The minister of Public health declared the first avian influenza patient in the third epidemic in Pichit province. The patient, 17 years old male who died on July 24, 2006, had contacted dead chicken with bare hands. He had been screened and taken care of immediately. Eventually, the first test was negative for avian influenza virus, while the blood test was suspicious of dengue virus infection. His symptoms were deteriorating after the onset on July 15, 2006. The public health worker had imposed close surveillance on 3 household contacts and the areas had been monitored on 24 hours basis. The medical experts from central government have been dispatched today (July, 26 2006) to Pitsanuloke province for 24 hours consultation.

In the morning of July 26, 2006, H.E.Pinit Jarusombat, the public health minister, accompanied by Dr.Praj Boonyawongwirojana, Permanent Secretary,  Dr.Tawat Suntarajan, General director of Disease Control Department, Dr. Paijit Vorachit, General Director of the Medical Science department and Dr.Jaral trinwuthipong, Assistant minister, Ministry of Agriculture and cooperation, have lead the group of mass media to visit the affected areas and check the procedures of avian influenza preparedness for control and prevention in Pichit hospital and Bangmoonnak hospital in Pichit province, which had been declared red areas, where new epidemic of avian influenza occurred in local breed chickens in Tambon(village) Phoum and Tambon nernmakok, Bangmoonnak district.

H.E.Pinit said that the registered new avian influenza patient was 17 years old male, resident of 132/1 Moo 11 Tambon Tabklow, Tabklow district, Pichit province, died from avian influenza plus symptoms of Dengue infection, on July 24,2006. His onset was on July 15, 2006 with fever, cough and headache. He had an injection at the private clinic, and later on, admitted into the Tabklow hospital at 01.00 pm. on July 18, 2006. He had a history of contacting 10 dead chickens while burying the carcasses, 7 days before the onset. The ministry team had registered the patient into the avian influenza suspect screening system. The influenza rapid test and blood sample sent to the Medical Science Center Pitsanuloke revealed negative results. His chest X-ray was normal and had moderate fever.

The blood sample had been subsequently, drawn 3 times on July 20, 21, 22, 2006 respectively and the tests revealed high hematocrit, lower platelet count of which are suspect signs of hemorrhagic fever, those are rampaging in Pichit areas. The Dengue control operation is undertaken, hence the treatment for dengue was prescribed. Though, the avian influenza virus infection was not ruled out, therefore, when the patient died, the phlegm had been sent to the Medical Science Department on July, 24, 2006. The positive result was disclosed at 06.00 am. (July 26, 2006). So, it is likely that the patient had been infected with both avian influenza and Dengue viruses, which is the first case ever in Thailand and the world.

For Control procedures, the SRRT(Surveillance Rapid Response Team) had been sent into moo 11 village, Tabklow district and distributing chemo-prophylaxis to all 3 household contacts. The 14 days surveillance was imposed and daily monitoring till no signs and symptoms develop.

H.E.Pinit also said that he had asked 2 medical experts from the Medical Services Department to leave for Pitsanuloke province and provide consultation to medical teams in the 4 provinces namely, Pitsanuloke, Pichit, Kamoangphet and Sukothai. One will arrives today and the Medical Services Department has opened hotline for telephone consultation on 24 hour basis, Should new patient occur, the medical expert will join the SRRT to the site. The minister commented that no one would be blamed since the initial symptoms were confused.

The provincial governors, Medical units, provincial livestock authority had been instructed to impose control measures 24 hours. should dead chickens been reported, the control measures must be executed immediately. The Medical Science Department had been asked to send the mobile laboratory for detecting avian influenza infection to Pichit hospital, hence, the clinical samples will be tested and result will be known within 6 hours, instead of sending the samples to Pitsanuloke, while, the neighboring provinces such as Nakhon Sawan, Kampangphet and Petchabun could send the samples to this mobile laboratory as well. After that the result will be reported via internet which the doctor in charge will have easily accessed to the result himself. The laboratory is expected to arrive  in Pichit this evening.

Above all, co-operation from the community is crucial. The practices of avoiding eating dead chickens from unknown cause, do not touch or contact sick or dead chickens with bare hands, always wash hands after touching things, practice frequent hands washing, of which the aforementioneds are the most effective ways to protect self and destroy the virus if transmitting by hands.

Dr.Praj Boonyawongwirojana, Permanent Secretary, the Ministry of Public health, disclosed that the number of suspect avian influenza patients, admitting in different hospitals, report daily, in mass media are those in the system of screening avian influenza patient from colds and seasonal influenza, which are nothing to worry about. Higher number of patients indicate the effectiveness of health workers and , importantly, every areas have the preparedness plan, of which exercise is executed from time to time. And now, most of the state hospitals have 2 isolation rooms, designed especially for treating avian influenza disease in man. Should the number of the patients increase to 2-4 folds, the hospitals are still capable to handle.

Dr.Tawat Suntarajan, informed that the preventive networking had been established in every health service units and been prepared for the worst scenario. The community hospital which is the first unit in the combat zone had been stockpiling 20 sets of antivirus drug-oseltamivir and influenza rapid test kits. Bigger hospitals have 50-100 sets. Besides, more than one million capsules of antivirus drug are stored in the Central. Adequate personal protection equipment – PPE for health workers had been supplied and district and provincial SRRT are on 24 hours standby, ready to dispatch to the site, should suspect case been reported.

Dr.Paijit Worachit, Director General of Medical Science Department, disclosed that 13 medical science centers have been receiving 30 samples on the average for avian influenza virus confirmation. Pitsanuloke Center alone, receive 30 samples daily. Most of the results indicate that half of the samples are seasonal influenza and ordinary colds. Mutation virus have not been observed and surveillance on Oseltamivir resistant virus still show no problems. The drug is effective in treating the avian influenza virus.

Dr.Jaral Trinwutipong, assistant minister, Agricultural and co-operation ministry said that 2000 samples of chicken had been tested for H5N1 virus and found positive in BangMoonNak district adjacent to TabKlow district and DongJareon subdistrict. The ministry has instructed the provincial governors to intensified the poultry surveillance in 3 districts and keep the volunteer health worker to be vigilant for dead chicken. Eating dead chicken is strictly forbidden.