Phetchabun Medical Journal

Guidance for Outbreak Investigation of Infectious Diseases Among the Elderly

Worrayot Darasawang — 2024-08-30

Thailand is transitioning into an aging society, where elderly individuals undergo physiological changes due to increased age, including alterations in their immune systems. This makes them more susceptible to various infectious diseases and increases the likelihood of outbreaks. The epidemiological description of infectious diseases in the elderly and the investigation guidelines for such diseases in Thailand are limited. This article aims to summarize the epidemiology of infectious diseases in the elderly and propose investigation guidelines for infectious diseases in this demographic. The author has reviewed information from documents, textbooks, and research articles from both domestic and international sources and written the article in their own words. Infectious diseases in the elderly have a high morbidity and mortality rate if not promptly diagnosed, as older individuals often present with atypical symptoms compared to younger adults, such as the absence of fever but experiencing other symptoms like fatigue and reduced appetite. In outbreak investigation of infectious diseases among the elderly, a crucial step is defining case-finding criteria that do not emphasize a single symptom, such as fever. Additionally, the case-finding process should involve extended screening time, use of easily understandable language, and collaboration with local personnel familiar with communicating with the elderly. This approach ensures more accurate identification of the outbreak size and aids in determining the factors contributing to the outbreak, as well as establishing comprehensive and sustainable measures to prevent future outbreaks.

An outbreak investigation of influenza A (H3NX) in a prison in Phetchabun province

Nattawut Khoontep — 2024-08-30

On February 24, 2023, the Social Medicine Department at Phetchabun Hospital was notified of an influenza outbreak in a prison, with 98 cases reported. Most patients presented with fever, cough, sore throat, headache, and muscle pain, while some also experienced fatigue and loss of appetite. The Surveillance and Rapid Response Team conducted an investigation from February 24-26, 2023, aiming to confirm diagnosis and outbreak, describe its epidemiological characteristics, and implement control measures. This descriptive cross-sectional study, conducted from February 1 to March 31, 2023, included inmates and staff. Data were collected through medical record reviews and active case finding using a questionnaire. Suspected cases were defined by the presence of fever and cough, along with symptoms such as sore throat, runny nose, body aches, or fatigue. Probable cases were those who tested positive for influenza using Rapid Influenza Diagnosis Tests, while confirmed cases were identified through RT-PCR. Environmental assessments of the prison were also conducted. The study identified 624 cases, all inmates, with a male-to-female ratio of 11:1. The median age was 34 years. Common symptoms included sore throat (95.95%), headache (94.34%), and runny nose (91.26%). Laboratory tests confirmed the presence of Influenza A (H3NX). In conclusion, this outbreak was Influenza A (H3NX) outbreak and was characterized by a rapid increase in cases, which significantly decreased following detection and investigation. The outbreak was likely caused by the introduction of the virus into the overcrowded prison environment, facilitating rapid transmission.