BANGKOK — A case of the severe strain of mpox, which is currently spreading rapidly in Africa, has been found as the first case in Thailand. The patient is a foreigner who traveled from Africa.
On August 22, acting Public Health Minister Somsak Thepsuthin confirmed that the first monkeypox case in Thailand, found in a European man who travelled from an African country to Thailand, was of the clade 1b strain.
None of the 43 people at risk due to close exposure to the patient has shown any sign of infection so far. They are under observation by public health officials without the need for a 21-day quarantine.
Previously, on August 21, Dr. Thongchai Keeratihatthayakorn, Director-General of the Department of Disease Control, held a press conference regarding this case of monkeypox (Clade I) at the Department of Disease Control. He stated that this patient is a 66-year-old European who traveled from a country on the African continent with an outbreak of monkeypox Clade I.
“It was a connecting flight, not a direct flight. The patient had very little contact with others because he arrived in Thailand at 6 p.m. on August 14 and went straight to his accommodation. Then, on the morning of August 15, symptoms began to appear with blisters, so he went to the hospital immediately,” said Dr. Thongchai.
The doctor suspected monkeypox infection, so they first tested for Clade IIb, which came back negative. They then tested for Clade Ib, but the results were inconclusive. Therefore, a detailed examination was conducted to obtain definitive confirmation.
“Disease control prevention and information awareness are crucial. We don’t want people to panic and self-diagnose. That is why we are holding a press conference today,” said Dr. Thongchai.
He added that this pathogen has many strains, depending on which strain is spreading. In 2022, it was Clade IIb, which was also detected in Thailand with about 800 cases reported in 2022 and about 140 cases in 2023. All of these cases belonged to the Clade IIb strain. The approximately 10 deaths from monkeypox in Thailand were all due to people co-infected with HIV.
Regarding the WHO’s surveillance recommendation, Clade I doesn’t spread as easily as COVID. It requires very close contact, such as sexual intercourse. The Disease Control Department, Ministry of Public Health, has consistently enforced strict control measures at entry points into the country since the WHO increased surveillance levels.
The WHO is particularly concerned about the rising number of cases in Africa, due to the increase in infections in children, suggesting that the virus may spread more easily by means such as saliva droplets. In the past, monkeypox was mainly spread through close contact, especially sexual contact.
“In Thailand, we have tightened controls for travelers entering the country and increased vigilance and public awareness, especially among foreign tourists and sex workers. They need to be more careful and watch out for symptoms such as unusual rashes or lesions on the body,” said Dr. Thongchai.
Symptoms to look out for include pustules on the body, fever and headache. If any of these symptoms occur, sufferers should see a doctor immediately and inform the hospital of their risk factors. The doctors will carry out a test for monkeypox. If a sample is found, it will be sent to the Department of Medical Sciences for identification of the strain of the pathogen and further monitoring.
Dr. Yongyos Thammawut, director-general of the Department of Medical Sciences, Ministry of Public Health, added that the department is closely monitoring monkeypox strains in Thailand through regular laboratory tests.
Recently, complete genome sequencing of 191 samples identified eight substrains: A.2, A.2.1, B.1, B.1.12, B.1.3, B.1.7, C.1, and C.1.1. The C.1 substrain was the most prevalent, accounting for 85.34% of cases, followed by A.2.1 (5.76 percent), C.1.1 (3.66 percent), and A.2 (2.09 percent). The C.1 substrain is now the predominant strain in Thailand, unlike in the early stages of the outbreak when A.2 was more prevalent. This indicates ongoing viral evolution and mutation accumulation as the virus adapts over time.
Currently, monkeypox viruses are divided into three main strains: Clade I, clade IIa and clade IIb. Sub-strain C.1 is considered less severe than the other strains, particularly Clade I, which is spreading in Africa and has a mortality rate of up to 10 percent. In contrast, clade II, including C.1, has a mortality rate of less than 1 percent in people with normal immune systems.
The Department of Medical Sciences, along with the Public Health Sciences Research Institute and Medical Sciences Centers and a network of 62 laboratories, is prepared to test for monkeypox.
Results can be reported within 24 hours and cover 24 provinces including Bangkok, Khon Kaen, Chonburi, Chiang Rai, Chiang Mai, Trang, Nakhon Pathom, Nakhon Ratchasima, Nakhon Si Thammarat, Nakhon Sawan, Nonthaburi, Pathum Thani, Phitsanulok, Phuket, Ratchaburi, Lampang, Songkhla, Samut Prakan, Samut Songkhram, Sa Kaeo, Saraburi, Surat Thani, Udon Thani, and Ubon Ratchathani.
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