Public health in jeopardy

Written By Unknown on Saturday 29 June 2013 | 07:45















With the convenience and speed of modern air travel and the increasing number of people on the move, no country is safe from what once would have been a localised outbreak of infectious disease.


If the outbreak is virulent, it is unlikely to remain localised for very long and that is when Bangkok's role as an air hub and crossroads of Asia can attract unwelcome visitors. The Public Health Ministry is the first line of defence and this week it has been busy.


In a precautionary move, the ministry put hospitals and health officials on alert and issued airport advisories in Thai, English and Arabic in a bid to keep a deadly new Sars-type virus out of the kingdom. Known as Mers (Middle East respiratory syndrome), the coronavirus has been branded by the World Health Organisation (WHO) as a major global health threat.


The ministry is clearly concerned that Thai workers and other travellers coming from the Middle East could carry it and that pilgrims journeying to Saudi Arabia for the Haj in coming months could be vulnerable. With 40 known deaths in 77 cases in eight countries, it is important to contain it before it does as much damage as the Sars virus, which had a slow start and then took nearly 800 lives in 30 countries a decade ago.


But while the ministry looks at the global picture and charts threats and trends, it must not lose sight of what is happening in its own backyard. Some years ago, a health researcher working for the WHO in Vietnam complained that an exotic "disease du jour" would always attract the most attention and suck funding from the "old" third world diseases such as tuberculosis (TB), malaria, dengue and other tropical scourges. Key to this is the ability of a new coronavirus such as Mers to pose a threat to those living in the richer countries. If it does, research grants suddenly become available and Big Pharma takes an active interest in finding a vaccine or cure. Not so in developing countries.


TB alone accounts for over 12,000 deaths a year in Thailand, with up to 100,000 new cases diagnosed annually. Dengue pales by comparison but is becoming rampant. The number of patients infected doubled this month to an average of 570 a day and health experts have warned the country to brace for the worst dengue season in memory. The figure already stands at 49,000 cases with 49 deaths and a record 4,400 cases in Bangkok this year. Nearly half of these were children.The experts blame the rise in the number of common house mosquitoes, leading to an increased risk of residents being bitten; the fact that mosquitoes are breeding at higher rates with 100-200 eggs at a time; and the decline in efficacy of Deet, which is the active ingredient in many mosquito repellents.


Dengue fever itself appears to be becoming more virulent as demonstrated by the case of a 21-year-old university student in Phuket. Janjira Dispan suffered through one bout, recovered and then had the misfortune to be bitten and infected again. Sadly, she did not survive the second round and died on June 14.


Rising temperatures, longer rainy seasons and increased urbanisation are all contributing to the explosion of dengue and other debilitating vector-borne diseases, which are no longer cyclical. Substandard sanitation and overcrowding allow more disease-carrying mosquitoes to live closer to people with disastrous consequences.


We need solutions and we need them now.




















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Article source: http://www.thethailandlinks.com/2013/06/29/public-health-in-jeopardy/

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