Tourist Deaths In Chiang Mai Just A ‘Coincidence’

[TigerWan]

A coincidence.

Interesting documentary on History channel the other day titled "Race and Intelligence".

Saw the show and the one glaring fact is that intelligence grows with the need for it to grow.

This means that when a community progresses, so must their intelligence. If you hold down a community, lets say by using financial oppression, then the intelligence does not need to grow.

Humans are born with the largest developed brain of all animals, according to the relative size of their body. This brain is not completely wired up, and needs stimulation to become the best it can be. Although there are physiological restraints caused genetically, this does not account for the huge disparity found in this country. It is my belief that this disparity is caused by the fact that so many people here in Thailand live well below any poverty line across the world, and as such do not have the stimulation needed to develop their brain to it's fullest potential. Can this problem be fixed?

I am interested in any intelligent comments, please post.

Although you are going off topic:

Frankly, I would have thought that trying hard to survive at or below the poverty line was an excellent stimulus to the brain.

As opposed to having everything set up for an easy life. In the easy life, ones brain can easily atrophy. Brains, as you say, like muscles, need to be worked to develop. If you are driven to think - how can I survive? - it must be good for the brain.

I must comment I doubt tedium counts as quality stimulation.

Malcolm Gladwell has written extensively on heritage and how it really does matter. I often think tropical peoples are different that colder climed folks who have to worry - and work to survive winter.

The Mai pen rai attitude stems from this I'm sure. Worrying is not essential to survival hence the lackadaisical attitude toward .. everything.

[TigerWan]

Dearest condolences Beatriz . We are so callous here but most of us know the level of. "len " is it called? Many hope for change, perhaps these deaths can become a catalyst for it.

Please tell us any details you may know, there is very little real info about the illnesses. Was there persistent vomiting with few other symptoms until dehydration crises?

NO, this is NOT a coincidence, and they need to look beyond the hotel. My good friend Soraya Vorster, aged 33, died on january 10, 2011 in Chang Mai of the same thing. She wasnt staying at this hotel but her death was the same. There needs to be a thorough investigation on why this is happening. Its literally a case of life or death, this could happen to more people and we need to find out why!

[Oberkommando]

Boonlert Buranupakorn is an untouchable. He has money, connections and power. He owns the hotel amongst billions of Baht's worth of assets Worldwide. His nephew is currently Mayor of Chiang Mai.

Forget about investigations, justice or accountability and remember where you are.

[tigermonkey]

"

Hmm... ok, if you actually do research. In general no Virus can act that fast, within a few hours to produce symptoms, Virus' generally take longer for symptoms to show up, and then are persistant while your body attempts to fight it off. This all has to do with immune response.

Bacterial infections are different and can cause serious illness much faster than viral infections as a number of bacteria produce enterotoxins which are excreted during their replication and growth. This is the biggest issue with bacteria and not the actual bacterium themselves.

One example is:

staphylococcal enterotoxin B agent: Staphylococcus aureus symptoms: acts in 3-12 hours; produces chills, headache, and high fever (up to 106 degrees) for several days death: incapacitating but rarely fatal.

although most can be treated, botulism is generally one exception which can kill quickly, yet other people have known to survive.

Toxic shock syndrome is probably one of the more severe reactions to Staphylococcus which can kill in hours. Have a read about it.

http://en.wikipedia...._shock_syndrome

How about instead of people just blurting garbage, you actually make sure what your saying is fact, instead of assuming and DO SOME RESEARCH FIRST.

Whether or not a bacterial 'food poisoning' occuerred here is very hard to tell, assuming all the symptoms, etc of the individuals has actually be accurately disclosed. Not saying there possibly isn't an issue with the hotel, but we honestly don't know.

AND no it can't be cyanide, cyanide prevents your blood cells binding to oxygen, so you would essentially internally suffocate, which the girl in hospital before dying did not.

It certainly sounds like a bacterial toxin, which is why someone young died and her friends survived. As bacterial toxins don't act dependent on the immune system like Virus' do and hence why they can be so deadly to anyone of any age.

The old people, now thats a mystery, but certainly not improbably that one died and the other died later due to their age.

The old people and the girls you can possibly explain (as two seperate accounts), but having the third thai tourist guide, means it is likely connected to the hotel, or by chance they all at at the same place that day.

Was there any suggestion that the girls and the tourist guide where familair with each other?

Yes, I have also studied science, but clearly I learnt something during when I studied.

Well now if we are going down the toxin path I would go for a plant toxin rather than bacterial, beans are a common component of Asian diet, and these are rich sources of toxins, from ricin in castor oil beans to

Phytohaemagglutnin (Kidney Bean Lectin). This toxic agent is found in many species of beans, but it is in highest concentration in red kidney beans (Phaseolus vulgaris).

The syndrome is usually caused by the ingestion of raw, soaked kidney beans, either alone or in salads or casseroles. As few as four or five raw beans can trigger symptoms. Several outbreaks have been associated with "slow cookers" or crock pots, or in casseroles which had not reached a high enough internal temperature to destroy the glycoprotein lectin. It has been shown that heating to 80 degrees C. may potentiate the toxicity five-fold, so that these beans are more toxic than if eaten raw. In studies of casseroles cooked in slow cookers, internal temperatures often did not exceed 75 degrees C..

The problem with toxins being the cause of death is that although they act within a few hours, they all involve nausea and vomitting, which seems to have been absent.

Anaphylactic shock would seem a better candidate for sudden death, In the majority of anaphylactic shock incidents, the culprits are shellfish or peanuts, both feature prominently in Thai cuisine.

P.S I'm glad to hear you have studied science, many of my students have "taken" science rather than "studied" it

It is wonderful that you have studied/taught science and learned a little -- but you are entirely wrong about cyanide poisoning and anaphylaxis respectively.

Virtually all fatal cases of cyanide poisoning conclude with cardiac arrest . While it is true that cyanide ion causes a failure in respiration, this occurs at the cellular level due to the inhibition of cytochrome oxidase. This results in rapid metabolic failure, and the first organ to fail is usually the heart.

There were no apparent symptoms of anaphylaxis that I am aware of.

I will stay with my earlier posted hypothesis ( post #152) the only thing missing is the usual skin pallor of cynaide poisoning victims -- but Thais would not have reported this in any case -- they all think we are a 'funny' color.

Oh, yes I have studied 'science' a little also - medical degrees from three universities.

[EyesWideOpen]

Could some math wizard please work out the odds of four people dying in the same hotel in one month....Am going to take a wild guess at around 200,00 to one ??

[TigerWan]

Oh seems we do have a report of some symptoms . P 7 C 171

Jill St Onge pathology report had her lung tissue as "shot" . All Phi Phi incidents; vomiting profusely .

A German man and an Iranian women a month or so later in Phuket same symptoms

Doctors reported that she had asthma and Pol. Col. Montri Sampunnanont, the Deputy Chiang Mai Provincial Police Commander told the Chiang Mai Mail that she had been seen with labored breathing and that might be the cause of her death.

However, Dr. Paskorn Arkarasewee, the Director of the Office of Epidemiology said the real cause of the death of the guide Mrs. Waraporn had not been determined and that the cause of death of Sarah Carter, the New Zealand tourist, was still unclear.

A Chiang Mai Muang District Police said that Ms. Sarah Katherine Carter, 23, a student from New Zealand traveled from Phuket to Chiang Mai and checked in to the hotel on February 2 with two friends. On February 3 they were found seriously ill with vomiting and nausea so the hotel staff called an ambulance to take them the hospital for treatment where, on February 6, Sarah Carter died. The other two girls also ill, eventually recovered and returned home.

[TAWP]

Could some math wizard please work out the odds of four people dying in the same hotel in one month....Am going to take a wild guess at around 200,00 to one ??

After the first one have died there is exactly the same probability that another will die there as in any other hotel. (The event in itself doesn't show foul play.) However the chance of having exactly 4, determined and decided before either of them actually did, dying in the same hotel in a short time-span is minuscule.

The chance that someone else will die, is per chance of random, the same for this hotel as any other hotel.

Anyway, if anyone wants to argue probability we can...

However, what we see here is most likely not an act of uneven ['limited observation over time'] distribution of random event. The similarities between the deaths indicates a pattern. And that nullifies any calculations or assumptions based on chance or probability.

[Jingthing]

Would you stay at that hotel? Would you suggest someone you care about stay at that hotel? Would the owners of that hotel suggest that their friends and relatives stay at that hotel?

Why is still open then?

Next ...

[jfchandler]

Jing, if you file a complaint with the CM Mayor's Office, I'm sure your concerns will be promptly tended to... I hear he's well acquainted with the owners.

Meanwhile, how about making a hotel reservation there thru Agoda, AsiaRooms or any of the other booking sites... Very easy to do, I'm sure...

Edited March 10, 2011 by jfchandler

[TigerWan]

I wish I could edit my last post as I ran my own opinion regarding the Phi Phi incidents into the report quotes , sorry .

But severe, relentless vomiting is a common symptom. Monkey Tiger /Med Dr., please answer; Can dehydration cause the heart conditions reported in CM ?

10 known deaths, and 5 associated recovered illnesses in 22 months. How many not reported? So the first CM death in a different hotel but same chain?

Can you post links to this info, please?

Is it also a coincidence that different guest reviews from people of different countries talk about a VERY BAD SMELL in the room ?

[Bubbalicious]

Looks like they are trying desperatly to obfuscate. Unfortunatly that appears all too similar to what happend with the deaths in Phi Phi.

When you have a track record like that people assume you guilty until you prove yourself innocent. Good Luck Chiang Mai Governors family and TAT.

They will continue to delay and obfuscate and the problem will be buried, it always has been in the past. I can see why the Thai authorities treat outsiders like idiots because we deserve nothing better as there is never the will or coordination between effected parties to obtain satisfactory answers from the Thai authorities under pain of consequences serious enough to force someone to take ownership of the issue.

I am referring here to diplomacy at international level not the attempts of bereaved to get answers, as they are serially let down by those who purport to represent them.

That just about sums it all up.

People can talk about all the conspiracy crap until they are blue in the face. It doesn't stand for anything, never has, never will. This case/investigation is all but over. Although it is likely to carry on for maybe a couple of weeks. Things have to be seen to be done, then it will just fizzle out. Unless of course one of the Embassies of the victims, activly gets involved and starts demanding proper answers? For sure that will not be the British Embassy.

jb1

Well, I can see why that press conference was held seeing now about the ownership group.

But, from reports I heard today from a health care industry friend (and confirmed by another friend's FB page) this case DOES go beyond the Downtown Inn. First, there is the case of this American woman, Soraya, and then, apparently, there are 3 other Thai deaths that are being looked at as being related (though unrelated to the hotel). And which apparently haven't hit the newspapers yet (no secret as to why that might be, seeing as how it would be bad for the whole town, business wise). But, from what I was told they are looking at a variety of things that it could be - various food contamination possibilities, and things like pesticides or chemical toxins getting into vegetables, etc. that might have been used in the dishes, as well as viral infections and a variety of other possible causes (sketchy mix of English and Thai from my friend, but from what I gathered the health office is casting a wide net as to the possibilities).

Part of the delay in naming causes for this is that some samples have been sent overseas for testing (US and Japan were mentioned), I assume either for higher tech testing or to double/triple check whatever results they've gotten locally.

Whatever else is going on investigation wise, I'm pretty sure this press conference wont be the last of what we hear on this issue. But it sure would be nice if the media keeps pressing on this so we can get more timely answers.

Edit: One other thing. I haven't read thru all the latest pages but I see a lot of talk here about the Phuket cases. A Phuket link is also one of the long list of things they are looking at (trying to eliminate, etc) I guess seeing as how those causes of death were never completely determined (even with the European - Norwegian? specialists who came in).

Edited March 10, 2011 by Bubbalicious

[TheLaughingMan]

Guys, I think I might be catching this terrible affliction...... every time I read one of these threads on police labelled "coincidental deaths of 4 people in the same hotel in the same time frame" or "suicides with their hands tied behind their backs" I become violently ill and start vomiting relentlessly.... should I go to the hospital or you think I'll recover?

[anterian]

"

Hmm... ok, if you actually do research. In general no Virus can act that fast, within a few hours to produce symptoms, Virus' generally take longer for symptoms to show up, and then are persistant while your body attempts to fight it off. This all has to do with immune response.

Bacterial infections are different and can cause serious illness much faster than viral infections as a number of bacteria produce enterotoxins which are excreted during their replication and growth. This is the biggest issue with bacteria and not the actual bacterium themselves.

One example is:

staphylococcal enterotoxin B agent: Staphylococcus aureus symptoms: acts in 3-12 hours; produces chills, headache, and high fever (up to 106 degrees) for several days death: incapacitating but rarely fatal.

although most can be treated, botulism is generally one exception which can kill quickly, yet other people have known to survive.

Toxic shock syndrome is probably one of the more severe reactions to Staphylococcus which can kill in hours. Have a read about it.

http://en.wikipedia...._shock_syndrome

How about instead of people just blurting garbage, you actually make sure what your saying is fact, instead of assuming and DO SOME RESEARCH FIRST.

Whether or not a bacterial 'food poisoning' occuerred here is very hard to tell, assuming all the symptoms, etc of the individuals has actually be accurately disclosed. Not saying there possibly isn't an issue with the hotel, but we honestly don't know.

AND no it can't be cyanide, cyanide prevents your blood cells binding to oxygen, so you would essentially internally suffocate, which the girl in hospital before dying did not.

It certainly sounds like a bacterial toxin, which is why someone young died and her friends survived. As bacterial toxins don't act dependent on the immune system like Virus' do and hence why they can be so deadly to anyone of any age.

The old people, now thats a mystery, but certainly not improbably that one died and the other died later due to their age.

The old people and the girls you can possibly explain (as two seperate accounts), but having the third thai tourist guide, means it is likely connected to the hotel, or by chance they all at at the same place that day.

Was there any suggestion that the girls and the tourist guide where familair with each other?

Yes, I have also studied science, but clearly I learnt something during when I studied.

Well now if we are going down the toxin path I would go for a plant toxin rather than bacterial, beans are a common component of Asian diet, and these are rich sources of toxins, from ricin in castor oil beans to

Phytohaemagglutnin (Kidney Bean Lectin). This toxic agent is found in many species of beans, but it is in highest concentration in red kidney beans (Phaseolus vulgaris).

The syndrome is usually caused by the ingestion of raw, soaked kidney beans, either alone or in salads or casseroles. As few as four or five raw beans can trigger symptoms. Several outbreaks have been associated with "slow cookers" or crock pots, or in casseroles which had not reached a high enough internal temperature to destroy the glycoprotein lectin. It has been shown that heating to 80 degrees C. may potentiate the toxicity five-fold, so that these beans are more toxic than if eaten raw. In studies of casseroles cooked in slow cookers, internal temperatures often did not exceed 75 degrees C..

The problem with toxins being the cause of death is that although they act within a few hours, they all involve nausea and vomitting, which seems to have been absent.

Anaphylactic shock would seem a better candidate for sudden death, In the majority of anaphylactic shock incidents, the culprits are shellfish or peanuts, both feature prominently in Thai cuisine.

P.S I'm glad to hear you have studied science, many of my students have "taken" science rather than "studied" it

It is wonderful that you have studied/taught science and learned a little -- but you are entirely wrong about cyanide poisoning and anaphylaxis respectively.

Virtually all fatal cases of cyanide poisoning conclude with cardiac arrest . While it is true that cyanide ion causes a failure in respiration, this occurs at the cellular level due to the inhibition of cytochrome oxidase. This results in rapid metabolic failure, and the first organ to fail is usually the heart.

There were no apparent symptoms of anaphylaxis that I am aware of.

I will stay with my earlier posted hypothesis ( post #152) the only thing missing is the usual skin pallor of cynaide poisoning victims -- but Thais would not have reported this in any case -- they all think we are a 'funny' color.

Oh, yes I have studied 'science' a little also - medical degrees from three universities.

Leaving the sarcastic one upmanship aside, and if your diagnosis of cyanide is correct, then how did it happen. Are you implying murder, or some natural route for ingestion? Are you familiar with death from vinyl acetate fumes?

[jfchandler]

First, there is the case of this American woman, Soraya,

I've asked here in a prior post, and in a couple other places where the subject is ongoing, of those people who have posted claiming to know this particular victim: Where was she staying at the time of her death? Thus far, none of those supposed acquaintances have provided any response.

and then, apparently, there are 3 other Thai deaths that are being looked at as being related (though unrelated to the hotel). And which apparently haven't hit the newspapers yet (no secret as to why that might be, seeing as how it would be bad for the whole town, business wise).

B, if there's some info about potential additional victims re this case that you're referring to in your post on someone's FB page, can you provide the link here? Or at least copy and post the pertinent info... If it's in Thai, it can be translated....

[Markaew]

No one is asking if the "authorities" (I use that word loosely) did a search of the rooms to determine if there was any cash still in the rooms of the deceased/sick. Was it all removed? Was any cash left in their belongings? It is very easy to kill foreigners just to take their money. There is no one to investigate a local's actions, only a foreigner's because maybe some money can be extracted . Maybe they showed too much cash and someone relieved them of it. I would like to hear a report about witnesses stating the behavior of the tourist. Maybe they were displaying arrogance and a local decided to shut them up and take their money.

[Steely Dan]

It has just occured to me that one thing actually does surprise me, that being this thread is still open and references to the hotel name and pictures of it not removed. I would like to suggest that perhaps the best way to resolve this little issue is to change the name of the hotel to the Uptown inn, which will only need four letters removing and two new ones adding which should be inexpensive.

[jimbeam1]

Anterian,

I don't normally go in for theses conspiracy theories. My thoughts are that you should wait to see what comes up with the updates. But someone, maybe two or three pages back, did in my opinion come up with something quite feasible. Especially now we have come up with a possible 5th victim, who was staying at a different hotel and also there may be more cases pending.

The person who came up with the post mentioned, bottled water, not the actual water itself, but the method of cleaning the bottles prior to filling them. Which is to cleanse them with a cyanide solution. What he was in fact saying, is that maybe this solution was not washed out of the bottles, prior to filling them with water. To me that sounds quite reasonable.

jb1

[Bubbalicious]

First, there is the case of this American woman, Soraya,

I've asked here in a prior post, and in a couple other places where the subject is ongoing, of those people who have posted claiming to know this particular victim: Where was she staying at the time of her death?  Thus far, none of those supposed acquaintances have provided any response.

and then, apparently, there are 3 other Thai deaths that are being looked at as being related (though unrelated to the hotel). And which apparently haven't hit the newspapers yet (no secret as to why that might be, seeing as how it would be bad for the whole town, business wise).

B, if there's some info about potential additional victims re this case that you're referring to in your post on someone's FB page, can you provide the link here? Or at least copy and post the pertinent info... If it's in Thai, it can be translated....

If you're looking for more details on the additional victims. I got that info verbally straight from a person who was in a meeting earlier this week with various public health types in the city. I don't know where my FB friend got the info from (maybe it's in the Thai press or Thai forums? I don't know). Another Thai acquaintance mentioned a report in the Thai press about a 'virus' being the cause (but I wouldn't take that to be the final verdict, as it seems they don't know or don't have enough questions answered to make a call on anything definite). But I see that the info on samples being sent to Japan and the U.S., which my friend heard in the meeting, was mentioned in that press conference as well (as reported by the Chiang Mai Mail).

But, in trying to get a run down on this info on additional victims, I was talking to my Thai friend who was at the meeting and it went something like this:

TF: "There are 4 Thai and 4 farang" who were victims.

Me: "4 Thais?"

TF: "Chai. 4 men."

Me: "4 Thais?" (still in disbelief)

TF: "4"

Now, I took that to mean the original 1 woman and 3 additional people. The friend said 'men' but maybe meant to say 'person'. The friend didn't seem to have any info on the additional victims and had to run, so I didn't get to follow it up. But, after listening to the laundry list of things they are looking at (and trying to eliminate as possibilities) it appears that these additional 3 have also died, I assume, under some similar circumstances or with similar symptoms.

I raised the new potential victims in the hope that someone in position to ask, might ask someone in the know. "Hey, what's this I hear about additional Thais having died?"

As for your question on the hotel where Soraya was staying. That would also be interesting to know. I imagine it's not widely known among the friends. But I did notice that the husband is on FB. I thought about messaging and asking, but decided not to.

[msg362]

A coincidence.

Interesting documentary on History channel the other day titled "Race and Intelligence".

Saw the show and the one glaring fact is that intelligence grows with the need for it to grow.

This means that when a community progresses, so must their intelligence. If you hold down a community, lets say by using financial oppression, then the intelligence does not need to grow.

Humans are born with the largest developed brain of all animals, according to the relative size of their body. This brain is not completely wired up, and needs stimulation to become the best it can be. Although there are physiological restraints caused genetically, this does not account for the huge disparity found in this country. It is my belief that this disparity is caused by the fact that so many people here in Thailand live well below any poverty line across the world, and as such do not have the stimulation needed to develop their brain to it's fullest potential. Can this problem be fixed?

I am interested in any intelligent comments, please post.

Maybe not poverty, more the lack of teaching problem solving and the culture of 'respect for elders', not challenging and avoiding the truth out of 'respect'

[sunnyrolfe]

Glad to hear it's only coincidence and it's all safe. So now just to prove it I think abhasit and his henchmen should hold a convention and stay there a few night themselves. And a few of the police big knobs from Chiang Mai can have a bridal suite too.

[andrewdrummond]

As for your question on the hotel where Soraya was staying. That would also be interesting to know. I imagine it's not widely known among the friends. But I did notice that the husband is on FB. I thought about messaging and asking, but decided not to.

I do not think the husband believes whefre Soraya was staying has any connection with her death. Suffice to say it was not the Downtown Inn.

The US State department repeat today that no link has been established between any of the deaths and has offered assistance

http://www.andrew-drummond.com/2011/03/11/us-offers-help-in-chiang-mai-deaths-probe/

[AjarnPasa]

Kiwi investigators say that the 23 year old had a very contagious virus that caused myocarditis (acute inflammation of the heart muscle). i.stuff.co.nz/world/asia/4760041/Test-link-virus-to-dead-Kiwi-tourist

So much for the cyanide theories

[Briggsy]

Kiwi investigators say that the 23 year old had a very contagious virus that caused myocarditis (acute inflammation of the heart muscle). i.stuff.co.nz/world/asia/4760041/Test-link-virus-to-dead-Kiwi-tourist

So much for the cyanide theories

Please note this info comes from Thailand's Bureau of Epidemiology after it briefed the NZ embassy not "Kiwi investigators".

[andrewdrummond]

Kiwi investigators say that the 23 year old had a very contagious virus that caused myocarditis (acute inflammation of the heart muscle). i.stuff.co.nz/world/asia/4760041/Test-link-virus-to-dead-Kiwi-tourist

So much for the cyanide theories

Please note this info comes from Thailand's Bureau of Epidemiology after it briefed the NZ embassy not "Kiwi investigators".

Which is a bit odd because they seemed to have briefed the Bangkok Post that Sarah Carter had the 'coxsackie B' virus, which is a similar enterovirus but different. If its 'coxsackie B' then they cannot rule out the British couple so quickly for instance. Coxsackie B can be transmitted through the mouth, (oral/fecal) through the air, and you can even get it from an inanimate object, such as by touching a tap (faucet) glass, even bedlinen.

Clear as mud

[animatic]

Dr Akarasewi said autopsy results showed the British couple had blocked heart arteries, which could have caused their deaths.

Both of them being in their late 70's and having partially blocked arteries would be normal.

For both of them to die within a short time, like same night, from from blocked arteries is not a reasonable conclusion. Apparently the Dr. doesn't care if his reputation is besmirched by his own mouth.

Edited March 12, 2011 by animatic

[geriatrickid]

I have not commented in this thread because I wanted to see what the conclusions of the cultures and tests. The findings do make sense to me. Coxsackieviruses are part of the genus enterovirus.The enteroviruses are made up of 5 subgenera which include the coxsakieviruses, the echoviruses and one virus that should cause people to pay attention, the poliovirus. Coxsackievirus A should be familiar to people that read the papers since it is associated with hand, foot and mouth disease, of which there have been outbreaks of in Thailand. The reported symptoms all are compatible with the suggestion of an enterovirus. The finding of myocarditis as well as the reports of apparent disorientation all point to an enterovirus. As well, the viruses have different impact on people. Some people might just have what appears to be a common stomach upset or a cold, while it kills others.

Here's the part that concerns me. The manner in which the virus spread. Enteroviruses are spread by human contact with surfaces contaminated with the the secretions from an infected person. You know how the cruise ships can get hit with a norovirus outbreak causing passengers to fall ill and require the ship to be thoroughly decontaminated? I believe the same situation is occurring here. More importantly, some of the carriers of the enteroviruses are asymptomatic, meaning they do not show any symptoms, but they function as a carrier spreading the virus wherever they go. Wherever the cough, whatever they touch, whenever they poop, they leave the enterovirus behind. The bugger can survive for days on a surface. The best way of preventing transmission is hand washing.

My expectation of how this is going to be handled. Staff at the suspect hotel may be tested to see if someone is a carrier. This testing will not be made public due to patient confidentiality and more importantly to avoid panic. I think Chiang Mai has its own version of a Typhoid Mary.

[inmysights]

Okay, shot in the dark, but given the prevalence of this particular shrub http://en.wikipedia.org/wiki/Nerium_oleander

Symptoms/toxicity curiously same. Just a thought.

[msg362]

I have not commented in this thread because I wanted to see what the conclusions of the cultures and tests. The findings do make sense to me. Coxsackieviruses are part of the genus enterovirus.The enteroviruses are made up of 5 subgenera which include the coxsakieviruses, the echoviruses and one virus that should cause people to pay attention, the poliovirus. Coxsackievirus A should be familiar to people that read the papers since it is associated with hand, foot and mouth disease, of which there have been outbreaks of in Thailand. The reported symptoms all are compatible with the suggestion of an enterovirus. The finding of myocarditis as well as the reports of apparent disorientation all point to an enterovirus. As well, the viruses have different impact on people. Some people might just have what appears to be a common stomach upset or a cold, while it kills others.

Here's the part that concerns me. The manner in which the virus spread. Enteroviruses are spread by human contact with surfaces contaminated with the the secretions from an infected person. You know how the cruise ships can get hit with a norovirus outbreak causing passengers to fall ill and require the ship to be thoroughly decontaminated? I believe the same situation is occurring here. More importantly, some of the carriers of the enteroviruses are asymptomatic, meaning they do not show any symptoms, but they function as a carrier spreading the virus wherever they go. Wherever the cough, whatever they touch, whenever they poop, they leave the enterovirus behind. The bugger can survive for days on a surface. The best way of preventing transmission is hand washing.

My expectation of how this is going to be handled. Staff at the suspect hotel may be tested to see if someone is a carrier. This testing will not be made public due to patient confidentiality and more importantly to avoid panic. I think Chiang Mai has its own version of a Typhoid Mary.

Correct me if I'm wrong, but this virus typically only produces mild symptoms. The prospect of killing ? 4 ? people in a short time is low is it not?

Edited March 12, 2011 by msg362

[geriatrickid]

Correct me if I'm wrong, but this virus typically only produces mild symptoms. The prospect of killing ? 4 ? people in a short time is low is it not?

You are correct. However, there are many types that are lethal in humans who have pre-existing health conditons or that do not have sufficient immunity. Hence, the reason it will cause different outcomes in some people. It's sort of like how some people can eat street vendor food with no problems, while others will be doomed to several days of not being far from a toilet. Enteroviruses are distinguished by their ability to mutate quickly, which makes them even more difficult to manage. There aren't many effective treatments out there because they are viruses. So far the only viruses that can be managed are the related poliovirus and Hepatitis A by means of vaccines.

The nature of a virus being the cause of the illnesses and deaths means that the public health authorities are going to have limited options. The usual response, particularly when there are signs that indicate an infectious virus, is to implement a disinfection and prevention procedure (i.e. disinfect the hotel, encourage hand washing and good hygiene amongst the food vendors etc.). We've already seen several general announcements from the public health officials about this. It makes sense to me why they would do this in a general manner since they cannot pidentify patient zero or the reservoir of the virus. As much as I would like to criiticize the Thai health officers, they cannot really do much to deal with the situation since it all comes down to general hygiene and that is something we as individuals are responsible for. If this was a typical outbreak as seen in a seniors residence or a hospital it would be easier to manage. A disinfection regimen could be implemented and surveillance of hygiene effected. However, this is a general population manifestation and all that can be done is to keep trying to identify the carriers and to encourage proper hand washing etc. people have a tough time dealing with things they cannot control, so I anticipate losts of conspiracy theories and allegations of murders. Unfortunately, this situation is seen all over the world and the end result is illness and death. The takeway from this is to practice basic hygiene and to avoid touching your mouth or eyes after touching a surface and to vigorously wash one's hands.

[Donnyboy]

even when personal hygiene is practised, you cannot guarantee food safety when so many food outlets have poor hygiene standards/practises