In early September 2010, a nurse in Pua District Hospital observed an unusual increase in number of mumps cases and an outbreak investigation was conducted on 5 Oct 2010. This study described epidemiological characteristics of the outbreak as well as secondary attack rates and outcome of MMR vaccination campaign conducted during the outbreak. We reviewed medical records at Pua District Hospital and interviewed the cases’ family members, classmates and teachers. A clinical case was a person with acute parotitis or acute lymphadenitis at preauricular, submandibular or submental area with onset of illness from 1 Jun to 31 Dec 2010. A confirmed case was a clinical case who tested positive for mumps viral IgM by enzyme-linked immunosorbent assay (ELISA), mumps virus by polymerase chain reaction (PCR) or virus isolation. During the investigation period, we also conducted a single mass measles, mumps and rubella (MMR) vaccination campaign, targeting children aged 1-6 years in 10 sub-districts. From 1 Jun to 13 Oct 2010, 129 clinical cases (attack rate = 0.2%) were found in 11 out of 12 sub-districts. Of which, 70.4% were less than six years old children. Among 10 laboratory confirmed cases, six were positive for mumps IgM by ELISA and four positive for mumps virus by PCR, with one case revealed as genotype J. Secondary attack rate among 1-6 years old children was 31.4%. Attack rate among children aged 1-6 years during the pre-vaccination campaign period was 289.4 per 10,000 populations and decreased to 54.3 per 10,000 after the campaign. This investigation supported the Ministry of Public Health to change from using monovalent measles vaccine to MMR vaccine for 9-month old children in June 2010.

Three main tuberculosis (TB) reporting systems were operating in Thailand: notifiable disease surveillance (R506), TB registration and control in Bureau of Tuberculosis (BTB) and TB report for reimbursement in National Health Security Office (NHSO). A cross-sectional study was conducted in Satun Province in July 2011 to determine whether the three systems responded well to the objectives of TB surveillance. Patients diagnosed with TB and received anti-TB drugs at least once in 2010 from three hospitals were compared with TB cases reported in three systems. In the hospitals, 170 TB cases, including 95 new smear positive pulmonary TB cases, were reviewed. Coverage and positive predictive value were 73% and 83% for R506, 87% and 100% for BTB, and 79% and 99% for NHSO respectively. Success rate (82%) of all cases was lower than that was reported in BTB (96%). Median duration from diagnosis to reporting in R506, BTB and NHSO were six, 61 and two days respectively. All systems had sufficient budget, human resources and regular training. In addition, all systems had good capacity to achieve the major objectives of TB surveillance and their specific objectives. However, the systems had total 295 variables which resulted in high workload for reporting. Integrating three systems as one national TB reporting system was recommended to improve coverage, timeliness and success rate.

Malaria epidemic along Thai-Myanmar border is still an ongoing occurrence. We explored malaria surveillance systems in Mae Sot District in order to improve the detection and response efforts in the region. The main objective was to study effectiveness of the malaria surveillance systems at Thai-Myanmar border. Data were collected by reviewing medical records, interviewing personnel at operation levels and observing the surveillance sites. The reporting system under Bureau of Epidemiology (BOE) was hospital-based, with 76% coverage, 100% positive predictive value and 100% timeliness. It was acceptable and stable, yet less flexible. The reporting system of Bureau of Vector Borne Disease (BVBD), existed from the village level, was used to obtain information for malaria prevention and control. The reports were sent via online malaria database system. Its sustainability could be affected by withdrawal of the Global Fund. Information of both systems was closely linked at the hospital (district) level. At border areas, health personnel regularly shared information through buddy health volunteers from both countries. Collaboration between epidemiology and information technology units should be strengthened in BOE and the reporting forms should be simplified by BVBD. The central Thai government should consider how to sustain the malaria surveillance and response system in the long run.

Since 1993 when an injury surveillance system was established in Thailand, the central Ratchaburi Province has been consistently ranked high for traffic injuries. This study aimed to describe the operation and usefulness of the injury surveillance system at Ratchaburi Provincial Hospital, and assess the sensitivity and quality of the surveillance data. The study was carried out among the injured people who visited the emergency room and/or were admitted to Ratchaburi Hospital in 2011, including those who died upon or before arrival at the hospital. Data were collected from log books, the hospital database and interviews with key informants. The sensitivity of reports in the system revealed as 93.2% for injured patients, 71.3% for deaths upon arrival, and 67.7% for deaths before arrival. Of 33 variables assessed for data accuracy, 24 (72.2%) did not pass the standard of 90%, including age, systolic and diastolic blood pressure, pulse rate, respiratory rate, blunt/penetrating injury, diagnosis, region of injury, and severity of injury. The data were used for planning purposes and to conduct a trauma audit conference. In summary, the injury surveillance system at Ratchaburi Hospital was deemed to have a high sensitivity for detecting injured patients, yet low sensitivity for those dying before being assessed. To improve the sensitivity of reporting dead cases and quality of data, the hospital was recommended to provide annual trainings for personnel working for the surveillance system.