1Dengue Thailand for NAC 2014

Dengue Surveillance and
Response in Thailand
Dr.Sopon Iamsirithaworn, MD, MPH, PhD
Office of Disease Prevention and Control 1,
Department of Disease Control, Ministry of Public Health, Thailand
1 April 2014
Outline of Presentation
Case-based surveillance for dengue
(DF/DHF/DSS)
Epidemiology of dengue in Thailand
Dengue responses in Thailand, 2013
2
Source of Dengue Surveillance Data
Case-based surveillance and
reported as DF/DHF/DSS
District Hospitals
Provincial hospitals
ผลลัพธ์ ของการติดเชือไวรัสเด็งกี (Dengue infection)
มีอาการป่ วย 10%
ไม่ มอี าการ 90%
Expanded dengue
Dengue
syndrome *
Undifferential Dengue fever
haemorrheagic
Fever
syndrome(DF4%)
fever (DHF1%)
(viral syndrome)
CNS/Encephalitis
(Fever 5%)
Plasma leakage
- Hepatitis/FHF
Classical
With
- Myocarditis
unusual
- ARF
haemorrhage No shock With shock
(DSS)
- Eye involvement
- IAHS
- etc.
* Severe dengue
unusual manifestation
isolated organopathy
ผลลัพธ์ของการติดเชื้อไวรัสเด็งกี่
DSS
DHF
Dengue Fever
Undifferentiated Fever
No Symptom
Dengue Incidence Rate in Thailand, 1958-2013
Rate per 100,000 pop
350
2013
2nd largest outbreak
(235/100,000)
1987
Largest outbreak
(325/100,000)
300
250
200
150
100
50
1958
1st Outbreak
1978
Every district
0
1958
1963
1968
1973
1978
1983
1988
1993
1998
2003
2008
2013
Year
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Regional dengue surveillance
WHO: Dengue Situation Updates as of 14 March 2014. Accessed at
www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/index.html
Health Security and Emergencies
7
Regional dengue surveillance
WHO: Dengue Situation Updates as of 14 March 2014. Accessed at
www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/index.html
Health Security and Emergencies
8
Regional dengue surveillance
WHO: Dengue Situation Updates as of 14 March 2014. Accessed at
www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/index.html
Health Security and Emergencies
9
Regional dengue surveillance
WHO: Dengue Situation Updates as of 14 March 2014. Accessed at
www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/index.html
Health Security and Emergencies
10
Global Dengue Situation
• Incidence of dengue has increased dramatically
around the world in recent decades
• Over 2.5 billion people
(over 40% of the world's
population) are at risk
• WHO currently estimates
50–100 million dengue
infections worldwide
every year
• 2-5 yr epidemic cycles
Health Security and Emergencies
11
DF/DHF/DSS Situation in Thailand, 2013
No. of cases:
Morbidity rate:
pop
No. of deaths:
CFR:
150,934
235 per 100,000
133
0.09%
Source: Bureau of Epidemiology, MoPH, Thailand
DF/DHF/DSS Situation in Thailand, 2013
Thailand
Bangkok
Source: Bureau of Epidemiology, MoPH, Thailand
Number of Reported DF/DHF/DSS by Month, Thailand
January 2013 – February 2014
No. of cases
2013
2014
Week of disease onset
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Updated situation of DF/DHF/DSS, Thailand
1 January 2010 – 25 March 2014
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Dengue Morbidity Rates and Case Fatality Rates,
Thailand, 1958-2013
Morbidity rate
(per 100,000 pop)
CFR (%)
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Percentage of reported DF/DHF/DSS
cases, Thailand, 2013
2.0%
55.40%
42.60%
DF
DHF
DSS
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Seasonal Trend of Dengue in Thailand
Fig. 4 Reported Cases of D.H.F,Total(26,27,66) by Month, Thailand, 2003 - 2007
June - Aug
N u m b er o f C ases
14000
12000
10000
8000
6000
4000
2000
0
Jan
Feb
Mar
2003
Apr
May
2004
Jun
Jul
2005
Aug
Sep
2006
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Oct
Nov
2007
Dec
Incidence rate of DF/DHF/DSS per 100,000 pop by
age group, Thailand, 2013
Rate/100,000 pop
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Percentages of Dengue in Adults and Children,
Thailand
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Percentage of Reported DF/DHF/DSS Cases
by Gender, Thailand, Jan-Aug 2013
Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Dengue Serotypes Circulation in Thailand,
1972-2013
%Serotype
Rate per 100,000 pop
100%
350
300
75%
250
200
50%
150
100
25%
DEN-1
DEN-2
DEN-3
Source : 1. National Surveillance System, Bureau of Epidemiology, MOPH, Thailand
2. Serotype data: Department of Medical Sciences, MOPH, Thailand
DEN-4
CR
2013
2011
2012
2009
2010
2007
2008
2006
2004
2005
2002
2003
2000
2001
1999
1997
1998
1995
1996
1993
1994
1992
1990
1991
1987
1989
1986
1984
1985
1982
1983
1980
1981
1979
1977
1978
1975
1976
1973
1974
0%
1972
50
0
Dengue control strategies in Thailand
ผลการศึกษา
Dengue responses in Thailand, 2013
• National agenda
– Public health crisis
– Emergency operation center
• Multi-sectoral collaboration
– Government, private, local administration,
public sectors
– Intensive risk communication
• Strengthening dengue surveillance
• Improving clinical practice guidelines for
dengue treatment in adult patients
Minister of Health and Public Education
Larval survey and
breeding source
reduction by
community participation
Thank you for your attention

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