moving along. They assigned a case manager who called to understand the case and then followed up over email a couple of times. All-in-all it was rather painless.

🤢 What it was like to be in a hospital on Koh Samui with Dengue fever

I spent the next 4 nights in that hospital, in bed the entire time with little or no energy to do anything else. Managed to watch all 3(!) seasons of Ted Lasso though. I went from feeling tired but kind of ok on the first day to absolutely lifeless and then bouncing back again on the last day.

Doing anything mentally demanding on my computer while in bed or especially at the desk felt like an impossible task most of the time. When I showered, I did it sitting down and it took most of my energy for the day. Even standing for two minutes while brushing my teeth felt hard so I would do it sitting on the toilet. Eating was a chore even though I got an anti-nausea pill before every meal. I had no appetite at all and just made myself eat to help my body fight this.

I was getting the IV fluids the entire time I was there up until we left the hospital. I’ve never had an IV before and then spent 5 days straight with it. Every 4 hours the nurses checked my vitals (blood pressure, pulse, temperature) as well as how much water I drank and how many times I went “peepee and poopoo” (that’s a quote, sorry). This level of monitoring was reassuring, but I also couldn’t get a good night’s sleep the entire time we were there.

The nurses check on you at 8 PM, then at midnight, then at 4 AM, then at 6:30 I get anti-nausea medication, then at 7 staff brings breakfast, then at 8 AM the nurses come again, then later someone comes to pick up the breakfast tray… you see where I’m going with this. Also, the fancy IV drip machine was very sensitive and would start WAILING as soon as I bent my elbow even slightly creating extra pressure in the vein. Sometimes, unsurprisingly I bent my arm in my sleep. We’d have to call the nurses and wait for them to come and turn it off.

Let’s just say, a restful night’s sleep wasn’t a part of my recovery process.

According to my doctor, for many people with Dengue fever, the worst days are days 5-7, it gets the worst right before it gets better. It was also true for me. I felt the worst on days 5 and 6 and then got substantially better on day 7, general weakness aside.

Day 6 The sh*t day

During the early hours of day 6, I got up to go to the bathroom. I didn’t wake up my husband to help me roll the IV stand as he did most of the time. As soon as I sat on the toilet, I started feeling very dizzy and nauseous, like I was going to pass out and throw up all at the same time. After trying to fight it to no avail I pressed the Help button on the bathroom wall. I slid down onto the floor scared that I might pass out and fall over. As the nurses ran in, the world started to go dark. Ugh, what a disgusting slippery feeling. But the ammonia they put under my nose, after a few jarring minutes, brought me back to reality. I never fully passed out but feeling my consciousness slipping away wasn’t my favorite.

I’m not going to lie, it felt scary. And it felt scary to see my husband scared for me. In those moments I was so glad that we stayed in the hospital. I can’t imagine how terrifying something like this would be at a hotel.

That same day my blood pressure dropped significantly and I could see the nurses getting worried. They were rechecking again and again to get a reading. The doctor recommended staying one more day because of my condition. It was a miserable day, I was just lying there like a deflated balloon. Barely moving, uncomfortable from the fever, the body aches, the fatigue, and lowered blood pressure, but also from laying in the same position for multiple days because of the IV.

The Dengue fever rash that many patients get never appeared. I also never did puke, so that was nice.

Day 7: Leaving the hospital

On day 7, I woke up feeling so much better, what a relief! My blood tests had been trending in the right direction, so we knew today was going to be the day! We received the green light to leave from the doctor in the late afternoon, but the accounting department had not secured confirmation of payment from the insurance company’s local partner yet.

Our options were to wait for the confirmation or pay out of pocket and resolve it with the insurance company later. This part was a bit stressful as the evening was approaching with no resolution. We went in a circle and pinged everyone to make sure we got out of the hospital without paying the bill out of pocket. The total for my Dengue fever adventure was USD 3500+ (clinic, transfer, and hospital stay) or 123k in Thai Baht.

We needed to make sure the hospital sent all the final paperwork to our insurance, that the insurance communicated to the partner, and that the local partner sent an official commitment to pay to the hospital. After waiting and checking in with the insurance and the hospital for a few hours, the hospital staff confirmed they got everything they needed. The USD 1500 they took as a deposit was going to be credited back to my card.

We left the hospital pretty late, around 8 PM. I haven’t been that excited to get into a taxi and leave a place in a long time. Don’t get me wrong – that hospital and its staff were wonderful, but leaving it meant the scary part was behind me.

Day 8: Koh Samui, First day out of the hospital

While I felt better, I was still really weak. We stayed at a hotel right on the beach, but I didn’t feel like walking the 20 meters to see it, nor did I feel like I could go out to eat at the restaurants across the road. All I could muster was to sit on the balcony to feel the wind on my skin, listen to the waves, and count myself lucky to be able to do that. My husband brought takeout and I just stayed in bed. I finally got to sleep through the night without interruptions.

Day 9: Koh Samui, Second day out of the hospital

I felt a bit better in the morning. My appetite was still shaky, but it was back and I was eager to enjoy a nice non-hospital meal outside those walls. The breakfast place was directly across the road, maybe 30 meters or less from door to door. I got ready and we slowly walked up to the busy road. It didn’t feel good but I thought it would get better once I sat down. Nope. As soon as we walked up to the restaurant door I knew I could not do it. I felt queasy, and it took too much effort to just stay upright. So back I went, exhausted from this incredible feat of walking 60 meters, and waited for my take-out breakfast. Stayed in bed all that day as well.

Day 10: Koh Samui, Third day out of the hospital

Tried to go out for breakfast again and managed it, yay! Oh, the small joys of life! Dengue fever rids you of any desire to eat so enjoying food again was wonderful. Then, I even had it in me to walk over to the beach and enjoy the stormy shore for a few minutes. It may not sound like much but at that moment it was everything – being out in the world, seeing, smelling, hearing, and feeling it again. We all know the wisdom: appreciate the moment, be present, and be grateful for the here and now. But it’s easy to lose sight of how special the small moments and sensations are until life smacks you in the face.

Days 11-15: Koh Samui, Getting back to normal post Dengue fever

All symptoms but general weakness subsided. It was a gradual but steady recovery: every day I could feel another improvement in how I felt and how much I could do. It took about 10 days after the lowest point to feel close to 90% healthy again.

Going back to Koh Tao after Dengue subsided

Two weeks after the first symptoms, we headed back to Koh Tao to try to finish our Advanced 35 scuba-diving certification. We didn’t yet know that it wasn’t meant to happen (we ended up doing it in Amed, Bali several weeks later) and we would end up at that same Koh Tao clinic talking to the same doctor in no time (but that’s a story for another time). But we did get to have 3 incredibly fun and adventurous days of staying at Nang Yuan Island and diving at Sail Rock before that.

Read: Koh Nang Yuan Viewpoint and Island: Ultimate Guide (2024)

🏥In Conclusion (and why you need medical insurance)

I hope you don’t see my story as an argument to stay home. To me, the lesson is quite the opposite. Before our “year of travel”, I was so afraid to even consider my mortality because I hadn’t fulfilled my biggest dream. When I was in the hospital with Dengue I remember saying to my husband: “I’m pretty sure I’ll be alright, but if anything happens, I’m not as scared as I would be before because I’m content with our life choices”. Tomorrow isn’t promised, so doing the things that make you feel alive, that make you feel like you are living today, and not putting life off for a better day is essential. We can assess the risk and try to mitigate it, but ultimately accept that it’s always there and have things in place to take the best care of ourselves if something happens.

Having coverage made it an easy decision to seek care and stay in the hospital. It wouldn’t have been a straightforward decision if we hadn’t. Hey, the doc said you could stay at a hotel so why run up a hospital tab?  In the US, where insurance can cost you an arm and a leg – sometimes literally if you don’t tend to your health in time – you see folks deferring medical care because they don’t have insurance all the time. Guess what, ignoring health issues doesn’t make them vanish. It’s also peace of mind to know a medical emergency won’t wipe out your travel budget. Just get travel medical coverage when traveling.

I recommend SafetyWing

I love how straightforward the plan is. It’s a worldwide subscription, that renews as long as you travel so it’s perfect for digital nomads and long-term travelers like us. But you don’t have to be a nomad to use it. You can also buy it for one-off trips instead of a subscription.

• It’s affordable, has good coverage, and a $0 deductible.
• It has add-ons for extreme sports and electronics theft.
• It covers more than just health, it covers emergency evacuation, lost luggage, travel interruptions, emergency dental, and personal liability. Check out their site for full benefits. They make it easy to understand the coverage and the website is very user-friendly.

You can also get a quick quote right here:

Disclosure

My husband and I use SafetyWing travel medical insurance ourselves and recommend it based on first-hand experience. We, unfortunately, had two medical accidents in the last year alone that SafetyWing covered. If you purchase a policy from SafetyWing through a link on this site, I may be paid a commission.

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