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Clinical manifestations of early childhood dengue virus infection in Thailand

Prommalikit O, Thisyakorn U, Thisyakorn C

Med J Malaysia, 2021 Nov;76(6):853-856.
PMID: 34806672

INTRODUCTION: Clinical manifestations of dengue infection has a wide spectrum. This study aimed to describe and compare the clinical aspects of dengue infection in early childhood and those in older children.
MATERIALS AND METHODS: All dengue patients hospitalised at King Chulalongkorn Memorial Hospital, Bangkok, Thailand during 1987-2008 and aged 0-15 years were included. All parameters were compared between patients in two groups: aged 0-2 years and >2-15 years.
RESULTS: Of the 2,221 children who were diagnosed with dengue, 179 were children aged 0-2 years compared with 2,042 children aged >2-15 years. The early childhood group presented significantly more frequently with hepatomegaly, drowsiness, diarrhoea, rash, convulsions, splenomegaly, and unusual manifestations. Dengue fever (DF) was more common in the early childhood group and dengue haemorrhagic fever (DHF) was less common. The mortality rate of the early childhood group was 1.67%, which was significantly higher than that of the comparative group. Approximately 65% of study subjects were serologically proven to have primary infection, compared to 9.8% of older children.
CONCLUSIONS: Clinical manifestations of dengue infection in early childhood are different in some aspects from those of dengue infection in older children, and mortality is higher. To effectively prevent dengue infection morbidity and mortality in children, it is essential that clinicians correctly recognize and diagnose dengue infection, particularly in early childhood.
Regression of a cervical spinal mass following highly active antiretroviral therapy (HAART) in child with advanced human immunodeficiency virus (HIV) disease

Leng LK, Pancharoen C, Bunupuradah T, Thisyakorn U, Trinavarat P, Sosothikul D, et al.

J Med Assoc Thai, 2007 Sep;90(9):1937-42.
PMID: 17957942

This report documents a case of infiltrating cervical spinal mass, most likely a spinal tumor, in a girl with HIV infection that regressed following HAART and without treatment of the tumor or any anti-infectives.
Pertussis in Asia: Recent country-specific data and recommendations

Jog P, Memon IA, Thisyakorn U, Hozbor D, Heininger U, von König CHW, et al.

Vaccine, 2022 02 16;40(8):1170-1179.
PMID: 35074239 DOI: 10.1016/j.vaccine.2021.12.004

The Global Pertussis Initiative (GPI) Roundtable Meeting held in 2019, which preceded the COVID-19 pandemic, focused on the incidence, surveillance, and immunization practices for pertussis in the Asian region. Participants from China, India, Indonesia, Malaysia, Pakistan, Philippines, South Korea, Taiwan, and Thailand presented country-specific information on pertussis prevalence, diagnosis, surveillance, vaccine administration and schedules, maternal and neonatal disease rates, and policies and practice of vaccination during pregnancy. In recent years, many Asian countries have seen an increase in pertussis cases, although underreporting of the disease is a concern. Currently, most Asian countries have only passive surveillance for pertussis in place. There is a need for improved surveillance to determine the disease burden and justify vaccination policies and recommendations, such as essential vaccination, boosters, and vaccination during pregnancy. Better awareness of the disease in adolescents and adults is necessary, and infant and childhood vaccination schedules need to be improved in many countries. Differences between private versus public sector vaccination schedules and between whole-cell and acellular pertussis vaccines should continue to be examined. It can be anticipated that unmet needs in the prevention and management of pertussis will continue as the COVID-19 pandemic evolves and that key recommendations highlighted in this meeting report will be of ongoing importance.
Three Decades of Dengue Surveillance in Five Highly Endemic South East Asian Countries

Wartel TA, Prayitno A, Hadinegoro SR, Capeding MR, Thisyakorn U, Tran NH, et al.

Asia Pac J Public Health, 2017 Jan;29(1):7-16.
PMID: 28198645 DOI: 10.1177/1010539516675701

We described and quantified epidemiologic trends in dengue disease burden in 5 Asian countries (Indonesia, Thailand, Malaysia, Philippines, and Vietnam) and identified and estimated outbreaks impact over the last 3 decades. Dengue surveillance data from 1980 to 2010 were retrieved from DengueNet and from World Health Organization sources. Trends in incidence, mortality, and case fatality rate (CFR) were systematically analyzed using annual average percent change (AAPC), and the contribution of epidemic years identified over the observation period was quantified. Over the 30-year period, incidence increased in all countries (AAPC 1980-2010: 6.7% in Thailand, 10.4% in Vietnam, 12.0% in Indonesia, 18.1% in Malaysia, 24.4% in Philippines). Mortality also increased in Indonesia, Malaysia, and Philippines (AAPC: 6.8%, 7.0%, and 29.2%, respectively), but slightly decreased in Thailand and Vietnam (AAPC: -1.3% and -2.5%), and CFR decreased in all countries (AAPC: -4.2% to -8.3%). Epidemic years, despite representing less than a third of the observation period, contributed from 1 to 3 times more cases versus nonepidemic years. Implementation of more sensitive surveillance methods over the study period may have contributed to a reporting or ascertainment bias in some countries. Nonetheless, these data support the urgent need for novel, integrated, or otherwise effective dengue prevention and control tools and approaches.
Fulltext Proceedings of the 6th Asia Dengue Summit, June 2023

Srisawat N, Gubler DJ, Pangestu T, Limothai U, Thisyakorn U, Ismail Z, et al.

PLoS Negl Trop Dis, 2024 Mar;18(3):e0012060.
PMID: 38551892 DOI: 10.1371/journal.pntd.0012060

The 6th Asia Dengue Summit (ADS) themed "Road Map to Zero Dengue Death" was held in Thailand from 15th-16th June 2023. The summit was hosted by Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand in conjunction with Queen Saovabha Memorial Institute, The Thai Red Cross Society; Faculty of Tropical Medicine, Mahidol University; and the Ministry of Public Health. The 6th ADS was convened by Asia Dengue Voice and Action (ADVA); Global Dengue and Aedes Transmitted Diseases Consortium (GDAC); Southeast Asian Ministers of Education Tropical Medicine and Public Health Network (SEAMEO TROPMED); Fondation Mérieux (FMx) and the International Society for Neglected Tropical Diseases (ISNTD). Dengue experts from academia and research, and representatives from the Ministries of Health, Regional and Global World Health Organization (WHO) and International Vaccine Institute (IVI) participated in the three-day summit. With more than 51 speakers and 451 delegates from over 24 countries, 10 symposiums, and 2 full days, the 6th ADS highlighted the growing threat of dengue and its antigenic evolution, flagged the urgent need to overcome vaccine hesitancy and misinformation crisis, and focused on dengue control policies, newer diagnostics, therapeutics and vaccines, travel-associated dengue, and strategies to improve community involvement.
Fulltext Dengue and other common causes of acute febrile illness in Asia: an active surveillance study in children

Capeding MR, Chua MN, Hadinegoro SR, Hussain II, Nallusamy R, Pitisuttithum P, et al.

PLoS Negl Trop Dis, 2013;7(7):e2331.
PMID: 23936565 DOI: 10.1371/journal.pntd.0002331

Common causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation and disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue and other causes of acute fever in dengue-endemic Asian countries are needed.
Fulltext Invasive meningococcal disease in Malaysia, Philippines, Thailand, and Vietnam: An Asia-Pacific expert group perspective on current epidemiology and vaccination policies

Thisyakorn U, Carlos J, Chotpitayasunondh T, Dien TM, Gonzales MLAM, Huong NTL, et al.

Hum Vaccin Immunother, 2022 Nov 30;18(6):2110759.
PMID: 36084311 DOI: 10.1080/21645515.2022.2110759

Invasive meningococcal disease (IMD) imposes a significant burden on the global community due to its high case fatality rate (4-20%) and the risk of long-term sequelae for one in five survivors. An expert group meeting was held to discuss the epidemiology of IMD and immunization policies in Malaysia, Philippines, Thailand, and Vietnam. Most of these countries do not include meningococcal immunization in their routine vaccination programs, except for high-risk groups such as immunocompromised people and pilgrims. It is difficult to estimate the epidemiology of IMD in the highly diverse Asia-Pacific region, but available evidence indicate serogroup B is increasingly dominant. Disease surveillance systems differ by country. IMD is not a notifiable disease in some of them. Without an adequate surveillance system in the region, the risk and the burden of IMD might well be underestimated. With the availability of new combined meningococcal vaccines and the World Health Organization roadmap to defeat bacterial meningitis by 2030, a better understanding of the epidemiology of IMD in the Asia-Pacific region is needed.
Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial

Capeding MR, Tran NH, Hadinegoro SR, Ismail HI, Chotpitayasunondh T, Chua MN, et al.

Lancet, 2014 Oct 11;384(9951):1358-65.
PMID: 25018116 DOI: 10.1016/S0140-6736(14)61060-6

An estimated 100 million people have symptomatic dengue infection every year. This is the first report of a phase 3 vaccine efficacy trial of a candidate dengue vaccine. We aimed to assess the efficacy of the CYD dengue vaccine against symptomatic, virologically confirmed dengue in children.
Fulltext Meningococcal disease surveillance in the Asia-Pacific region (2020): The global meningococcal initiative

Aye AMM, Bai X, Borrow R, Bory S, Carlos J, Caugant DA, et al.

J Infect, 2020 11;81(5):698-711.
PMID: 32730999 DOI: 10.1016/j.jinf.2020.07.025

The degree of surveillance data and control strategies for invasive meningococcal disease (IMD) varies across the Asia-Pacific region. IMD cases are often reported throughout the region, but the disease is not notifiable in some countries, including Myanmar, Bangladesh and Malaysia. Although there remains a paucity of data from many countries, specific nations have introduced additional surveillance measures. The incidence of IMD is low and similar across the represented countries (<0.2 cases per 100,000 persons per year), with the predominant serogroups of Neisseria meningitidis being B, W and Y, although serogroups A and X are present in some areas. Resistance to ciprofloxacin is also of concern, with the close monitoring of antibiotic-resistant clonal complexes (e.g., cc4821) being a priority. Meningococcal vaccination is only included in a few National Immunization Programs, but is recommended for high-risk groups, including travellers (such as pilgrims) and people with complement deficiencies or human immunodeficiency virus (HIV). Both polysaccharide and conjugate vaccines form part of recommendations. However, cost and misconceptions remain limiting factors in vaccine uptake, despite conjugate vaccines preventing the acquisition of carriage.