Keypoints:
situationsmallpox apeThat has increased from about 1 year ago, there were more than 20 patients, but during June-July 2023 met hundreds of patients and co-infected with HIV, althoughsmallpox apeIt can be treated according to the symptoms and can be cured by itself. But the relationship that doesn’t know me, doesn’t know you is the reason why I can’t follow the touch. As a result, the number of sick people increased and there was the first death in Thailand and also an HIV infection. Symptoms and recent treatmentsmallpox ape which the World Health Organization (WHO) is studying the use of one drug in the treatment and Thailand is one of the countries that have been given this drug to be used
Smallpox escalates, joins HIV infection
diseasesmallpox apeIt is an emerging infectious disease in Thailand. Found in Thailand since last year, from July 2022 until April 2023, met only over 20 cases, but in May, met more than 20 monthly, June met almost 50 cases, July met. a hundred As for the month of August It is expected that it will be in the hundreds as well.
As of August 8, 2023, there were a total of 189 cases reported in Thailand, 161 of whom were Thai nationals and 28 were foreigners.
According to documents from the Department of Disease Control, it was reported that from January 1 to August 15, 2023, there were 217 patients, 30 foreigners, 187 Thais, with an average age of 20-64 years, among which died. 1 case, 34 years old, untreated HIV infection
Infections were reported in 19 provinces, with three provinces in the red level: Bangkok (136 cases), Nonthaburi (14 cases), Chonburi (9 cases).
Orange has 3 provinces: Samut Prakan, 9 cases, Phuket, 8 cases, Pathum Thani, 7 cases.
There are 13 provinces in yellow: Samut Sakhon, Lopburi, Maha Sarakham, Khon Kaen, Phayao, 2 each, Nakhon Ratchasima, Kalasin, Chachoengsao, Suphan Buri, Nakhon Nayok, Chiang Rai, Ayutthaya, 1 each, and Rayong 3.
Infected people tend to spread more. In the first phase, patients were found in Bangkok and its vicinity before spreading to other provinces. Most of the patients were men who had sex with men. and 82 HIV-infected cases (43%)
In the beginning, there will be a number of foreigners. But in later infections Almost 100 percent of the infected are Thai people, and foreigners who were recently infected were infected in Thailand. It’s not an infection from abroad.
Dr. Sophon Iamsirithavorn The Deputy Director-General of the Department of Disease Control (Khor.) said that the situation of smallpox epidemic increased. reflecting the continued risky behavior Nearly half of all new smallpox cases are HIV-infected.
This group of patients is already immunocompromised. It is often associated with other opportunistic infections, causing severe symptoms that lead to death.
“The current situation is worrisome. in risk groups who have unsafe sex As for people who don’t have risky sexual behaviors, they shouldn’t be too worried. The most infected areas are Bangkok, perimeter, tourist provinces. which is a province where there are people with very risky behaviors, ”said Dr. Sophon.
infected with HIV-smallpox, the first death of a monkey
Globally, 152 deaths of smallpox cases have been reported since the start of the outbreak in Europe and other countries since May 2022.
In Thailand, in mid-August 2023, the Department of Disease Control received a report of a death of a smallpox patient from Bamrasnaradura Infectious Diseases Institute. therefore sent a team to investigate and control the disease The Division of Epidemiology and the Office of Disease Prevention and Control 6, Chonburi, went to investigate the disease together with the Chonburi Provincial Public Health Office and relevant agencies in the area. It was found that
The deceased was a 34-year-old male with a history of fever, headache, itching, and rashes and blisters on the skin in different parts of the body since July 3, 2023, and was admitted to a private hospital in Chonburi Province. On July 11, 2023, doctors suspected smallpox. Therefore, samples were sent to confirm the genetic material of the smallpox virus. and at the same time detecting HIV and syphilis infections
Later, the patient had a sore throat, fungal infection was detected. which is an opportunistic infection of HIV Smallpox lesions from smallpox spread all over the body on the skin. After four weeks of treatment, the doctor allowed him to go home. Later, on August 9, the patient had fatigue and difficulty breathing. The relatives therefore brought the patient to be treated at Bamrasnaradura Infectious Diseases Institute.
A rash from smallpox was found spreading all over the body. and extensive tissue necrosis in the nose and throat Complications of infection in the arms and legs have pneumonia and symptoms of encephalitis A CD4 count of 16 cells/mL indicates severe immunodeficiency. Doctors have also prescribed smallpox antiviral drugs and antibiotics. Later, the patient’s condition deteriorated and died on the night of August 11, 2023.
Chakrarath Pittayawonganon, M.D. Director of the Division of Epidemiology, Department of Disease Control, Ministry of Public Health.Explain that cases of smallpox infection and IHV infection can be divided into 2 groups:
1. HIV-infected but receiving antiretroviral drugs able to control the level of immunity to be within normal limits When infected with smallpox, the symptoms of smallpox are pustules, similar to small abscesses. distributed throughout the body
2. HIV patients with opportunistic infections very low body immunity Risk of complications such as pneumonia, fungal or bacterial encephalitis when infected with smallpox will make the pustules become larger, clustered, with a large number of abscesses
“Deaths can be caused by HIV. However, due to the nature of smallpox infection, the symptoms that are expressed are more than patients who are not infected with HIV or who are HIV-infected but can be controlled. Therefore, it was not possible to clearly determine which infection died from it, ”said Dr. Chakrarath.
You don’t know me – you can’t follow the toucher.
From the investigation of smallpox patients in Thailand Most of them have sexual behavior that comes from dating via dating/dating applications. Therefore, there is a risk that it may be infected by having sex with someone you don’t know.
when it is found that one is infected Was unable to track close contacts with the patient because when the activity is completed The user account has already been cancelled. This makes it more difficult to investigate the disease, or some cases have sex like One Night Stand.
“Some people change their sex partners every day without knowing each other’s names. Many people hide their real identity when using the application. which is a concern that Smallpox infection is starting to look like an AIDS trend. starting with a group of people Then it spread to other groups, ”said Dr. Chakrarath.
Risk factors – smallpox symptoms
Major risk factors for infection and transmission It is having sex with an unknown stranger who is infected with smallpox. The risk is divided into 3 levels:
1. Intimate contact, such as having sexual activity even wearing a condom can become infected because the patient’s pustules may touch the skin cause infection
2. close contact, such as sharing a bed share a bathroom Being close to each other or just holding hands The risk will be reduced.
and 3. indirect contact, such as the patient going to sleep in a hotel Then the staff came to clean the room. A general feast that is not so close that they snuggle together. eating together at the table
successively
Those at risk can be examined.
Initial symptoms on their own A rash/blister on the genitals, anus, mouth, or body and had a history of close contact, intimate contact, or having sex with suspected smallpox or smallpox patients Observe yourself within 21 days after touching the patient if you have symptoms such as fever, headache, aches, swollen lymph nodes, rashes, or blisters or pustules in the genital area, anus, or around the hands, feet, chest, face, or mouth. to be examined at a health facility or hospital immediately by notifying symptoms and risk history for diagnosis
A specific drug for the treatment of smallpox
There is currently no specific treatment for smallpox, so symptomatic treatment is used. However, 100 people in Thailand have received an antiviral drug called Tecovirimat (or TPOXX) from the World Health Organization (WHO) to treat severely ill patients with smallpox that may cause complications. And the effectiveness of this drug must be measured simultaneously.
It is currently being used and stored at Bamrasnaradura Infectious Diseases Institute. The criterion for smallpox patients to receive the drug was HIV infection with low immune levels. There are complications from opportunistic diseases. People with pneumonia Which this drug is oral type, 1 patient will take only 2 times, however, data is still being collected for actual usage in Thailand. Including information on side effects from taking the drug.
“Patients with smallpox are not at risk. Symptomatic treatment can be used. The disease will take about 2-4 weeks to heal and then it will disappear by itself, ”said Dr. Chakrarath.
Contact-prevention of smallpox
Smallpox is a sexually transmitted disease. And direct contact without having to have sex, such as touching the skin around the pustules then get into the body through the skin that may have broken skin or a wound
In addition, smallpox disease began to be found among males who have sex with men. that despite being protected with a condom But it can’t prevent smallpox infection. Because abscesses occur on the body If you come in contact, you can get infected.
And if you have sex in a bisexual sexual orientation, the infection will spread among women. and the risk spreads to other groups as well
Smallpox can be prevented.
by abstaining from sex with strangers Do not touch skin-to-skin with people with rashes, blisters or pus. It is recommended to wash your hands frequently. Do not share personal belongings with others.
If people have questions or need advice on how to act, they can ask for information at the Department of Disease Control hotline, call 1422.
2023-08-26 09:16:00
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