THAILAND: UNDIAGNOSED DEATHS

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UNDIAGNOSED DEATHS - THAILAND (02): (CHIANG MAI)
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: 14 Mar 2011
Source: Phuketwan Tourism News [edited]
<http://phuketwan.com/tourism/young-french-tourists-death-chiang-mai-link-13817/>

Young French Tourist's Death No. 6 in Chiang Mai
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The revelation of a 6th death and the results of an investigation by
Thailand's Department of Disease Control has shed new light on the
series of mysterious fatalities in Chiang Mai.

The 6th death involved a Frenchwoman -- one of 2 who fell sick, a
media release from the department says. It highlighted the exceptional
nature of a complaint that appears to have struck down 6 young women
aged 23-33 between 9 Jan 2011 and 4 Feb 2011, killing 3 of them.

These 3 deaths -- the unnamed Frenchwoman, a New Zealand woman also
23, and an American, aged 33 -- have been linked by the media to 3
other deaths, 2 British pensioners, a man and a woman and a
47-year-old Thai guide.

The joint investigation by the department with the Chiang Mai
Provincial Health Office found 4 clinically-confirmed cases of
myocarditis (inflammation of the heart muscle) and another 2 patients
with mild symptoms.

"These 6 patients were among 3 separate groups of tourists visiting
Chiang Mai, Thailand, between 9 Jan 2011 and 4 Feb 2011. All were
young women aged 23-33 years and were from the United States (1),
Canada (1), France (2) and New Zealand (3)." 5 of the 6 women "became
ill while visiting Chiang Mai and one developed symptoms 3 days before
arriving there." However, an extensive epidemiological investigation
"has not revealed any common exposures across the 3 groups."

The media release says autopsies on 2 of the dead patients (American
and French) were done by forensic medical experts from Chiang Mai
University. The joint investigation team found 4 clinically-confirmed
cases of myocarditis (inflammation of the heart muscle) and another 2
patients with mild symptoms. "The autopsies found nothing abnormal
except for inflammation of the heart muscle," it says.

"The Department of Disease Control has shared this information with
the World Health Organisation and US CDC offices in Bangkok, as well
as the New Zealand Embassy and the International Health Regulation
focal points of France and the European Community." The report
carefully distinguishes between the cases involving the 6 young women
and the other cases.

"In a separate episode, since 3 Feb 2011, there were 3 other deaths
in the same hotel where the 3 New Zealanders stayed," it says. "This
included an elderly British couple and a 47-year-old Thai woman. As
these 3 deaths occurred outside the hospital, the police took charge
of the investigation. The autopsies of the 2 elderly Britons found a
high degree of coronary occlusion while the examination of the Thai
woman found no inflammation of the heart muscle or any other clear
evidence to explain the cause of her death."