Factors affecting the number of influenza patients before and during COVID-19 pandemic, Thailand.

This study was aimed to explore the association between potential factors including public health and social measures and the number of influenza patients in Thailand between 2014-2021. Secondary data from relevant agencies were collected. Generalized Estimating Equation (GEE) and regression coefficient (ß) were performed at a significance level of 0.05. We found factors associated with number of influenza patients during the time prior to COVID-19 pandemic were monthly income per household (Adjusted ß = -0.02; 95% CI: -0.03, -0.01), population density (Adjusted ß = 1.00; 95% CI: 0.82, 1.18), rainy season (Adjusted ß = 137.15; 95% CI: 86.17, 188.13) and winter time (Adjusted ß = 56.46; 95% CI: 3.21, 109.71). During the time of COVID-19 pandemic, population density (Adjusted ß = 0.20; 95% CI: 0.15, 0.26), rainy season (Adjusted ß = -164.23; 95% CI: -229.93, -98.52), winter time (Adjusted ß = 61.06; 95% CI: 0.71, 121.41), public health control measures (prohibition of entering to into an area with high number of COVID-19 infections (Adjusted ß = -169.34; 95% CI: -233.52, -105.16), and restriction of travelling also reduced the number of influenza patients (Adjusted ß = -66.88; 95% CI: -125.15, -8.62) were associated with number of influenza patients. This study commends strategies in monitoring influenza patients to focus on the areas with low income, high population density, and in specific seasons. Public health and social measures which can be implemented are prohibition of entering to risk-areas (lock down), and restriction of travelling across provinces which their effectiveness in reducing influenza infections.

An overlooked poultry trade network of the smallholder farms in the border provinces of Thailand, 2021: implications for avian influenza surveillance.

Introduction: In Thailand, community-level poultry trade is conducted on a small-scale involving farmers and traders with many trade networks. Understanding the poultry movements may help identify different activities that farmers and traders might contribute to the spread of avian influenza. Methods: This study aimed to describe the characteristics of players involved in the poultry trade network at the northeastern border of Thailand using network analysis approaches. Mukdahan and Nakhon Phanom provinces, which border Laos, and Ubon Ratchathani province, which borders both Laos and Cambodia, were selected as survey sites. Results: Local veterinary officers identified and interviewed 338 poultry farmers and eight poultry traders in 2021. A weighted directed network identified incoming and outgoing movements of where the subdistricts traded chickens. Ninety-nine subdistricts and 181 trade links were captured. A self-looping (trader and consumer in the same subdistrict) feedback was found in 56 of 99 subdistricts. The median distance of the movements was 14.02 km (interquartile range (IQR): 6.04-102.74 km), with a maximum of 823.08 km. Most subdistricts in the network had few poultry trade connections, with a median of 1. They typically connected to 1-5 other subdistricts, most often receiving poultry from 1 to 2.5 subdistricts, and sending to 1-2 subdistricts. The subdistricts with the highest overall and in-degree centrality were located in Mukdahan province, whereas one with the highest out-degree centrality was found in Nakhon Phanom province. Discussion: The poultry movement pattern observed in this network helps explain how avian influenza could spread over the networks once introduced.

Investigation of a Cluster of Immunization Stress-Related Reactions after Coronavirus Disease 2019 (COVID-19) Vaccination, Thailand, 2021.

On 28 April 2021, the investigation team of the Department of Disease Control, Ministry of Public Health, was notified of a cluster of people developing neurological symptoms following COVID-19 vaccination in a province in eastern Thailand. We conducted an investigation from 29 April to 20 May 2021 to confirm the outbreak, describe the epidemiological characteristics and identify possible risk factors. A matched case-control study was conducted. Matching factors were gender and vaccination site. A confirmed case was a person receiving COVID-19 vaccination in the province and developed at least one neurological symptom between 21 April and 20 May 2021. The rapid assessment of the vaccination cold chain system was carried out. We found a total of 36 cases out of 3920 vaccinees (attack rate = 0.92%), all cases were recovered and classified as an immunization stress-related reaction (ISRR) by the National AEFI Expert Committee. An analytic study found that menstruation was significantly associated with ISRR (AOR = 6.84 [95%CI = 1.09-42.91]). The environmental survey suggested that the cold chain system was properly managed. Further studies on other precipitating causes of ISRR should be performed. In terms of recommendation, health providers should pay greater attention to women menstruating during and after COVID-19 immunization.

Case-Control Study of Use of Personal Protective Measures and Risk for SARS-CoV 2 Infection, Thailand.

We evaluated effectiveness of personal protective measures against severe acute respiratory disease coronavirus 2 (SARS-CoV-2) infection. Our case-control study included 211 cases of coronavirus disease (COVID-19) and 839 controls in Thailand. Cases were defined as asymptomatic contacts of COVID-19 patients who later tested positive for SARS-CoV-2; controls were asymptomatic contacts who never tested positive. Wearing masks all the time during contact was independently associated with lower risk for SARS-CoV-2 infection compared with not wearing masks; wearing a mask sometimes during contact did not lower infection risk. We found the type of mask worn was not independently associated with infection and that contacts who always wore masks were more likely to practice social distancing. Maintaining >1 m distance from a person with COVID-19, having close contact for <15 minutes, and frequent handwashing were independently associated with lower risk for infection. Our findings support consistent wearing of masks, handwashing, and social distancing to protect against COVID-19.