The abbreviated 2-1-1 schedule of purified chick embryo cell rabies vaccination for rabies postexposure treatment.

During August 1988 to January 1990, the immunogenicity and safety of purified chick embryo cell rabies vaccine (PCEC) given by the conventional and abbreviated regimens in 82 vaccinees moderately to severely exposed to laboratory proven rabid animals were studied. The 16 vaccinees received PCEC six doses as conventional schedule on days 0, 3, 7, 14, 28 and 90, the 11 vaccinees received six doses of PCEC plus human rabies immune globulin (HRIG) on day 0. The 29 vaccinees received an abbreviated schedule of PCEC as two doses on day 0, one dose each on days 7 and 21 and the 26 cases received PCEC abbreviated schedule plus HRIG on day 0. The kinetics of the neutralizing antibodies on days 0, 7, 14, 28, 56, 180 and 365 were studied for comparative purpose. All vaccinees had high antibody levels from day 14 which last longer than a year and were safe after one year follow up. The adverse reactions of the vaccine were mild and self-limited.

KAPI (shrimp paste) mixed with rice food poisoning.

On 17 January 1985, a group of students came to Siriraj hospital with food poisoning. There were 17 cases, 9 males and 8 females, aged between 13-18 years. The symptoms were vomiting 16 cases (94.12%), abdominal pain 7 cases (41.18%), diarrhea 4 cases (23.53%) and palpitation 2 cases (11.76%). The incubation period was about 2.82 hours. AII cases had a history of having lunch with Kapi (Shrimp paste) mixed with rice from the same food shop. In order to prove the cause of the illness, a group of investigators went to the shop, and then a Kapi specimen which was used for preparing the food was brought to the Infectious Disease unit for examination. It is was tested by culture but the result was negative for organism, while the other half of the specimen was investigated further at the Toxicology unit and a large amount of Sodium dithionite was found. It was concluded that the contamination of this chemical in the Kapi mixed with rice was the cause of food poisoning among the victims.

Treatment of falciparum malaria with sulfalene-pyrimethamine versus sulfadoxine-pyrimethamine.

The study was carried out in 89 uncomplicated falciparum malaria adult cases admitted to Paholpol-Phayuhasena Hospital, Kanchanaburi Province, Thailand, during July 1979 and March 1980. The patients were divided alternatively into 2 groups. Group I, 46 patients, were treated with a single dose of 1000 mg sulfalene and 50 mg pyrimethamine (2 tablets of Metakelfin). Group II, 43 patients, were treated with 1000 mg sulfadoxine and 50 mg pyrimethamine (2 tablets of Fansidar). The parasitemia was cleared within 7 days in 7 cases (15.2%) of group I and in 11 cases (25.6%) of group II. The results of both groups are not statistically significant. It is concluded that the success rate of Fansidar in the treatment of falciparum malaria is decreasing in Thailand and Metakelfin can be used in the treatment of falciparum malaria either alone in mild cases or in combination with quinine as an alternative to Fansidar.

Incidence, clinical manifestation and general management of snake bites.

There are regional patterns in snake-bites. Bites by cobras have a high incidence in Thailand and in the Philippines with a high case fatality rate. Among the venomous snakes of haemorrhagic nature, bites by Trimeresurus species such as green pit viper, Taiwan habu and Taiwan bamboo viper are important in Thailand and Taiwan for their high incidence of bite, although the case fatality rates are low. Bites by Malayan pit vipers are also important in Thailand and Malaysia because of their high incidence. Bites by sea snakes are more common in Malaysia than in the Philippines and Thailand.