On 22 March 2019 the Thai Department of Disease Control (DDC) was notified that 16 workers, including Thai and Myanmar migrant workers, from two factories located in Nakhon Phathom Province, had presented with a fever with rash during the previous 2 weeks. Active case finding was conducted among workers in both factories using face-to-face interviews. Suspected cases were defined as a worker who developed fever with rash with one of the following symptoms: cough, coryza or conjunctivitis. Testing for measles IgM antibodies and viral identification through throat swabs by polymerase chain reaction (PCR) were performed to confirm diagnosis. Vaccination history among cases was reviewed. Nationality and age-specific attack rates (AR) were calculated. An environmental study and a social network analysis were conducted to better understand the transmission process. A total 56 cases (AR = 0.97%) were identified. Of 21 serum measles IgM collected, 8 (38.0%) were positive. Of 8 throat swabs collected, 5 (62.5%) were positive for measles genotype D8. The disease attack rate in migrant employees was twice as large as the rate in Thai counterparts (AR = 0.7 and 1.4%). The first case was identified as a Myanmar worker who arrived in Thailand two weeks prior to his illness. The Myanmar workers’ accommodation was more crowded than that for Thai workers. The hot spots of transmission were found at a drinking water tank which had shared glasses. Among the cases, 62.5% could not recall their vaccination history, and 25% had never had an injection containing a measles vaccination. The majority of migrant cases had never completed a two-dose measles vaccination. To halt the outbreak, measles vaccines were administered to the employees, particularly those working in the same sections with the cases and shared glasses were removed. For future policy action, a vaccination program should be incorporated into the work permit issuance process.
On 29 Jan 2020, the Operation team was notified by the Emergency Operation Center that there was a Chinese man infected with SARS-CoV-2 admitted in a private hospital in Bangkok. Division of Epidemiology, Office of Disease Prevention and Control 1, 11, and Institute for Urban Disease Control and Prevention jointly deployed to conduct an investigation. Descriptive study was conducted by interviewing the index case about his symptoms, travel history, and reviewing medical records. Contact tracing was done. Close contacts of the index case were classified to high-risk and low-risk contacts. Laboratory testing for SARS-CoV-2 was done among high-risk contacts and symptomatic low-risk contacts. The index case was a 30-year-old Chinese. He had worked in Guangxi province, China. He spent 2 days in Wuhan city and 2 days in Guangzhou city before traveling to Thailand. He developed fever, cough, and sore throat after being in Thailand for 3 days. According to the median incubation period of COVID-19, he could be infected from China. Since he started traveling from China, he wore a surgical mask all the time. From contact tracing, the high-risk contacts that could be followed, none of them had laboratory test positive. Therefore, this strategy of wearing a face mask should be encouraged nationwide especially in case that physical distancing could not be done.
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