Thailand’s other little known killer disease

■ Just a few short months ago, hardly anybody had heard of coronavirus, let alone COVID-19. That’s no longer the case, of course. Today, this nasty virus is recognized around the world as a mass killer. Here in Thailand, thankfully, we’ve been spared the worst effects of the disease with a relatively small number of deaths (50+) compared to the US (61,656) and Spain (24,000) – and counting.

For now at least, CVID-19 is less deadly than Thailand’s long list of other killer diseases - cancer, malaria, dengue, hepatitis, measles, tuberculosis, Japanese encephalitis, rabies, leptospirosis, seasonal flu and HIV.

But there’s another disease that few people know about – and yet it’s responsible for up to 2,800

deaths a year. Called melioidosis, it’s the country’s third most-deadly infectious disease after AIDS and tuberculosis. The number of fatalities could be even higher, according to some reports, because of a lack of information about the disease.

Endemic to Thailand's northeast, particularly among farming communities, melioidosis is caused by a soil and water-dwelling bacteria found in tropical regions of the world. Some 40% of those infected die from the disease. But without proper diagnosis and antibiotics given on time, the mortality rate climbs to 90 percent.

Symptoms range from mild such as fever, skin changes, pneumonia and abscesses to severe with inflammation of the brain and joints. Dangerously low blood pressure can cause death. Personto-person or animal-to-human transmission is extremely rare.

Symptoms of the disease vary considerably from patient to patient, which make diagnosis difficult. "Most of (those infected) die without knowing that they die of melioidosis. They die quickly," said Dr Limmathurotsakul Limmathurotsakul, the head of microbiology department at MORU Faculty of Tropical Medicine in Bangkok, in an interview with Al Jazeera. "When public awareness (of the disease) is zero, do you think any doctor will write on the death certificate that you die of this disease?"

During the Vietnam War, melioidosis was dubbed the 'Vietnam Time Bomb' because soldiers infected through contact with the soil and water often didn't develop symptoms until after they had arrived back home.

The US Center for Disease Control and Prevention classifies melioidosis as a microorganism that could be used as a ‘bioterrorism agent.’ placing it in the same category as anthrax. Although it has never been used in bioterrorism, this classification gives insight into its dangers to humans.

The number one cause of death among Thais is cancer-related diseases, followed by heart disease and strokes.

Last year’s forgotten epidemic

In June, 2019, the Department of Disease Control announced a dengue haemorrhagic fever epidemic as there had been 28,785 patients during the first five months of the year, 43 of whom died. The figures were twice the five-year average, said Dr Preecha Prempree, deputy director-general of the department, who attributed the epidemic to failure to control mosquito larvae.

By September, the number of patients nationwide with dengue haemorrhagic fever had increased to 52,670, with 69 fatalities.

During the same period, Bangkok had treated 5,899 patients with five fatalities. The figures were lower than those in the same period in 2018, but higher than average over the past five years.

Controls were subsequently put into place by the Public Health Ministry in conjunction with seven state agencies to seriously control mosquito larvae., focusing on communities, temples, schools and hospitals.