Thailand Experiences in Managing Health Crisis Kuala Lumpur, MALAYSIA 17-19 December 2012 Dr. Pahurat K. Taisuwan Department of Disease Control, Ministry of Public Health, Thailand
Thailand more concern about public health emergency [World Health Organization, 2005, 10-11]; for examples: 1) Severe outbreak of Cholera or severe diarrhea, Dengue hemorrhagic fever 2) Emerging Infectious diseases, i.e., SARS, Bird flu 3) Bioterrorism agents, i.e., anthrax, botulin and smallpox 4) Chemical agents, for instance ricin, phosgene, and sarin 5) Mass trauma, for instance explosions/blasts, burns, and injuries 6) Natural disaster, for instance storms, floods, and earth quakes 7) Radiation emergencies.
During the past ten years, Thailand had experience to the natural infectious diseases outbreak and natural disaster; for instance, -on 1998, the 1 st Food borne botulism from home- canned bamboo shoots there were 13 severe cases with 2 death cases, -on 2001, the Anthrax mail hoaxes, more than 200 hoax letters had been send to important people and offices -on 2002, SARS outbreak there were 9 probable SARS cases with 2 death case, -on 2006 the 2 nd Food borne botulism from home- canned bamboo shoots 163 peoples got sick, 56 severe cases with no death case,
-on 2004-09 Avian Influenza H5N1 1 st and 2 nd round outbreak 25 confirmed cases with 17 died. -on 2009-2010, Newly Influenza H1N1 outbreak 25 confirmed cases with 17 died. -on 2011, National wide flood, 65 provinces under flood, people 12.8 millions got affected, thousands, died and lost, with economical lost 1.44 million*millions baht -on early of 2012, Hand, foot and mouth outbreak -October 2012- present, Diphtheria outbreak in Thailand, we found about 40 confirmed cases, 4 death cases
1 st Food borne botulism from home-canned bamboo shoots
The Anthrax Mail Hoaxes Figure 8 specific scenarios for Thai HCWs and SRRTs
SARS outbreak Thailand MOPH set up a special taskforce at DDC to coordinate the response. This taskforce worked out with concerned DDC and MOPH offices to organize initial response to SARS which included these activities: 1) modifying existing surveillance to accommodate for detection and investigation and community control of SARS, 2) developing technical guideline for hospital infection control, 3) arranging advocacy and orientation meetings with provincial health offices and hospitals in the public and private sectors, 4) organizing medical equipment and supplies system in support of the surveillance and infection control, 5) closely monitoring daily change of international and national SARS situation, and 6) providing information for administrators and the public.
MOPH’s early response to the media was of a reactive approach, trying daily to respond to questions and correct rumors. By mid April, with MOPH’s SARS operation center set up and running, MOPH resorted to an organized proactive approach to the media. All MOPH announcements, advises, situation updates and technical information on SARS were released from formal spokesmen and also posted on MOPH’s SARS web page for public use. This level of managed response to media virtually helped put MOPH in better control with public information demand, and presumably contributed tremendously to stabilization of public sensitivity to the situation.
2 nd Food borne botulism from home-canned bamboo shoots: Thailand revised investigation and response, laboratory diagnosis and case management capacity after bird flu outbreak. Figure 3 a botulism patient with mechanical ventilation Figure 6 Information center for psychosocial support patient ’ s families and media Figure 7 reference processes from Nan province hospital to higher capacity hospitals
For Thailand, significant progress, i t has been recognized that the strength of public health infrastructures, especially for surveillance, laboratory verification, case management, risk communication and transparency of information shared between each multi-sector task from the nation level to local level, including building up infectious diseases information system combine to geographical information system.