Epidemiology and characterization of leptospirosis at an urban and provincial site in Thailand.

Patients with FUOs at the Children's Hospital in Bangkok and the Chao Phya Abhai Bhu Bejhr Hospital in Prachinburi were screened for leptospirosis by blood and urine culture in addition to microagglutination testing of their serum. Animal populations in urban and periurban areas of Bangkok were surveyed for evidence of leptospira infection. Three rural sites near the Prachinburi Provincial Hospital were also surveyed. The rodents' and domestic animals' blood, urine, and/or kidney cell samples were cultured for leptospira. Sera from these animals were also tested for leptospira antibody. The bataviae serovar was the most commonly detected leptospiral agent in both man and animals. Presenting symptoms varied with age with children showing primarily fever, vomiting, headache, abdominal and generalized muscle pain and diarrhea whereas adults had fever, headache, anorexia, muscle pain and constipation. Blood samples from patients suspected of having leptospirosis were tested for antibody by the MAT and cultured in EMJH media. The following serogroups were identified: bataviae, autumanalis, javanica, hebdomadis, and pyrogens. Leptospirosis incidence in humans was much higher in the rainy/flooding year of 1983 compared to the relatively dry year of 1984. Results of our animal surveillance studies indicate that in addition to rats, which have previously been mentioned, dogs, bandicoots, cattle and pigs could be the source of human leptospirosis infection in both urban and provincial locations in Thailand.

The effect of interferon-alpha A on two cases of Japanese encephalitis in Thailand.

Two Japanese encephalitis cases with serious comatous symptoms were treated with the Human Recombinant Interferon-alpha A. The clinical responses to IFN were found to be satisfactory. The first case showed improvement on the 5th day of IFN treatment and the general condition slowly improved. The second case recovered from the comatous stage on the 6th day of IFN, followed by quick improvement of general symptoms in the 2nd week and complete recovery without any mental sequelae. Leukopenia and neutropenia occurred during the first week of administration of IFN, but were only temporary. Slight elevation of SGOT and SGPT was observed in the first case. No other side effects including general toxicity, neurotoxicity or allergy, or any abnormal hematological and blood chemistry changes were observed in these 2 cases. Two other JE cases (the 3rd and 4th consecutive JE cases) were not treated with IFN, but received the usual regimens of symptomatic and supportive drugs. Both patients died on the 7th-9th day of illness. This study suggests that the Human Recombinant Leukocyte A Interferon possibly is an effective and promising agent in the treatment of Japanese encephalitis in Thailand. More studies to treat JE cases with this IFN are being performed in order to assess the efficacy, tolerance and safety of rIFN-alpha A on Japanese encephalitis in Thailand.