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Lessons learned from influenza A(H1N1)pdm09 pandemic response in Thailand.

Ungchusak K, Sawanpanyalert P, Hanchoworakul W, Sawanpanyalert N, Maloney SA, Brown RC, Birmingham ME, Chusuttiwat S - Emerging Infect. Dis. (2012)

Bottom Line: The national response came under intense public scrutiny as the number of confirmed cases and associated deaths increased.The review found that the actions taken were largely appropriate and proportionate to need.However, areas needing improvement were surveillance, laboratory capacity, hospital infection control and surge capacity, coordination and monitoring of guidelines for clinical management and nonpharmaceutical interventions, risk communications, and addressing vulnerabilities of non-Thai displaced and migrant populations.

View Article: PubMed Central - PubMed

Affiliation: Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. kum.ungchusak@gmail.com

ABSTRACT
In 2009, Thailand experienced rapid spread of the pandemic influenza A(H1N1)pdm09 virus. The national response came under intense public scrutiny as the number of confirmed cases and associated deaths increased. Thus, during July-December 2009, the Ministry of Public Health and the World Health Organization jointly reviewed the response efforts. The review found that the actions taken were largely appropriate and proportionate to need. However, areas needing improvement were surveillance, laboratory capacity, hospital infection control and surge capacity, coordination and monitoring of guidelines for clinical management and nonpharmaceutical interventions, risk communications, and addressing vulnerabilities of non-Thai displaced and migrant populations. The experience in Thailand may be applicable to other countries and settings, and the lessons learned may help strengthen responses to other pandemics or comparable prolonged public health emergencies.

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Related in: MedlinePlus

Third edition (July 17, 2009) of clinical practice guidelines for treatment of patients with suspected influenza A(H1N1)pdm09 virus infection in Thailand. The guidelines were prepared by the Clinical Management Taskforce, Thailand Ministry of Public Health, and experts from medical schools. The guidelines are subject to modification according to the pandemic influenza situation; updates are made available at www.moph.go.th. CXR, chest x-ray; COPD, chronic obstructive pulmonary disease; SLE, systemic lupus erythematosus; DM, diabetes mellitus; bid, twice a day; CAPD, continuous ambulatory peritoneal dialysis; RR, respiratory rate; SpO2, saturation of peripheral oxygen.
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Figure 2: Third edition (July 17, 2009) of clinical practice guidelines for treatment of patients with suspected influenza A(H1N1)pdm09 virus infection in Thailand. The guidelines were prepared by the Clinical Management Taskforce, Thailand Ministry of Public Health, and experts from medical schools. The guidelines are subject to modification according to the pandemic influenza situation; updates are made available at www.moph.go.th. CXR, chest x-ray; COPD, chronic obstructive pulmonary disease; SLE, systemic lupus erythematosus; DM, diabetes mellitus; bid, twice a day; CAPD, continuous ambulatory peritoneal dialysis; RR, respiratory rate; SpO2, saturation of peripheral oxygen.

Mentions: A clinical case management and practice guideline was rapidly made available to all health care workers; the guideline was updated on 3 occasions as new information became available. Revisions focused on the medical management of patients at risk for severe disease, including the need for early administration of oseltamivir (Figure 2). However, anecdotal reports suggested that nationwide adoption of new guidelines by physicians may take up to a month, indicating a need for innovative methods to introduce and implement new guidelines.


Lessons learned from influenza A(H1N1)pdm09 pandemic response in Thailand.

Ungchusak K, Sawanpanyalert P, Hanchoworakul W, Sawanpanyalert N, Maloney SA, Brown RC, Birmingham ME, Chusuttiwat S - Emerging Infect. Dis. (2012)

Third edition (July 17, 2009) of clinical practice guidelines for treatment of patients with suspected influenza A(H1N1)pdm09 virus infection in Thailand. The guidelines were prepared by the Clinical Management Taskforce, Thailand Ministry of Public Health, and experts from medical schools. The guidelines are subject to modification according to the pandemic influenza situation; updates are made available at www.moph.go.th. CXR, chest x-ray; COPD, chronic obstructive pulmonary disease; SLE, systemic lupus erythematosus; DM, diabetes mellitus; bid, twice a day; CAPD, continuous ambulatory peritoneal dialysis; RR, respiratory rate; SpO2, saturation of peripheral oxygen.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3376790&req=5

Figure 2: Third edition (July 17, 2009) of clinical practice guidelines for treatment of patients with suspected influenza A(H1N1)pdm09 virus infection in Thailand. The guidelines were prepared by the Clinical Management Taskforce, Thailand Ministry of Public Health, and experts from medical schools. The guidelines are subject to modification according to the pandemic influenza situation; updates are made available at www.moph.go.th. CXR, chest x-ray; COPD, chronic obstructive pulmonary disease; SLE, systemic lupus erythematosus; DM, diabetes mellitus; bid, twice a day; CAPD, continuous ambulatory peritoneal dialysis; RR, respiratory rate; SpO2, saturation of peripheral oxygen.
Mentions: A clinical case management and practice guideline was rapidly made available to all health care workers; the guideline was updated on 3 occasions as new information became available. Revisions focused on the medical management of patients at risk for severe disease, including the need for early administration of oseltamivir (Figure 2). However, anecdotal reports suggested that nationwide adoption of new guidelines by physicians may take up to a month, indicating a need for innovative methods to introduce and implement new guidelines.

Bottom Line: The national response came under intense public scrutiny as the number of confirmed cases and associated deaths increased.The review found that the actions taken were largely appropriate and proportionate to need.However, areas needing improvement were surveillance, laboratory capacity, hospital infection control and surge capacity, coordination and monitoring of guidelines for clinical management and nonpharmaceutical interventions, risk communications, and addressing vulnerabilities of non-Thai displaced and migrant populations.

View Article: PubMed Central - PubMed

Affiliation: Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. kum.ungchusak@gmail.com

ABSTRACT
In 2009, Thailand experienced rapid spread of the pandemic influenza A(H1N1)pdm09 virus. The national response came under intense public scrutiny as the number of confirmed cases and associated deaths increased. Thus, during July-December 2009, the Ministry of Public Health and the World Health Organization jointly reviewed the response efforts. The review found that the actions taken were largely appropriate and proportionate to need. However, areas needing improvement were surveillance, laboratory capacity, hospital infection control and surge capacity, coordination and monitoring of guidelines for clinical management and nonpharmaceutical interventions, risk communications, and addressing vulnerabilities of non-Thai displaced and migrant populations. The experience in Thailand may be applicable to other countries and settings, and the lessons learned may help strengthen responses to other pandemics or comparable prolonged public health emergencies.

Show MeSH
Related in: MedlinePlus