November 10, 2011 Liz Borkowski, MPH 4Comment

Thailand is experiencing its worst flooding since 1942, and millions of people are affected. The death toll has reached 533, due mostly to drowning but also to electrocutions. CNN reports that more than 113,000 people have arrived at 1,700 government shelters set up across the country, and Bangkok officials have warned residents of interruptions to electricity and tap water.

In addition to immediate dangers like drowning, the potential for widespread disease outbreaks is worrisome.

Citing concerns about water-borne diseases spreading through contaminated floodwater, UNICEF announced that it’s distributing more than 300,000 hygiene and sanitation items, including soap and chlorine drops for water purification.

Darryl Loo reports for Bloomberg News that officials in Bangkok are targeting garbage removal in an attempt to keep disease-bearing vermin from proliferating:

The municipal government said it will pay 300 baht ($9.70) a day for the next two months to remove garbage in a city that normally produces 8,000 tons of waste daily. Concern that uncollected food scraps may be harboring vermin increased after Health Minister Wittaya Buranasiri said yesterday seven people were being treated for leptospirosis, a bacterial infection spread in water contaminated with rat urine.

…”We are now in a campaign to get rid of garbage because this will attract rats, and the rat urine will leave the disease on small puddles of water on the ground,” Porntep said.

Humans become infected through direct contact with the urine of rats and other infected animals or with a urine- contaminated environment, according to the World Health Organization. The bacteria enter the body through cuts or abrasions on the skin, or through the mucous membranes of the mouth, nose and eyes.

In the early stages of the disease, symptoms include high fever, severe headache, muscle pain, chills, redness of the eyes, abdominal pain, jaundice, hemorrhages in the skin and mucous membranes, vomiting, diarrhea, and rash, the Geneva-based agency said.

The director of Thailand’s Department of Disease Control told Bloomberg that so far, they haven’t seen the cholera-causing bacteria Vibrio Cholerae in any of the flooded areas. No one wants to see a repeat of the situation in Haiti, where cholera has killed more than 6,500 Haitians since an outbreak of the disease started in October 2010. The toll of the disease in Haiti is in the news again following the filing of a lawsuit against the UN. BBC News explains that a recent UN report “strongly suggested that the disease was introduced by UN peacekeepers from Nepal living on a base where poor sanitary conditions allowed human waste to enter the Artibonite river system.”

Inadequate clean water and sanitation allow diseases like cholera to spread, and in this regard Thailand is in much better shape than Haiti. According to the World Health Organization/ UNICEF Joint Monitoring Programme for Water Supply and Sanitation, in 2008, just 17% of Haitia’s population used improved sanitation facilities, and 63% used improved drinking-water sources. Thailand’s figures were much better: 96% used improved sanitation facilities, and 100% used improved drinking water sources. (For more on how cholera spreads and what “improved” sanitation entails, see my earlier post “In Praise of Toilets.”)

Disasters can compromise water and sanitation systems, so aid groups and officials in Thailand are right to be vigilant about preventing disease outbreaks. But Thailand is in the position of repairing existing infrastructure, rather than trying to establish clean water and sanitation facilities for populations that didn’t have them to begin with. Countries with better public health infrastructure and systems are better equipped to handle major disasters.

4 thoughts on “Floods in Thailand spark fears of disease outbreaks

  1. But the Thais made no effort to educate people two months ago when the floods got to be a disaster. Nor did they make any preparations for medical assistance until recently and until a week or two ago have handled it on case by case basis and told media like Bloomberg that it was under control, minimal, and “measures were being taken” so as to manage damage control. The scale of disease and sickness in Thailand is monumental and growing worse geometrically. Leptospirosis alone will account for thousands of deaths. Even the Thai government , two weeks ago, admitted that at leaset 10,000 cases of Leptospirosis were likely. The Thai press has ignored any mention of disease and its types, education, preparation of any kind until a little more than a week ago. Thailand is in crisis developing which will dwarf the damage by water.

  2. Noitom, that’s a good point – there can be a big difference between the number of cases reported by officials and the number of cases they know of (and also a difference with the number of cases that actually occur, since not everything necessarily gets reported). If a government were failing to alert its citizens to an outbreak of a disease like cholera for PR reasons, that would be a serious problem.

    Are there reliable other sources of information in Thailand that are reporting on cases of diseases associated with the flooding?

  3. Hi I will be in Bangkok from the 22-12-2011 to the til the 28-12-2011 & I am very concerned about whether it is safe to be there @ that time. We will be staying @ the Indra Regent Hotel. Please email me whether it is safe & whether we should take any precautions like taking malaria & cholera medications.

    Waiting for a favourable reply

    Best regards


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