International Emerging Infections Program

Mueang Nonthaburi, Thailand

International Emerging Infections Program

Mueang Nonthaburi, Thailand

Time filter

Source Type

Nguku P.M.,Ministry of Public Health and Sanitation | Sharif S.K.,Public Health and Sanitation | Mutonga D.,Ministry of Health | Amwayi S.,Ministry of Public Health and Sanitation | And 10 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

An outbreak of Rift Valley fever (RVF) occurred in Kenya during November 2006 through March 2007. We characterized the magnitude of the outbreak through disease surveillance and serosurveys, and investigated contributing factors to enhance strategies for forecasting to prevent or minimize the impact of future outbreaks. Of 700 suspected cases, 392 met probable or confirmed case definitions; demographic data were available for 340 (87%), including 90 (26.4%) deaths. Male cases were more likely to die than females, Case Fatality Rate Ratio 1.8 (95% Confidence Interval [CI] 1.3-3.8). Serosurveys suggested an attack rate up to 13% of residents in heavily affected areas. Genetic sequencing showed high homology among viruses from this and earlier RVF outbreaks. Case areas were more likely than non-case areas to have soil types that retain surface moisture. The outbreak had a devastatingly high case-fatality rate for hospitalized patients. However, there were up to 180,000 infected mildly ill or asymptomatic people within highly affected areas. Soil type data may add specificity to climate-based forecasting models for RVF. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.


Fry A.M.,Centers for Disease Control and Prevention | Chittaganpitch M.,National Institute of Health | Baggett H.C.,International Emerging Infections Program | Peret T.C.T.,Centers for Disease Control and Prevention | And 10 more authors.
PLoS ONE | Year: 2010

Background: We describe the epidemiology of hospitalized RSV infections for all age groups from population-based surveillance in two rural provinces in Thailand. Methods: From September 1, 2003 through December 31, 2007, we enrolled hospitalized patients with acute lower respiratory tract illness, who had a chest radiograph ordered by the physician, from all hospitals in SaKaeo and Nakhom Phanom Provinces. We tested nasopharyngeal specimens for RSV with reverse transcriptase polymerase chain reaction (RTPCR) assays and paired-sera from a subset of patients with IgG enzyme immunoassay. Rates were adjusted for enrollment. Results: Among 11,097 enrolled patients, 987 (8.9%) had RSV infection. Rates of hospitalized RSV infection overall (and radiographically-confirmed pneumonia) were highest among children aged <1 year: 1,067/100,000 (534/100,000 radiographically-confirmed pneumonia) and 1-4 year: 403/100,000 (222/100,000), but low among enrolled adults aged ≥65 years: 42/100,000. Age <1 year (adjusted odds ratio [aOR] = 13.2, 95% confidence interval [CI] 7.7, 22.5) and 1-4 year (aOR = 8.3, 95% CI 5.0, 13.9) were independent predictors of hospitalized RSV infection. Conclusions: The incidence of hospitalized RSV lower respiratory tract illness among children <5 years was high in rural Thailand. Efforts to prevent RSV infection could substantially reduce the pneumonia burden in children aged <5 years.


Simmerman J.M.,International Emerging Infections Program | Suntarattiwong P.,Queen Sirikit National Institute of Child Health | Levy J.,International Emerging Infections Program | Jarman R.G.,Us Armed Forces Research Institute Of Medical Science | And 8 more authors.
Influenza and other Respiratory Viruses | Year: 2011

Background Evidence is needed on the effectiveness of non-pharmaceutical interventions (NPIs) to reduce influenza transmission. Methodology We studied NPIs in households with a febrile, influenza-positive child. Households were randomized to control, hand washing (HW), or hand washing plus paper surgical face masks (HW+FM) arms. Study nurses conducted home visits within 24hours of enrollment and on days 3, 7, and 21. Respiratory swabs and serum were collected from all household members and tested for influenza by RT-PCR or serology. Principal Findings Between April 2008 and August 2009, 991 (16·5%) of 5995 pediatric influenza-like illness patients tested influenza positive. Four hundred and forty-two index children with 1147 household members were enrolled, and 221 (50·0%) were aged <6years. Three hundred and ninety-seven (89·8%) households reported that the index patient slept in the parents' bedroom. The secondary attack rate was 21·5%, and 56/345 (16·3%; 95% CI 12·4-20·2%) secondary cases were asymptomatic. Hand-washing subjects reported 4·7 washing episodes/day, compared to 4·9 times/day in the HW+FM arm and 3·9 times/day in controls (P=0·001). The odds ratios (ORs) for secondary influenza infection were not significantly different in the HW arm (OR=1·20; 95% CI 0·76-1·88; P-0.442), or the HW+FM arm (OR=1·16; 95% CI.0·74-1·82; P=0.525). Conclusions Influenza transmission was not reduced by interventions to promote hand washing and face mask use. This may be attributable to transmission that occurred before the intervention, poor facemask compliance, little difference in hand-washing frequency between study groups, and shared sleeping arrangements. A prospective study design and a careful analysis of sociocultural factors could improve future NPI studies. © 2011 Blackwell Publishing Ltd.


Levy J.W.,International Emerging Infections Program | Suntarattiwong P.,Queen Sirikit National Institute of Child Health | Simmerman J.M.,International Emerging Infections Program | Simmerman J.M.,Centers for Disease Control and Prevention | And 5 more authors.
Influenza and other Respiratory Viruses | Year: 2014

Within a hand-washing clinical trial, we evaluated factors associated with fomite contamination in households with an influenza-infected child. Influenza virus RNA contamination was higher in households with low absolute humidity and in control households, suggesting that hand washing reduces surface contamination. © 2013 The Authors.


Fry A.M.,Centers for Disease Control and Prevention | Lu X.,Centers for Disease Control and Prevention | Olsen S.J.,Centers for Disease Control and Prevention | Chittaganpitch M.,National Institute of Health | And 4 more authors.
PLoS ONE | Year: 2011

Background: We describe human rhinovirus (HRV) detections in SaKaeo province, Thailand. Methods: From September 1, 2003-August 31, 2005, we tested hospitalized patients with acute lower respiratory illness and outpatient controls without fever or respiratory symptoms for HRVs with polymerase chain reaction and molecularly-typed select HRVs. We compared HRV detection among hospitalized patients and controls and estimated enrollment adjusted incidence. Results: HRVs were detected in 315 (16%) of 1919 hospitalized patients and 27 (9.6%) of 280 controls. Children had the highest frequency of HRV detections (hospitalized: <1 year: 29%, 1-4 year: 29%, ≥65 years: 9%; controls: <1 year: 24%, 1-4 year: 14%, ≥65 years: 2.8%). Enrollment adjusted hospitalized HRV detection rates were highest among persons aged <1 year (1038/100,000 persons/year), 1-4 years (457), and ≥65 years (71). All three HRV species were identified, HRV-A was the most common species in most age groups including children aged <1 year (61%) and all adult age groups. HRV-C was the most common species in the 1-4 year (51%) and 5-19 year age groups (54%). Compared to controls, hospitalized adults (≥19 years) and children were more likely to have HRV detections (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.5, 15.8; OR: 2.0, CI: 1.2, 3.3, respectively) and hospitalized children were more likely to have HRV-A (OR 1.7, CI: 0.8, 3.5) or HVR-C (OR 2.7, CI: 1.2, 5.9) detection. Conclusions: HRV rates were high among hospitalized children and the elderly but asymptomatic children also had substantial HRV detection. HRV (all species), and HRV-A and HRV-C detections were epidemiologically-associated with hospitalized illness. Treatment or prevention modalities effective against HRV could reduce hospitalizations due to HRV in Thailand.


Kosoy M.,Centers for Diseases Control and Prevention | Bai Y.,Centers for Diseases Control and Prevention | Sheff K.,Centers for Diseases Control and Prevention | Morway C.,Centers for Diseases Control and Prevention | And 9 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

To determine the role of Bartonella species as causes of acute febrile illness in humans from Thailand, we used a novel strategy of co-cultivation of blood with eukaryotic cells and subsequent phylogenetic analysis of Bartonella-specific DNA products. Bartonella species were identified in 14 blood clots from febrile patients. Sequence analysis showed that more than one-half of the genotypes identified in human patients were similar or identical to homologous sequences identified in rodents from Asia and were closely related to B. elizabethae, B. rattimassiliensis, and B. tribocorum. The remaining genotypes belonged to B. henselae, B. vinsonii, and B. tamiae. Among the positive febrile patients, animal exposure was common: 36% reported owning either dogs or cats and 71% reported rat exposure during the 2 weeks before illness onset. The findings suggest that rodents are likely reservoirs for a substantial portion of cases of human Bartonella infections in Thailand. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.


Feikin D.R.,International Emerging Infections Program | Feikin D.R.,Centers for Disease Control and Prevention | Feikin D.R.,Kenya Medical Research Institute | Audi A.,International Emerging Infections Program | And 17 more authors.
International Journal of Epidemiology | Year: 2010

Background In African settings with poor access to health care, surveillance and surveys of disease burden are often done through home visits. The optimal recall period to capture data on symptoms and health utilization is unknown. Methods We collected illness data among 53 000 people during fortnightly home visits in rural and urban Kenya. Dates of cough, fever and diarrhoea in the past 2 weeks and health-seeking behaviour were recorded. Incidence rates were modelled using Poisson regression for data collected from 1 July 2006 to 30 June 2007. Results Incidence rates were higher in days 0-6 before the home visit than in days 7-13 before the home visit for all three symptoms, for the rural and urban sites, for children and adults, for selfand proxy-reported symptoms and for severe and non-severe illness in children. Recall decay was steeper in the rural than the urban sites, and for proxythan self-reported symptoms. The daily prevalence of symptoms fell <80% of the maximum prevalence when asking about symptoms 43 days before the home visit for children and 44 days for persons 55 years of age. Recall of previously documented clinic visits, and prescriptions of antimalarials and antibiotics also declined by ~ 7, 15 and 23% per week, respectively, in children aged <5 years, and 6, 20 and 16%, respectively, in older persons (P<0.0001 for each decline). Conclusions A 2-week recall period underestimates true disease rates and health-care utilization. Shorter recall periods of 3 days in children and 4 days in adults would likely yield more accurate data. Published by Oxford University Press on behalf of the International Epidemiological Association 2010.


Sang R.,Kenya Medical Research Institute | Kioko E.,U.S. Army | Lutomiah J.,Kenya Medical Research Institute | Warigia M.,Kenya Medical Research Institute | And 11 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

In December 2006, Rift Valley fever (RVF) was diagnosed in humans in Garissa Hospital, Kenya and an outbreak reported affecting 11 districts. Entomologic surveillance was performed in four districts to determine the epidemic/epizootic vectors of RVF virus (RVFV). Approximately 297,000 mosquitoes were collected, 164,626 identified to species, 72,058 sorted into 3,003 pools and tested for RVFV by reverse transcription-polymerase chain reaction. Seventy-seven pools representing 10 species tested positive for RVFV, including Aedes mcintoshi/circumluteolus (26 pools), Aedes ochraceus (23 pools), Mansonia uniformis (15 pools); Culexpoicilipes, Culex bitaeniorhynchus (3 pools each); Anopheles squamosus, Mansonia africana (2 pools each); Culex quinquefasciatus, Culex univittatus, Aedes pembaensis (1 pool each). Positive Ae. pembaensis, Cx. univittatus, and Cx. bitaeniorhynchus was a first time observation. Species composition, densities, and infection varied among districts supporting hypothesis that different mosquito species serve as epizootic/epidemic vectors of RVFV in diverse ecologies, creating a complex epidemiologic pattern in East Africa. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.


Anyangu A.S.,Ministry of Public Health and Sanitation | Gould L.H.,Centers for Disease Control and Prevention | Sharif S.K.,Ministry of Public Health and Sanitation | Nguku P.M.,Ministry of Health | And 11 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

A large Rift Valley fever (RVF) outbreak occurred in Kenya from December 2006 to March 2007. We conducted a study to define risk factors associated with infection and severe disease. A total of 861 individuals from 424 households were enrolled. Two hundred and two participants (23%) had serologic evidence of acute RVF infection. Of these, 52 (26%) had severe RVF disease characterized by hemorrhagic manifestations or death. Independent risk factors for acute RVF infection were consuming or handling products from sick animals (odds ratio [OR] = 2.53, 95% confidence interval [CI] = 1.78-3.61, population attributable risk percentage [PAR%] = 19%) and being a herdsperson (OR 1.77,95% CI = 1.20-2.63, PAR% = 11%). Touching an aborted animal fetus was associated with severe RVF disease (OR = 3.83,95% CI = 1.68-9.07, PAR% = 14%). Consuming or handling products from sick animals was associated with death (OR = 3.67,95% CI = 1.07-12.64, PAR% = 47%). Exposures related to animal contact were associated with acute RVF infection, whereas exposures to mosquitoes were not independent risk factors. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.


Suntarattiwong P.,Queen Sirikit National Institute of Child Health | Jarman R.G.,Us Armed Forces Research Institute Of Medical Science | Levy J.,International Emerging Infections Program | Baggett H.C.,International Emerging Infections Program | And 3 more authors.
Pediatric Infectious Disease Journal | Year: 2010

We identified febrile pediatric outpatients seeking care for influenza like illness in Bangkok. Two nasal and 1 throat swab were tested using the QuickVue A+B rapid influenza kit and reverse transcription-polymerase chain reaction. Among 142 pandemic influenza A (H1N1)-positive patients, the QuickVue test identified 89 positive tests for a sensitivity of 62.7% (95% confidence interval [CI]: 54.7-70.6). Specificity was 99.2% (95% CI: 98-100). In the 0 to 2 years age group, sensitivity was 76.7% (95% CI: 61.5-91.8). Throat and nasal swabs are equally useful diagnostic specimens for reverse transcription-polymerase chain reaction diagnosis. Copyright © 2010 by Lippincott Williams & Wilkins.

Loading International Emerging Infections Program collaborators
Loading International Emerging Infections Program collaborators