Lakkana Thaikruea

Risk factors for hepatitis C virus infection among blood donors in northern Thailand

BACKGROUND:  The epidemiology, virology, and risk factors for hepatitis C virus (HCV) infection among blood donors in northern Thailand have not been extensively evaluated.

Evaluation of a multiplex human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus nucleic acid testing assay to detect viremic blood donors in northern Thailand

BACKGROUND: Screening of blood donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) has been implemented recently in the United States. There are limited data, however, on the additional NAT yield of donors in developing countries in Asia where the prevalence of infection is higher. In addition, data on hepatitis B virus (HBV) NAT in high prevalence areas are minimal.

Review of Fatal and Severe Cases of Box Jellyfish Envenomation in Thailand

The study aimed to describe severe and fatal cases of box jellyfish stings in Thailand. Medical records were reviewed and patients, relatives, health staffs, and witnesses were interviewed. The pictures of suspected box jellyfish were sent via e-mail to experts in the toxic jellyfish network for further identification. There were at least 8 cases of box jellyfish envenomation, with 4 fatal and 4 near-fatal cases. There were an equal number of male and female patients from 4 to 26 years of age. In each case, there was immediate severe pain followed by systemic reactions. Immediately after exposure to the sting, 7 victims collapsed experiencing severe pain at the tentacle marks, respiratory failure, and cardiac arrest. All patients had tentacle marks on their bodies. In none of the fatal cases was vinegar applied to the tentacle marks as first aid, but 3 out of the 4 near-fatal cases were treated with a vinegar application.

Severe Dermatonecrotic Toxin and Wound Complications Associated With Box Jellyfish Stings 2008-2013.

BACKGROUND: The Toxic Jellyfish Network and its surveillance system were set up in 2008 and in 2009, respectively. Case investigations detected 3 cases with severe cutaneous injuries described in this article. CASES: There were 57 probable cases of box jellyfish stings between 2008 and 2013. Three of these injuries resulted in dermal necrosis, and 2 were associated with severe wound complications. A Thai man aged 21 years sustained wounds on his left knee and thigh. He received oral antibiotics and daily wet dressings; he did not receive steroids. He subsequently developed blisters, swelling of the lower left leg, neuritis, and severe itching in the later stages. Nevertheless, his wounds did not become infected and there was no keloid scarring. An American woman aged 25 years sustained stings on her right hand and arm. She received antibiotic ointment and a tape that was placed directly on the wound without any gauze or padding underneath. She developed a wound infection 2 weeks postinjury. Surgical debridement was required twice to remove necrotic tissue; keloid scars persisted on evaluation at 4 months. An American woman aged 33 years received stings on her left upper thigh. Initial treatment was provided by local residents, who crushed morning glory leaves to extract the juice and then applied the juice (mixed with water) to her wounds. She received intravenous steroids, oral antihistamines, oral analgesics, and antibiotic cream at the hospital. Despite this aggressive treatment, the wounds became gangrenous and surgical debridement was required to remove necrotic tissue. CONCLUSION: Clinicians need to be knowledgeable regarding the potentially serious wounds that can develop following jellyfish stings. Additional research is needed to identify best management approaches.

The public health impact of a new simple practical technique for collection and transfer of toxic jellyfish specimens and for nematocyst identification

Our team aimed to create a new, simple, and inexpensive technique for collecting and transferring of toxic jellyfish specimens and for nematocysts identification. We collected tentacles of Chironex spp., Morbakka spp., and Physalia spp., and transferred them from the beaches by standard and by ‘vacuum sticky tape’ (VST) techniques. For the VST technique, our team placed the sticky tape on a tentacle and then folded it over to seal the tentacle in the equivalent of a vacuum. We kept the VST in room temperature. For nematocyst identification, we placed the VST on a glass microscope slide and took photographs down the microscope’s eye piece using a mobile phone camera. The image quality was as good as when produced by standard techniques. Different classes of toxic jellyfish could be identified. Thus, VST is a potential public health breakthrough because it is practical, durable, inexpensive, allows good discrimination. It enables early warning of danger to health and rapid response via social network.