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Norwegian Woman And American Woman Die Of Unknown Causes on Koh Phi Phi


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Although I'm not a mod, here it is:

Thailand tourist's lung tissue 'gone' after mysterious death

SEATTLE, Washington (CNN / 1 hour ago) -- A pathologist hired by the family of one of two women whose mysterious deaths in Thailand drew worldwide attention says her "lungs were 100 percent congested," Jill St. Onge's fiancee and brother said.

- CNN / 1 hour ago

Link, please?

http://edition.cnn.com/2009/WORLD/asiapcf/...tion=cnn_latest

It's not even the international edition the home page on the regular edition has the story now.

Thailand's looking pretty bad here.

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Although I'm not a mod, here it is:

Thailand tourist's lung tissue 'gone' after mysterious death

SEATTLE, Washington (CNN / 1 hour ago) -- A pathologist hired by the family of one of two women whose mysterious deaths in Thailand drew worldwide attention says her "lungs were 100 percent congested," Jill St. Onge's fiancee and brother said.

- CNN / 1 hour ago

Link, please?

http://edition.cnn.com/2009/WORLD/asiapcf/...tion=cnn_latest

It's not even the international edition the home page on the regular edition has the story now.

Thailand's looking pretty bad here.

Yes front and center with her picture.

And a damning indictment of the Thai investigation and official statements...

Does Thailand have a foot left to shoot?

Especially in the sphere of world tourism.

An insecticide is a definite possibility.

The fiancee was affected, but spent much less time in the room,

hence less cumulative exposure. And insecticide sprayed in the room

or outside the AC system if it is flow through AC,

or INTO the Internal unit of a two stage AC would account also.

Edited by animatic
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lungs were 100 percent congested,"

How could this happen - could an Insecticide cause this?

Why did her fiancee not get affected?

Type vomiting and lung congestion into google and you get ethelyne glycol poisoning.

http://books.google.co.th/books?id=_W6_T_I...lt&resnum=1

http://en.wikipedia.org/wiki/Ethylene_glycol_poisoning

Signs and symptoms

Symptoms of ethylene glycol poisoning usually follow a three-step progression, although poisoned individuals will not always develop each stage.[4]

Stage 1 (0.5 to 12 hours) consists of neurological and gastrointestinal symptoms; victims may appear to be intoxicated, exhibiting symptoms such as dizziness, incoordination of muscle movements, nystagmus, headaches, slurred speech, and confusion. Irritation to the stomach may cause nausea and vomiting.[4] Over time, the body metabolizes ethylene glycol into other toxins.

Stage 2 (12 to 36 hours) is a result of accumulation of organic acids formed by the metabolism of ethylene glycol and consists of increased heart rate, high blood pressure, hyperventilation, and metabolic acidosis. Additionally low calcium levels in the blood, overactive muscle reflexes, muscle spasms, QT interval prolongation, and congestive heart failure may occur. If untreated, death most commonly occurs during this period.[4]

Stage 3 (24 to 72 hours) of ethylene glycol poisoning is the result of kidney injury. Symptoms include acute tubular necrosis, red blood cells in the urine, excess proteins in the urine, lower back pain, decreased production of urine, absent production of urine, elevated blood level of potassium, and acute kidney failure.[11][12] If kidney failure occurs it is typically reversible, although weeks or months of supportive care including hemodialysis may be required before kidney function returns.[4]

The speed and time frame seems to fit also.

Edited by Thai at Heart
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Some symptoms and poisons;

http://www.keleka.net/deepbackground/resou...ics/toxicol.htm

Acetylsalicylic Acid (Aspirin) Symptoms: Nausea, though not neccesarily vomiting. Mental confusion and hearing difficulty. Sleepiness leading to coma. Pulse is high, breating is deep and slow. Post-mortem appearance: Dehydration. Fluid on the lungs. Liver and kidneys degernated. Acid and granular urine.

Metaldehyde Found in camping stove fuel and slug pellets. Doesn't taste too nasty, but soon leads to vomiting. Then restlessless, tremors of the arms, mild delirium. Then cramps and convulsions, unconsiousness, coma. Death is from respiratory failure and comes within 3 or 4 days.

And just for a dose of speculative conjecture, the man in Patong ,Phuket supposedly dead of cocaine (because a gram was in his room, reports the F'ing Gazette ) reportedly, saliva was coming from his mouth, that is a symptom of many poisons

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<< A pathologist hired by the family of one of two women whose mysterious deaths in Thailand drew worldwide attention says her "lungs were 100 percent congested," Jill St. Onge's fiancee and brother said. -- CNN >>

This statement really makes the "microbes in the stomach statement" seem a little inconsequential.

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The public announcements and press releases from officials in the Krabi/Phi-Phi region quite honestly smack of a disinformation campaign.

This would lead you to wonder if they do this as a knee-jerk reaction to any crisis or if they are hiding some information from the public eye.

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They are always covering up and hiding information, this should just be assumed.

Just an idea......some survivors reported a "smell" in the room. Maybe that had nothing to do with anything. It could have been a sewerage leak. It could have been many things.

Much has been made of the fact that they were in "the room." Perhaps they were poisoned, deliberately, outside of their rooms. Then, after feeling sick, they went inside their rooms (a natural thing to do).

Seven deaths of foreigners--not Thais--in the same region over a short period of time. It is hard for me to believe that the deaths are not connected in some way.

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:)

Just reading the last news reports from Norway. It appears that the lungs were filled with fluid. Now, not being a doctor. I can only make an uninformed assumption that lungs being filled with fluid ,then the cause of death was damage to the lungs that produced the fluid either by chemical damage to the lungs or some kind of viral/bacterial infection that caused the lungs to fill with fluid.

I made the original suggestion, quite a few posts ago, about Legionaire's disease. That can occur quickly and is due to a bacterial infection with the Legionella bacterium. Cause of death is often "failure of lungs due to build-up of fluid in lungs caused by damage to lungs by bacterial infection". Like I say. I'm not a doctor, but Legionaire's disease is known to be spead by air conditioners that are infected with bacteria in the cooling systems abnd air filters. I believe the original case of Legionaire's disease was in Philidelphia in a motel, and the bacterium was traced back to the air conditioning. Death occured quickly, in 24 hours or less due to lung damage and fluid build-up.

Another possiblity is some chemical substance that somehow got into the air conditioning. That substance would be inhaled (remember the boyfriend said there was a bad smell) and would kill by damaging the lungs and fillling them with fluid.

Anyhow. I'll guess we will see how the story develops.

This kind of infection happens all around the world, and it isn't fair to try to blame Thailand for it.

:D

Edited by IMA_FARANG
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I'm not a toxicologist, but I think paraquat or some other toxic substance could have been used in the murders(?) of Jill and Julie:

From Wikipedia:

Pure paraquat ingested is highly toxic to mammals and humans potentially leading to acute respiratory distress syndrome (ARDS) and there are no specific antidotes.

...

In acute toxicity studies using laboratory animals, Paraquat has been shown to be highly toxic by the inhalation route and has been placed in Toxicity Category I (the highest of four levels) for acute inhalation effects.

...

Even a single swig, immediately spat out, can cause death from fibrous tissue developing in the lungs leading to asphyxiation.

The symptoms with congested/destroyed lungs certainly seem to fit.

Paraquat is also cheap ad easy to come by:

The reason paraquat is such a widely used suicide agent in third-world countries is due to its widespread availability, low toxic dose (10 mLs or 2 teaspoons is enough to kill) and relative cheapness. There are campaigns to control or even ban paraquat outright, and there are moves to restrict its availability by requiring user education and the locking up of paraquat stores.

The whole idea of food poisoning sounds silly; it's an obvious attempt from the thai authorities to cover things up in order to save the tourism industry.

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Excerpt from an article in the New England Journal of Medicine: specific article

"Ethylene glycol is a component of antifreeze, which is the major source of exposure in poisonings. Antifreeze generally has a bright color, and its ethylene glycol content confers a sweet taste. These qualities render it a common source of pediatric ingestions. The principal clinical features of ethylene glycol poisoning are some degree of inebriation or alteration in consciousness, a profound metabolic acidosis, oxalate crystalluria, and acute renal failure. In severe cases, clinical hypocalcemia, multiorgan-system failure, and death occur.

Methanol poisoning most often occurs from the ingestion of windshield-washer fluid. Methanol is also used in copy machines and as an ingredient in canned-heating products, embalming fluids, and paint removers. Methanol poisoning is a well-known consequence of ingesting "moonshine" liquor.3 The ingestion of small quantities of methanol induces a profound metabolic acidosis, visual changes that may progress to blindness, and (in severe cases) multiorgan-system failure and death.4 Untreated methanol poisoning is associated with a rate of death of 28% and a rate of visual deficits or blindness of 30% in survivors."

- - - - - end of excerpt - - - - - - - - -

BB's comments: antifreeze would not be a common item on Phi Phi, but windshield washer fluid, or copy machine ink, or paint remover would. Looking at the two chemicals comparatively, methanol would appear to be more commonly found in Phi Phi. It's not far-fetched to imagine a fluid containing methanol could have been flushed down a drain or otherwise found its way to the cess pool on site.

Question: would such fluid create a chemical reaction that might emit toxic fumes?

By the same token, which potentially hazardous chemicals (drain cleaner, propylene glycol, or the two chemicals mentioned above and others) - would possibly emit fumes if unwittingly poured in to a cess pool? If so, such fumes could have been carried through drain plumbing that was not vented/trapped (as practically no Thai plumbing is properly vented/trapped). Laleena's two air conditioned rooms had units which probably redistributed stale interior air - if windows and doors were closed, which they most often are in tropical a.c. rooms, to keep cool air in, and to keep bugs out.

Edited by brahmburgers
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excerpt from U. of Missouri extension

full article titled: Insecticides

Organophosphates

The organophosphate insecticides are the most widely used class of insecticides today. More than 40 of them are currently registered for use, and all pose the risk of acute toxicity. Examples of commonly used organophosphates include chlorpyrifos, diazinon, malathion and methyl parathion. According to the American Association of Poison Control Centers, organophosphates are the most commonly implicated class of all pesticides in symptomatic illnesses (1996 data). All apparently share a common mechanism of cholinesterase inhibition and can cause similar symptoms. Because they share this mechanism, exposure to the same organophosphate by multiple routes or to multiple organophosphates by multiple routes can lead to serious additive toxicity. It is important to understand that there is a wide range of toxicity in these agents and wide variation in their absorption capacities. Exposure by inhalation results in the fastest appearance of toxic symptoms, followed by the gastrointestinal route and finally the dermal route. The most commonly reported early symptoms include headache, nausea, dizziness, and increased secretions, such as sweating, salivation, tearing and respiratory secretions. Progressive symptoms include muscle twitching, weakness, tremor, incoordination, vomiting, abdominal cramps and diarrhea.

- - - - end of excerpt - - - - -

BB's highlights in orange, sync with reports we've been hearing about the deaths on Phi Phi.

As mentioned in earlier posts, (one way) insecticide poisoning could have come about is if tainted water bottles had been re-filled. It's not too much of a stretch to imagine a worker on the premises use insecticide for something, and then store it in whatever container was handy - which could have been a used plastic water bottle. IF such a scenario happened, it wouldn't have been the first time a plastic water bottle was irresponsibly disposed of at a Thai beach resort.

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Fumigants (full article)

Fumigants should be handled with great respect as they pose a dangerous risk. Fumigants diffuse rapidly, a property essential to their function. Some will readily penetrate ...human skin. The most commonly used fumigants include methyl bromide and phosphine-producing materials. In structural fumigation, chloropicrin and sulfuryl fluoride are used. Following are brief descriptions of exposure symptoms for each of these fumigants.

Methyl bromide

Exposure to methyl bromide is severely irritating to the lower respiratory tract, sometimes causing fluid buildup in the lungs, hemorrhage or pneumonia. The onset of respiratory distress may be delayed 4 to 12 hours after exposure. Early symptoms of acute poisoning include headache, dizziness, nausea, vomiting, tremor, slurred speech and unsteady movements. If liquid methyl bromide contacts the skin, severe burning, itching and blistering occur.

Chloropicrin

This fumigant is severely irritating to the upper respiratory tract, eyes and skin. Inhalation sometimes leads to vomiting. Ingestion could be expected to be corrosive to the gastrointestinal tract.

Sulfuryl fluoride

Death due to oxygen deficiency may follow when persons enter a structure too early after treatment. Early symptoms of exposure include nose, eye and throat irritation, weakness, nausea, vomiting, difficult breathing, cough, restlessness, muscle twitching and seizures.

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Question. I have heard of rooms being "bombed" with pesticide bombs to eliminate cockroaches. The room is sealed up, the bomb activated, and the room is slowly fumigated for a day or so. After an appropriate amount of time humans can safely reenter the dead-cockroach-littered room. What would normally be used in Thailand to fumigate a room and would Thailand have the ingredients available to allow a do-it-yourself concoction to be built too strongly or incorrectly. No reason to think this happened, just wondering if others may have some knowledge that may make this a plausible scenario. -- Town

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Phuket Wan reports;

[ And the smell reported by Kells is "chemical ", not "sewage" as erroneously stated by Los Altos, Ca , USA article ]

http://phuketwan.com/tourism/phi-phi-death...ngestion-11168/

<h1 class="title">Phi Phi Deaths Riddle 'Linked to Lung Congestion'</h1> By Alan Morison

Saturday, May 30, 2009 ..........................

Blood and tissue samples were provided to members of St Onge's family by pathologists who carried out an autopsy on St Onge in Bangkok before her body was cremated.

As well as the lab tests being undertaken in Haad Yai, toxicology tests are now being carried out in Bangkok and the US, where St Onge's brother Robert told CNN a pathologist hired by the family ''said her lung tissue was gone.''

The fact that blood and tissue samples were provided to St. Onges's family, as they had requested, makes me think that the investigation by the Thai authorities is being conducted with transparency and that they are interested in knowing the truth of what happened, not in covering it up.

I believe that lung congestion does not necessarily mean an inhaled contaminant.

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Phuket Wan reports;

[ And the smell reported by Kells is "chemical ", not "sewage" as erroneously stated by Los Altos, Ca , USA article ]

http://phuketwan.com/tourism/phi-phi-death...ngestion-11168/

<h1 class="title">Phi Phi Deaths Riddle 'Linked to Lung Congestion'</h1> By Alan Morison

Saturday, May 30, 2009 ..........................

Blood and tissue samples were provided to members of St Onge's family by pathologists who carried out an autopsy on St Onge in Bangkok before her body was cremated.

As well as the lab tests being undertaken in Haad Yai, toxicology tests are now being carried out in Bangkok and the US, where St Onge's brother Robert told CNN a pathologist hired by the family ''said her lung tissue was gone.''

The fact that blood and tissue samples were provided to St. Onges's family, as they had requested, makes me think that the investigation by the Thai authorities is being conducted with transparency and that they are interested in knowing the truth of what happened, not in covering it up.

I believe that lung congestion does not necessarily mean an inhaled contaminant.

A 10% mix in the bottled water of ethelyne glycol drunk in haste the night before would be more than possible.

It is too incredulous to believe that they got fatal food poisoning within the same hours with no connection and there were no other fatalities or mass food poisoning. No efforts from the supposed cover up will prove conclusive. These people were obviously poisoned by something probably ingested close to or in the guest house. So PEE Sherlock Holmes sort it out. Someone in the room with a poisoned bottle of water is right now looking about the most likely.

Every room in Thailand gets 2 bottles of water for free on average. I would suggest go looking there.

Edited by Thai at Heart
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That article isn't translated, I think it's just a re-cap of the CNN piece.

It seems clear that some kind of noxious compound was in the rooms, and Kells survived as he was exposed less, as was presumably Bergheim's companion, Karina

As discussed previously;

Contaminated water bottles with the ' chemical " smell leaching from the actual persons who have ingested it is possible.

Where does the guest house get the water for guests, would be a first question for investigation.

If a contaminated 5 gallon bottle WAS used for mixing pesticide,etc., then someone else used it for water storage, we can be sure it has since been got rid of .

Paraquat seems a likely candidate...if just a small swig can induce tissue damage in the lungs.

( is a known dangerous carcinogenic, too.)

Poisons are everywhere and proper use isn't a consideration.

This would help explain the authorities "dis-information" ( aka; lying) too, not a good thing to have tourists poisoned with carelessness that is rampant throughout the country

I saw a picture of workers fogging for mosquitoes- large swaths of areas in Phuket , using no respiratory protection for themselves at all.

Another possibility;

There was an outbreak in UK/EU last year from padded fabric furniture imported from China that had preservative fumes emanating from it and that was making people sick.

Dimethyl fumarate, in the form of a fine, white crystalline powder, was found in sachets embedded in the furniture sourced to China.

http://www.smh.com.au/national/new-sofas-t...90411-a3e2.html

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Let's not throw the murder by poisoning theories out there for seven mysterious deaths, most of which have no similarities to each other. Sorry, there's no proof for that and you just end up sounding like some internet wacko who has watched too many serial killer mystery movies.

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Poisons are everywhere and proper use isn't a consideration.

This would help explain the authorities "dis-information" ( aka; lying) too, not a good thing to have tourists poisoned with carelessness that is rampant throughout the country

I saw a picture of workers fogging for mosquitoes- large swaths of areas in Phuket , using no respiratory protection for themselves at all.

Just before I came to Thailand a Thai friend warned me, "Careful there is too much Mai Bphen Rai in Thailand." At first I wondered how could taking it easy be a bad thing. But it has nothing to do with drinking Pina Colada's on the beach but the many who work with hazardous materials with no training or knowledge how to handle and dispose of this, the wiring, plumbing, septic system, sanitation etc and we have incidents like this. It's of course still possible the situation had nothing to do with Thailand but assuming it was this sadly is not surprising to people who know Thailand and other third world countries. It simply is a risk that goes with the territory. I remember visiting my lawyer near Silom and some type of noxious cleaner was being used with no ventilation in the area whatsoever. I held my breathe until I was in the elevator and out of there. Just yesterday a man was pile driving for hours behind my apartment at 5 am onward. Aside from his graciousness in waiting for the hour normal people would wake up he had no earplugs or gloves. Par for the course here. People come here and think the natives are so cute and friendly and they are getting a lovely glimpse of the land before time but the reality is there are many hazards and you have to be on guard.

Edited by wasabi
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Notable is both parties survivors reported a disagreeable "Chemical odor" in the air-con rooms.

Potential Sources:

  • Internal Refrigerant Leak
  • Internal Pesticide Residue
  • Internal Cleaning Agent Residue
  • Drainage Venting Of Gas Internally

  • External Source Entering Room
  • Inhalation of Atomized Water from Shower

Since these were the only two Air con rooms in the GH and the guests took advantage of the fact we know they had their windows closed up tightly.

Scenario is that persons like those most affected by the toxin(s) spent the most time in the environment without ample fresh air.

Many toxic gases are odorless and many benign gases are pungent.

Knowing there are both water treatment facilities and drainage canals nearby we are presented with an adequate explanation of a source of hazardous vapors and a vector, namely an improperly trapped shower drain.

We can be fairly certain that with open drainage nearby that the shower's drains fed directly to the waterway.

The last remaining question is what was the particular toxic gas that;

  • Smelled Bad
  • Had the potential to cause distress or death
  • Could conceivably exist in the water

There are any number of fumigants, pesticides, industrial chemicals, etc... that might have found their way into the waterway, combined, degraded into a potentially hazardous gas and wafted unchecked into the rooms via an open, improperly vented shower or sink drain, concentrated in the unventilated rooms, been recirculated and concentrated by the air cons and subsequently caused this senseless and tragic incident.

One chemical candidate is Acrolein, it has a piercing, disagreeable, acrid smell similar to that of burning fat.

http://en.wikipedia.org/wiki/Acrolein

It is sometimes used as a contact herbicide to control submersed and floating weeds, as well as algae, in irrigation canals and water treatment ponds.

Acrolein is a severe pulmonary irritant and lachrymatory agent. It was used as a chemical weapon during World War I. It is, however, not outlawed by the Chemical Weapons Convention. Skin exposure to acrolein causes serious damage. Acrolein concentrations of 2 ppm are immediately harmful.

http://www.atsdr.cdc.gov/mhmi/mmg124.html

Acrolein is toxic by all exposure routes. Exposure causes inflammation and irritation of the skin, respiratory tract, and mucous membranes. Delayed pulmonary edema may occur after inhalation. Systemic effects may occur after exposure by any route.

Acrolein produces irritation of the respiratory tract, increases airway resistance and tidal volume, and decreases respiratory frequency. It is also ciliastatic. Exposure to acrolein vapor concentrations as low as 10 ppm can lead to pulmonary edema and death. Inhalation may also cause an asthmatic reaction in sensitized individuals.

However one of the reported symptoms was extreme nausea and vomiting which is not reported in Acrolein inhalation poisoning but is reported when ingested.

Helping to get to the truth in this matter will bring some comfort to the friends and families of those who died and hopefully prevent this from happening again.

Please do your part to uncover the truth in this tragic mystery.

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I wouldn't/couldn't rule out something in the guest house water...as a cause.

But, it seems less likely than the inhaled route. I say that because of the commonality between the victims being in the only two air con rooms, where presumably there was less natural "fresh" air from outside and/or something introduced into the rooms by the air con system.

That, and, if there was something in the guest house water, you might presume that other guests would have become similarly ill -- not only the two couples staying in the two air con rooms.

That and, the inhaled route scenario seems to fit better with Ryan surviving with more modest symptoms, and indicating that he'd gone outside that night and spent less time indoors than his companion.

Circumstances would suggest some connection between either the adjoining location or set-up of the couples' two rooms. The people staying in those two rooms got sick. There's no indication other guests staying in other rooms at the guesthouse got sick... Why???

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Re - jfchandler, last Post,

Back on page 11, post 261 I made the following speculation which may account for the limited spread of the cause of death if a toxic gas was indeed involved-

"Forgive me if I'm wrong but looking at the various photographs of the guesthouse there does not seem to be any vents/out pipes from the rooms into the atmosphere outdoors? Could it be that a toxic gas entered the room via the bathroom drains and could not escape?

If so then trace elements may still be found on the room curtains - doubt they have been changed since.

Could somebody have tried to clear a blocked drain with some chemical or perhaps a backflow of water-bourne pesticide, etc. if these rooms were "down-flow" and the vapour was heavier than air it may answer why others were not similarly affected?"

Hopefully some conclusive proof will emerge soon which end our speculations and hopefully prevent a similar such incident whatever the cause may turn out to be.

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Remember all four of them got sick because they stayed in the rooms.

I wish the surviving companion to Bergheim could come forward and talk about excactly what happened but so far nothing heard .

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....there does not seem to be any vents/out pipes from the rooms into the atmosphere outdoors?

Typical for Thailand and, indeed, all of SE Asia. You could look at tens of thousands of houses, and not one would have vent pipes sticking up through roofs. The standard Thai way for a house, is to have a 1/2" PVC pipe sticking up right by the septic tank - if that. Similarly, you could inspect 10,000 shower drains on ground floors, and perhaps 1% would have a P-trap (other sorts of vapor traps wouldn't work for more than a month with a shower drain getting any sort of use, because of the volume of water and the scuzz within). Incidentally, P-traps are difficult to find at Thai plumbing supply shops (usually they're special order items).

If there is a septic/cess pool that services the guest house (and we haven't yet heard for sure whether there is), inspectors should do a thorough testing of any strange chemicals that may have been in there a month ago. It's not Thai-bashing to say that those sorts of scientific tests are beyond the capability of the local authorities, because it really would take a sophisticated testing regimen to test for a whole host of potentially toxic chemicals - any one of which might only leave a slight trace - after several weeks. Just as Thai inspectors sometimes send forensic samples overseas for DNA typing, so too should the authorities consider sending samples of the cess pool gunk to a capable overseas lab. I wouldn't doubt Swedish and/or American specialists would be willing to do such tests - possibly for free, considering the gravity of the scenario.

Edited by brahmburgers
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