Melioidosis in Thailand: Present and Future

doi:10.3390/tropicalmed3020038

. 2018;3(2):38.

doi: 10.3390/tropicalmed3020038. Epub 2018 Apr 8.

Melioidosis in Thailand: Present and Future

Soawapak Hinjoy ¹, Viriya Hantrakun ², Somkid Kongyu ¹, Jedsada Kaewrakmuk ³, Tri Wangrangsimakul ^{2

4}, Siroj Jitsuronk ⁵, Weerawut Saengchun ⁶, Saithip Bhengsri ⁷, Thantapat Akarachotpong ⁷, Somsak Thamthitiwat ⁷, Ornuma Sangwichian ⁷, Siriluck Anunnatsiri ⁸, Rasana W Sermswan ⁸, Ganjana Lertmemongkolchai ⁹, Chayada Sitthidet Tharinjaroen ¹⁰, Kanya Preechasuth ¹⁰, Ratchadaporn Udpaun ¹⁰, Poomin Chuensombut ¹¹, Nisarat Waranyasirikul ¹², Chanihcha Anudit ¹³, Surapong Narenpitak ¹⁴, Yaowaruk Jutrakul ¹⁵, Prapit Teparrukkul ¹⁶, Nittaya Teerawattanasook ¹⁷, Kittisak Thanvisej ¹⁸, Alisa Suphan ¹⁹, Punchawee Sukbut ²⁰, Kritchavat Ploddi ²¹, Poolsri Sirichotirat ²², Bongkoch Chiewchanyon ²³, Kamolchanok Rukseree ²⁴, Maliwan Hongsuwan ², Gumphol Wongsuwan ², Pornpan Sunthornsut ², Vanaporn Wuthiekanun ², Sandy Sachaphimukh ², Prapass Wannapinij ², Wirongrong Chierakul ², Claire Chewapreecha ², Janjira Thaipadungpanit ², Narisara Chantratita ^{2

25}, Sunee Korbsrisate ²⁶, Apichai Taunyok ²⁷, Susanna Dunachie ⁴, Prasit Palittapongarnpim ^{28

29}, Stitaya Sirisinha ²⁹, Rungrueng Kitphati ³⁰, Sopon Iamsirithaworn ³¹, Wipada Chaowagul ¹⁶, Ploenchan Chetchotisak ⁸, Toni Whistler ⁷, Surasakdi Wongratanacheewin ⁸, Direk Limmathurotsakul ^{2

4}

Affiliations

¹ Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.
² Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
³ Faculty of Science, Prince of Songkla University, Songkla 90110, Thailand.
⁴ Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK.
⁵ Faculty of Medicine, Prince of Songkla University, Songkla 90110, Thailand.
⁶ Department of Clinical Pathology, Chiang Rai Prachanukroh Hospital, Chiang Rai 57000, Thailand.
⁷ Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand.
⁸ Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
⁹ The Centre for Research & Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
¹⁰ Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand.
¹¹ Department of Clinical Pathology, Chiangkham Hospital, Phayao 56110, Thailand.
¹² Department of Clinical Pathology, Somdejphrajaotaksin Maharaj Hospital, Tak 63000, Thailand.
¹³ Department of Clinical Pathology, Uthai Thani Hospital, Uthai Thani 61000, Thailand.
¹⁴ Department of Internal Medicine, Udon Thani Hospital, Udon Thani 41000, Thailand.
¹⁵ Department of Clinical Pathology, Udon Thani Hospital, Udon Thani 41000, Thailand.
¹⁶ Department of Internal Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand.
¹⁷ Department of Clinical Pathology, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand.
¹⁸ Department of Internal Medicine, Nakhon Panom Hospital, Nakhon Panom 48000, Thailand.
¹⁹ Ubon Ratchathani Provincial Public Health Office, Ubon Ratchathani 34000, Thailand.
²⁰ Mukdahan Provincial Public Health Office, Mukdahan 49000, Thailand.
²¹ The Office of Disease Prevention and Control 8, Udon Thani 41000, Thailand.
²² The Office of Disease Prevention and Control 10, Ubon Ratchathani 34000, Thailand.
²³ The Office of Disease Prevention and Control 12, Songkla 90000, Thailand.
²⁴ Mahidol University Amnatcharoen Campus, Amnatcharoen 37000, Thailand.
²⁵ Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
²⁶ Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
²⁷ Department of Infectious Diseases & Immunology, Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA.
²⁸ National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand.
²⁹ Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
³⁰ Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok 10220, Thailand.
³¹ Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.

PMID: 29725623
PMCID: PMC5928800
DOI: 10.3390/tropicalmed3020038

Melioidosis in Thailand: Present and Future

Soawapak Hinjoy et al. Trop Med Infect Dis. 2018.

. 2018;3(2):38.

doi: 10.3390/tropicalmed3020038. Epub 2018 Apr 8.

Authors

Soawapak Hinjoy ¹, Viriya Hantrakun ², Somkid Kongyu ¹, Jedsada Kaewrakmuk ³, Tri Wangrangsimakul ^{2

4}, Siroj Jitsuronk ⁵, Weerawut Saengchun ⁶, Saithip Bhengsri ⁷, Thantapat Akarachotpong ⁷, Somsak Thamthitiwat ⁷, Ornuma Sangwichian ⁷, Siriluck Anunnatsiri ⁸, Rasana W Sermswan ⁸, Ganjana Lertmemongkolchai ⁹, Chayada Sitthidet Tharinjaroen ¹⁰, Kanya Preechasuth ¹⁰, Ratchadaporn Udpaun ¹⁰, Poomin Chuensombut ¹¹, Nisarat Waranyasirikul ¹², Chanihcha Anudit ¹³, Surapong Narenpitak ¹⁴, Yaowaruk Jutrakul ¹⁵, Prapit Teparrukkul ¹⁶, Nittaya Teerawattanasook ¹⁷, Kittisak Thanvisej ¹⁸, Alisa Suphan ¹⁹, Punchawee Sukbut ²⁰, Kritchavat Ploddi ²¹, Poolsri Sirichotirat ²², Bongkoch Chiewchanyon ²³, Kamolchanok Rukseree ²⁴, Maliwan Hongsuwan ², Gumphol Wongsuwan ², Pornpan Sunthornsut ², Vanaporn Wuthiekanun ², Sandy Sachaphimukh ², Prapass Wannapinij ², Wirongrong Chierakul ², Claire Chewapreecha ², Janjira Thaipadungpanit ², Narisara Chantratita ^{2

25}, Sunee Korbsrisate ²⁶, Apichai Taunyok ²⁷, Susanna Dunachie ⁴, Prasit Palittapongarnpim ^{28

29}, Stitaya Sirisinha ²⁹, Rungrueng Kitphati ³⁰, Sopon Iamsirithaworn ³¹, Wipada Chaowagul ¹⁶, Ploenchan Chetchotisak ⁸, Toni Whistler ⁷, Surasakdi Wongratanacheewin ⁸, Direk Limmathurotsakul ^{2

4}

Affiliations

¹ Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.
² Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
³ Faculty of Science, Prince of Songkla University, Songkla 90110, Thailand.
⁴ Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK.
⁵ Faculty of Medicine, Prince of Songkla University, Songkla 90110, Thailand.
⁶ Department of Clinical Pathology, Chiang Rai Prachanukroh Hospital, Chiang Rai 57000, Thailand.
⁷ Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand.
⁸ Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
⁹ The Centre for Research & Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
¹⁰ Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand.
¹¹ Department of Clinical Pathology, Chiangkham Hospital, Phayao 56110, Thailand.
¹² Department of Clinical Pathology, Somdejphrajaotaksin Maharaj Hospital, Tak 63000, Thailand.
¹³ Department of Clinical Pathology, Uthai Thani Hospital, Uthai Thani 61000, Thailand.
¹⁴ Department of Internal Medicine, Udon Thani Hospital, Udon Thani 41000, Thailand.
¹⁵ Department of Clinical Pathology, Udon Thani Hospital, Udon Thani 41000, Thailand.
¹⁶ Department of Internal Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand.
¹⁷ Department of Clinical Pathology, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand.
¹⁸ Department of Internal Medicine, Nakhon Panom Hospital, Nakhon Panom 48000, Thailand.
¹⁹ Ubon Ratchathani Provincial Public Health Office, Ubon Ratchathani 34000, Thailand.
²⁰ Mukdahan Provincial Public Health Office, Mukdahan 49000, Thailand.
²¹ The Office of Disease Prevention and Control 8, Udon Thani 41000, Thailand.
²² The Office of Disease Prevention and Control 10, Ubon Ratchathani 34000, Thailand.
²³ The Office of Disease Prevention and Control 12, Songkla 90000, Thailand.
²⁴ Mahidol University Amnatcharoen Campus, Amnatcharoen 37000, Thailand.
²⁵ Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
²⁶ Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
²⁷ Department of Infectious Diseases & Immunology, Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA.
²⁸ National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand.
²⁹ Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
³⁰ Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok 10220, Thailand.
³¹ Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.

PMID: 29725623
PMCID: PMC5928800
DOI: 10.3390/tropicalmed3020038

Abstract

A recent modelling study estimated that there are 2800 deaths due to melioidosis in Thailand yearly. The Thailand Melioidosis Network (formed in 2012) has been working closely with the Ministry of Public Health (MoPH) to investigate and reduce the burden of this disease. Based on updated data, the incidence of melioidosis is still high in Northeast Thailand. More than 2000 culture-confirmed cases of melioidosis are diagnosed in general hospitals with microbiology laboratories in this region each year. The mortality rate is around 35%. Melioidosis is endemic throughout Thailand, but it is still not uncommon that microbiological facilities misidentify Burkholderia pseudomallei as a contaminant or another organism. Disease awareness is low, and people in rural areas neither wear boots nor boil water before drinking to protect themselves from acquiring B. pseudomallei. Previously, about 10 melioidosis deaths were formally reported to the National Notifiable Disease Surveillance System (Report 506) each year, thus limiting priority setting by the MoPH. In 2015, the formally reported number of melioidosis deaths rose to 112, solely because Sunpasithiprasong Hospital, Ubon Ratchathani province, reported its own data (n = 107). Melioidosis is truly an important cause of death in Thailand, and currently reported cases (Report 506) and cases diagnosed at research centers reflect the tip of the iceberg. Laboratory training and communication between clinicians and laboratory personnel are required to improve diagnosis and treatment of melioidosis countrywide. Implementation of rapid diagnostic tests, such as a lateral flow antigen detection assay, with high accuracy even in melioidosis-endemic countries such as Thailand, is critically needed. Reporting of all culture-confirmed melioidosis cases from every hospital with a microbiology laboratory, together with final outcome data, is mandated under the Communicable Diseases Act B.E.2558. By enforcing this legislation, the MoPH could raise the priority of this disease, and should consider implementing a campaign to raise awareness and melioidosis prevention countrywide.

Keywords: Burkholderia pseudomallei; Thailand; awareness; diagnosis; melioidosis; mortality; prevention; surveillance; treatment.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

Evidence and distribution of melioidosis in Thailand from 1910 to 2015. Red icons represent geolocated records of culture-confirmed human cases (1a), culture-confirmed animal cases (1b) and presence of B. pseudomallei (1c). Green, orange, pink, rose, blue, and yellow colors represent Northeast, North, East, West, South, and Central Thailand, respectively. Interactive data are available online [54].

See this image and copyright information in PMC

References

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[1] Chittivej C., Buspavanij S., Chaovanasai A. Melioidosis with case report in a Thai. R. Thai Army Med. J. 1955;68:11–17.

[2] Chittivej C., Buspavanij S., Chaovanasai A. Melioidosis with case report in a Thai. R. Thai Army Med. J. 1955;68:11–17.

[3] Chayasirisobhon S., Intraprasit S., Jayanetsssra P., Punyagupta S. Acute septicemic melioidosis. J. Med. Assoc. Thai. 1976;59:375–379. - PubMed

[4] Chayasirisobhon S., Intraprasit S., Jayanetsssra P., Punyagupta S. Acute septicemic melioidosis. J. Med. Assoc. Thai. 1976;59:375–379. - PubMed

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[9] Hoffmaster A.R., AuCoin D., Baccam P., Baggett H.C., Baird R., Bhengsri S., Blaney D.D., Brett P.J., Brooks T.J., Brown K.A., et al. Melioidosis diagnostic workshop, 2013. Emerg. Infect. Dis. 2015;21:e141045. - PMC - PubMed

[10] Hoffmaster A.R., AuCoin D., Baccam P., Baggett H.C., Baird R., Bhengsri S., Blaney D.D., Brett P.J., Brooks T.J., Brown K.A., et al. Melioidosis diagnostic workshop, 2013. Emerg. Infect. Dis. 2015;21:e141045. - PMC - PubMed

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Melioidosis in Thailand: Present and Future

Affiliations

Melioidosis in Thailand: Present and Future

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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