The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020–2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to four different levels of Activities of Daily Living (ADL): social group; home group; bedridden group; and dead group. The volume of newcomers was projected by trend extrapolation methods with exponential growth. The transition probabilities from one state to another was obtained by literature review and model optimization. The mortality rate was obtained by literature review. Sensitivity analysis was conducted. By 2030, the number of social, home, and bedridden groups was 15,593,054, 321,511, and 152,749, respectively. The model prediction error was 1.75%. Sensitivity analysis with the change of transition probabilities by 20% caused the number of bedridden patients to vary from between 150,249 and 155,596. In conclusion, the number of bedridden elders will reach 153,000 in the next decade (3 times larger than the status quo). Policy makers may consider using this finding as an input for future resource planning and allocation. Further studies should be conducted to identify the parameters that better reflect the transition of people from one health state to another.

On 28 April 2021, the investigation team of the Department of Disease Control, Ministry of Public Health, was notified of a cluster of people developing neurological symptoms following COVID-19 vaccination in a province in eastern Thailand. We conducted an investigation from 29 April to 20 May 2021 to confirm the outbreak, describe the epidemiological characteristics and identify possible risk factors. A matched case-control study was conducted. Matching factors were gender and vaccination site. A confirmed case was a person receiving COVID-19 vaccination in the province and developed at least one neurological symptom between 21 April and 20 May 2021. The rapid assessment of the vaccination cold chain system was carried out. We found a total of 36 cases out of 3920 vaccinees (attack rate = 0.92%), all cases were recovered and classified as an immunization stress-related reaction (ISRR) by the National AEFI Expert Committee. An analytic study found that menstruation was significantly associated with ISRR (AOR = 6.84 [95%CI = 1.09–42.91]). The environmental survey suggested that the cold chain system was properly managed. Further studies on other precipitating causes of ISRR should be performed. In terms of recommendation, health providers should pay greater attention to women menstruating during and after COVID-19 immunization.

Introduction Necrotizing fasciitis (NF) is a rare skin and soft-tissue bacterial infection with high morbidity and mortality. Knowledge about the prevalence and incidence of NF in Thailand is quite sparse. The objective of this study was to determine the prevalence of NF in Thailand and factors that may be potentially associated with NF morbidity and mortality. Methods A cross-sectional study using secondary data from Thailand’s national health databases between 2014 and 2018 was conducted. Descriptive statistics using median and percentage formats were used. This was complemented by multivariable logistic regression to determine the association between various factors (such as age and underlying diseases) with NF morbidity and mortality. Univariate spatial data analysis was exercised to identify the geographical hot spots in which the disease appeared. Results During 2014–2018, we found 90,683 NF cases. About 4.86% of the cases died. The median age for all cases was 59.39 years old. The annual incidence of NF demonstrated an upward trend (from 26.08 per 100,000 population in 2014 to 32.64 per 100,000 population in 2018). The monthly incidence was highest between May and August. A high incidence cluster (as indicated by local Moran’s I) was found in the north-eastern region of Thailand. The most infected sites were on the ankles and feet (43.18%) with an amputation rate of 7.99% in all cases. Multivariable logistic regression indicated that the significant risk factor for amputation was a presence of underlying diseases, namely diabetes (OR 7.94, 95% CI 7.34–8.61). Risk factors for mortality included being elderly (OR 1.82, 95% CI 1.68–1.98) and a presence of underlying hypertension (OR 1.16, 95% CI 1.07–1.27), cirrhosis (OR 4.67, 95% CI 4.17–5.21), and malignancy (OR 1.88, 95% CI 1.55–2.26). Discussion and Conclusion As the elderly and those with chronic underlying diseases are likely to face non-preferable health outcomes from NF, healthcare providers should pay great attention to these groups of patients. Early and intensive treatment might be considered in these groups of patients. Further studies that aim to validate the volume of actual NF cases and reported NF cases are recommended.

Objective: On 1 December 2020, the Department of Disease Control of Thailand was notified of a cluster of food poisoning cases among participants at a church festival in Mae Ai district, Chiang Mai province. We conducted an outbreak investigation to confirm diagnosis, describe the epidemiological characteristics of the outbreak, identify possible sources of the outbreak and provide appropriate control measures. Methods:We reviewed medical records of the food poisoning cases from the health care centres. Active case finding was conducted among participants who had consumed food and water at the festival. An environmental survey was done in the village where the festival was held. A case-control study was conducted to identify the source of the outbreak. Samples for laboratory analysis included rectal swabs and fresh stool specimens from the cases and food handlers, surface swabs of cooking equipment, food, water and ice samples.Results: Among 436 participants surveyed, 368 (84.4%) cases of food poisoning were identified. The most common clinical manifestation was abdominal pain (89.7%), followed by watery diarrhoea (45.7%), nausea (43.5%), vomiting (38.9%), fever (18.5%) and bloody diarrhoea (4.6%). None died in this outbreak. The case-control study showed that mixed spicy seafood salad served in the festival was significantly associated with the disease by both univariable and multivariable analyses. However, the causative agent could not be identified. The environmental investigation suggested this seafood might have been undercooked. Conclusion:Clinical manifestations of the cases, incubation period and the suspected seafood salad suggested seafood-related food poisoning. Grimontia hollisae, the organism causing illness similar to Vibrio parahaemolyticus and commonly undetectable in the laboratory with routine testing, might be the pathogen that caused this outbreak.G. hollisae should be in differential diagnosis and identified in seafood-associated outbreaks.