Diphtheria Cases at the Thailand-Myanmar Border Area, Tak Province, 2013-2014:Clinical Features, Prevention and Control Measures

Abstract

The aims of this study were to describe characteristics of two diphtheria cases at the Thailand-Myanmar border area in Tak province, 2013-2014 and develop guidelines for disease prevention and control. The methods included medical record reviews of the two cases, results of epidemiological investigation, control and preventive measures by the surveillance and rapid response team. Both cases were Myanmar children. The first case diagnosed in 2013 was a 5-year old girl who was born and lived in Phop Phra district, Tak province, and the other case diagnosed in 2014 was a 7-year old girl who was born and lived in Myanmar border village close to Mae Ramat district area, Tak province. Both cases had fever, cough, sore throat, dyspnea, white patches in the throat and leukocytosis (white blood cells > 10,000/mm”). Toxigenic Corynebacterium diphtheriae was isolated from throat swab culture from the first case but the swab culture was not performed in the other case. Both cases received antibiotics, diphtheria antitoxin, and tracheostomy. The first case recovered after 29 days of hospital stay and the other died one day following hospital admission. Both had never had vaccination against diphtheria. This study indicated an opportunity for outbreak of vaccine-preventable diseases, such as diphtheria at the Thailand Myanmar border area and required effective prevention and control measures, including rapid response followingthe notification of a case or outbreak of diphtheria.