Environmental and travel factors related to leptospirosis in Thailand.

To identify potential environmental and travel factors related to leptospirosis, we conducted an unmatched case controlled study and household assessment of cases and controls in Nakhon Ratchasima province (north-eastern, Thailand) from August to December, 1998. Fifty-six cases and 145 controls were included in the study. Cases were hospitalized patients who had been diagnosed with leptospirosis and tested positive for anti-leptospiral IgM antibody using the Panbio ELISA (Panbio Inc, Brisbane, Australia). Controls were the neighbors of cases who had tested negative. Standardized questionnaires and household assessments were used to collect information on demographics, number of animals kept, evidence of rats in the home, presence of rat food inside the home, road characteristics, awareness of leptospirosis disease, environment, and travel history. Multivariant, unconditional logistic regression demonstrated that travel on potholed roads was independently associated with leptospirosis infection (OR 5.0; 95%CI 1.2-20.2) and traveling by car was a protective factor (OR 0.2; 95%CI 0.06-0.9).

A second outbreak of cholera in the home for mentally handicapped, Nonthaburi.

A second outbreak of cholera, due to the Ogawa strain, occurred in the home for Mentally Handicapped Children in Nonthaburi between July 29 and August 9, 1992. An outbreak of cholera due to the Inaba strain was reported in the same institution and season tin 1987. In 1992, the clinical attack rate was 8 per cent of 440 children; there were two deaths. Bath water was contaminated with Vibrio cholerae O1 E1 Tor Ogawa, the same strain as was isolated from the ill children. Chlorination of the water supply, obtained from an underground well, was insufficient. The water supply needs further investigation, and the sanitary conditions in the institutions should be improved.

Dengue haemorrhagic fever in Thailand, 1987.

In 1987, situation of DHF in Thailand was the worst for the past 30 years. There were 152,840 cases and 785 deaths from the preliminary report. The incidence was highest ever reported. Outbreak begun early in January and reached its peak in July. All 73 provinces were affected except six provinces which had incidence of less than 60 per 100,000 population. The highest attack rates were in school children, especially 5-9 year olds. Virus isolation in a north-eastern province recovered Den-3 and Den-2 more common than other serotypes. Although a large outbreak in 1987 is unlikely to happen in 1988 but with the endemic areas all over the country there is a potential for small outbreaks to occur. The Ministry of Public Health needs new approaches and increased resources to control this disease.