Respiratory Disease Surveillance in 6 Royal Thai Army Hospitals along Thai Borders
Session I – Narongrid Sirisopana
Title of Contribution: Respiratory Disease Surveillance in 6 Royal Thai Army Hospitals along Thai Borders
Authors: J. Gaywee1, N. Sirisopana1, C. Eamsila1, P. Watcharapichat1, T. Chuenchitra1, J. Vudtakanok2, S. Boonlikit3, W. Srichantrapunt4, S. Paonin5, S. Ngoenthongkrajang6, R. Pattanarangsan7, L. Bodhidatta1, R.G. Jarman1, J.A. Pavlin1, C.J. Mason1
Affiliation: 1Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand, 2 Fort Surasi Hospital, Kanchanaburi, Thailand, 3 Fort Surasinghanath Hospital, Sra-Kaeo, Thailand, 4 Fort Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand, 5 Fort Mengraimaharat Hospital, Chiangrai, Thailand, 6 Fort Khetudomsak Hospital, Chumphon, Thailand, 7 Fort Ingkayuthaborihan Hospital, Pattani, Thailand
Abstract: In order to determine the seasonal and regional etiology of respiratory diseases, enhance outbreak response capability, and to enable the safe collection of clinical samples, the Royal Thai Army established a network of respiratory disease surveillance at 6 hospitals in areas with high border traffic near Myanmar, Laos, Cambodia and Malaysia.
Adults presenting influenza like illnesses (history of fever and cough or sore throat or rhinorrhea) are consented and enrolled. Respiratory samples are tested with a rapid test for influenza A and B on-site. Aliquots are sent to AFRIMS in Bangkok for influenza genotyping using realtime RT-PCR and identifying other respiratory pathogens by MassTag PCR. MassTag PCR amplifies genetic material utilizing domain-specific primers tagged with a unique mass to allow spectrometric analysis and detection of up to 30 respiratory pathogens.
From March 2007 to October 2008, 862 samples were collected. On site influenza rapid testing found 74 were positive for influenza A and 37 for influenza B. More comprehensive realtime RT-PCR testing on an initial 779 samples demonstrated 189 influenza positive; 65 influenza A/H1, 64 influenza A/H3, 2 influenza A/unsubtypable and 58 Influenza B. Further detection by MassTag PCR on an initial 409 samples revealed 143 were infected by viruses (Influenza A, 20-B, RSV-A, -B, hMPV, enterovirus, adenovirus and PIV 4 subtypes) and bacteria (M. pneumoniae, H. influenzae and S. pneumoniae). In addition MassTag PCR identified co-infection of pathogens such as RSV-B with S. pneumoniae, adenovirus + corinavirus-OC43+ H. influenzae, H. influenzae with S. pneumoniae, influenza A, or PIV-1.
