Thai Health Ministry Speaks Regarding Chiang Mai Downtown Inn Deaths

[webfact]

International toxicologists consulted in Chiang Mai tourist deaths - Update 3

23 May 2011 – Thai public health authorities have enlisted the assistance of international toxicology experts this month to determine whether toxins or chemical agents might be involved in the deaths of five foreign tourists and a Thai guide and the associated illnesses of three other individuals in Chiang Mai earlier this year.

The Department of Disease Control, Ministry of Public Health (MOPH) and the Chiang Mai provincial authorities, enlisted the help of these expert toxicologists as part of the on-going investigation into the deaths that occurred between January and February this year. The toxicologists are from Australia, India, Sri Lanka, the United Kingdom, the United States, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (US CDC).

This consultation followed an earlier meeting of experts at the Department of Disease Control held on 10 May 2011 with the Chiang Mai provincial authorities to review information gathered over the past few months. This meeting involved clinicians, epidemiologists, laboratory specialists, pathologists, toxicologists and police as well as the WHO and the US CDC. Subsequently, representatives of relevant consulates were briefed on the progress of the investigation.

The toxicology experts have reviewed the available evidence and discussed several possible causes involving toxins and chemical agents as a cause of death. The toxicologists also discussed the suggestion made by the New Zealand TV3 ‘60 Minutes’ programme that chlorpyrifos (used as an insecticide) was responsible for the death of one woman from New Zealand and the illness of her two traveling companions.

While a cause has not been clearly identified to date, experts recognized that chlorpyrifos generally emits a strong odor which was not noted by the two surviving women. They also noted that chlorpyrifos is not well absorbed by the skin nor would it cause rapid illness or death in a healthy adult unless it was ingested or inhaled in very high quantities. Furthermore, the details of the clinical and laboratory investigation do not support chlorpyrifos as a cause.

The toxicologists are also considering the possibility that other chemical agents including those found in pest control products might cause signs, symptoms and laboratory findings consistent with the features seen. Experts are also currently working to identify the most suitable laboratories to carry out specific tests for selected pest control ingredients in the remaining samples.

Concurrently, environmental and toxicology assessment involving experts and laboratories from the Ministry of Agriculture; the Department of Health, MOPH; Ramathibodi Poison Center; the Faculty of Agriculture, Chiang Mai University is underway at the hotel where four persons died.

The initial assessment of overnight room ventilation in April found adequate air ventilation with normal levels of nitrogen dioxide and sulfur dioxide; and no evidence of carbon monoxide accumulation. A parallel investigation has also been undertaken by local police. While Thai authorities and international partners are actively pursuing the hypothesis that these six deaths might be linked to a similar cause, the investigation so far reveals few common traits except that:

- All occurred in Chiang Mai between 11 January and 19 February

- Six of the nine reported people affected lodged at one hotel (three were at two different hotels)

- The first six people identified are young (aged 23-29) female non-Thai nationals

The people who died and fell ill are being examined in three groups based on the hotels they stayed in, as follows:

1) One American woman (age 33) who died on 11 January and her Canadian colleague (age 29) who fell ill

2) One French woman (age 25) who died on 19 January

3) 1) One Thai woman (age 47) who died on 3 February

2) One New Zealand woman (age 23) who died 6 February and her two traveling companions (both age 23) who both fell ill

3) A couple from the United Kingdom – one man (78) and woman (74) who both died on February 19

Based on findings currently available, there is insufficient evidence to link the illnesses and deaths among these three groups. The American, Canadian and French woman had no activities in connection with other hotels and other cases. The French women also began to fall ill few days before arrival in Chiang Mai.

There have been reports that a Canadian man who died in January may have used the swimming pool of the hotel where the Thai woman, the New Zealand women and the United Kingdom couple stayed (hotel number 3 above). However it has not been possible to confirm these reports or even to establish the day when this visit was supposed to have occurred. In addition, the available evidence from medical records and autopsy by forensic expert do not currently support linkage with other deaths. Therefore the death of this man has not been included in the cluster.

It was also initially believed on the basis of clinical findings that myocarditis (inflammation of the heart muscle) was a common factor in a number of deaths. However, although it is clear that heart muscle damage occurred in these cases, further investigation of clinical, laboratory and histopathology records, has only established clear evidence of myocarditis in the case of the French woman. It is partly this evidence that has resulted in the scope of the investigation being widened to look for other causes of cardiac damage (that can mimic the clinical appearance of myocarditis), including toxins and chemical agents.

A final explanation of the most likely cause of the event(s), including exact cause of illnesses and deaths, and any important related factors, will be made based upon the synthesis of evidence from clinical, epidemiologic, laboratory, environmental and forensic investigations.

It is important to highlight that a complex investigation such as this which also includes international laboratory analyses takes time. Any new toxicology results are also likely to take time if specimens need to be shipped to specialist laboratories. It is also possible that cases may not all be linked, and may instead be due to different causes. Despite the best efforts of Thai authorities and international partners, a complete explanation for the cause of deaths may not be found for all cases.

The Thai Ministry of Public Health will provide information as it becomes available to the families, the international community and the media, and will provide regular updates on its Thai and English websites (www.ddc.moph.go.th). Any persons who may have specific medical or public heath concerns about this event are invited to report them or make queries using email address: askcmevent [at] gmail.com.

Source: http://www.ddc.moph.go.th

-- Thai Ministry of Public Health 2011-05-24

[Soutpeel]

Call me cynical, but my feeling all the evidence has been "sanitized" / contaminated / removed by Thailands finest and associated prior to any international bodies getting involved....international bodies investigate find nothing conclusive or definitive...All is happy again in Chang Mai....

Thailand saves "face" by stating international body investigates and finds no connection in these deaths and they were all unrelated....inclusive of the elderly couple who died a few hours apart in the same room.....

[foxteen]

well somehow,they should know the cause of deaths of those people,hope the true will come for the relatives

[jimbeam1]

Thai Public Health Authorities. Wow what a joke. <deleted> do they think they are going to find now, even if they did find anything, it would be covered up. It is just lucky for the Thai authorities that they have no morals at all, because if they did they would have to admit to being totally inept failures at being human. Although I suppose the relevant Embassy's/ governments of the Nationals concerned, are not any better.

jb1

[Methuselah]

Interestingly,pharmacological descriptions of chlorpyrifos state that it has a mild sulphurous odour.

[crusader79]

All very impressive and reassuring....had this announcement been made three months ago.

[lungmi]

In Germany we have a pandemic of ehc coli bacteria. No one knows for the moment why. But the research goes on..

I wish for Thailand the same system.

(It will cut off the speculations of underemployed posters)

[Johpa]

In Germany we have a pandemic of ehc coli bacteria. No one knows for the moment why.

Currently in Chiang Mai there is a pandemic of the E. Cohok bacteria similar to other outbreaks around the Kingdom. Everyone knows why this occurs: it is a result of the raksaa naa plague that has long impacted human habitation throughout the Siam region of the Golden Peninsula over the past century.

[msg362]

In Germany we have a pandemic of ehc coli bacteria. No one knows for the moment why.

Currently in Chiang Mai there is a pandemic of the E. Cohok bacteria similar to other outbreaks around the Kingdom. Everyone knows why this occurs: it is a result of the raksaa naa plague that has long impacted human habitation throughout the Siam region of the Golden Peninsula over the past century.

Sorry if i am being thick but what are you on about?

[The Snark]

That was an outstanding article. Well researched and covered the bases. Thanks to webfact for posting it. Now we wait and see what transpires.

[jfchandler]

And the hotel at the center of this remains open for business and hosting guests.... yet they still don't know what killed the people who were staying there....

I can't help but thinking back to the report in the 60 Minutes piece, with the reporter who visited the hotel saying the night she was there they were turning the place upside down because they were expecting an inspection the next day... So after all these months, what evidence is likely to be found in the hotel and its rooms.... Probably nothing...

As someone said above, this latest pronouncement would have been well-received, had it come on the heels of the deaths when everything was fresh... not so many months later that everything has dissipated or been cleaned away.

Let's not forget, at earlier points in time, the Thai authorities were insisting all the deaths were simply unrelated coincidence... Ya right... So now, after all this time, we get an international investigation.

[meithai]

In Germany we have a pandemic of ehc coli bacteria. No one knows for the moment why.

Currently in Chiang Mai there is a pandemic of the E. Cohok bacteria similar to other outbreaks around the Kingdom. Everyone knows why this occurs: it is a result of the raksaa naa plague that has long impacted human habitation throughout the Siam region of the Golden Peninsula over the past century.

Sorry if i am being thick but what are you on about?

I thought that was very witty.

I think he means e gohok bacteria BS/lying bacteria & raksaa naa - saving face plague.

[elektrified]

The press release from the Department of Disease Control, Ministry of Public Health dated 23 May is the most concise, straight-forward bit of information released by the Thai government to date. Let's see what, if anything, pans out.

[SantiSuk]

Rather predictable outcome.

I'm talking about the TV posters' response. Major incident happens; TV response - it will be covered up. Authorities launch investigation; TV response - it's too late and they'll find nothing. Coming soon, authorities provide findings; TV response - they are lying, you can't trust them.

Laughable

[Nisa]

Rather predictable outcome.

I'm talking about the TV posters' response. Major incident happens; TV response - it will be covered up. Authorities launch investigation; TV response - it's too late and they'll find nothing. Coming soon, authorities provide findings; TV response - they are lying, you can't trust them.

Laughable

[Nisa]

Let's not forget, at earlier points in time, the Thai authorities were insisting all the deaths were simply unrelated coincidence... Ya right... So now, after all this time, we get an international investigation.

Not only have international groups been involved since early on ... but even this latest report fails to make a medical link between the cases and states it may turn out the majority of these separate deaths & illnesses were unrelated and/or may have nothing at all to do with the hotel.

[pisico]

In Germany we have a pandemic of ehc coli bacteria. No one knows for the moment why.

Currently in Chiang Mai there is a pandemic of the E. Cohok bacteria similar to other outbreaks around the Kingdom. Everyone knows why this occurs: it is a result of the raksaa naa plague that has long impacted human habitation throughout the Siam region of the Golden Peninsula over the past century.

Precious wit !:lol:

[Nisa]

All very impressive and reassuring....had this announcement been made three months ago.

3 months ago they just began the "connection" investigation and had few test results back since that would have been in February when cases were still being reported but beyond the other statements from other agencies, the DDC has been putting out updates for 2 1/2 months. This is their 3rd.

Edited May 24, 2011 by Nisa

[homeslice]

The writing is on the wall, even if the authorities are too blind to acknowledge it. If you have a specific complaint you can follow the link below, have your name put on a list and suffer a similar fate...

Any persons who may have specific medical or public heath concerns about this event are invited to report them or make queries using email address: askcmevent [at] gmail.com.

Source: http://www.ddc.moph.go.th

[The Snark]

EXCUSE ME FOR A FEW MOMENTS!

While being critical of many aspects of these cases can be well justified from questionable competency in the past, we aren't experts and we don't know all the facts.

It appears a strong international investigation is going to take place and their findings are likely to be unbiased. Rabble rousing and arm chair trials and convictions are only serving to cloud and obfuscate the issues.

If this investigation fails to find the cause, that in itself will be indicative of an endemic problem that the Thai police and government needs to confront. Until then, all these discussions and accusations are only serving to get concerned people labeled sour grapes and ignored, sidelined and possibly even persecuted.

By all means, express your concerns, and endeavor to bring attention from the international community to bear on this issue, but don't blather and cost people credibility by expressing bias and unfounded or unproven rumors. Send word back home and to the international community that is factual and credible. That is the pressure that will force the locals to clean up their acts.

[webfact]

Cause of Thai tourist deaths 'may never be found'

BANGKOK, May 25, 2011 (AFP) - Thailand said Tuesday that there was insufficient evidence to link a spate of mysterious tourist deaths in its northern city of Chiang Mai, and the full cause may never be known.

Five foreigners and a Thai guide died while three others fell ill while staying in the popular tourist destination between January 11 and February 19 of this year.

Six of them stayed at the same hotel, while three others were at two different hotels. Most were young women.

But beyond that there were "few common traits" in their deaths, the Thai Ministry of Public Health's Department of Disease Control said in a statement, noting that international toxicologists were assisting the investigation.

"Despite the best efforts of Thai authorities and international partners, a complete explanation for the cause of deaths may not be found for all cases," it added.

The dead included a young New Zealand woman, an elderly British couple and a Thai tour guide who were all taken ill in February at the Downtown Inn in Chiang Mai, Thailand's second-biggest city.

The others were American and French, while a Canadian and two New Zealand women also fell sick.

One theory is that chlorpyrifos, which is used as an insecticide, was responsible for at least some of the deaths.

But experts said that chlorpyrifos generally emits a strong odour, which was not reported by those who fell ill, and is not usually fatal unless ingested or inhaled in very large quantities.

"Furthermore, the details of the clinical and laboratory investigation do not support chlorpyrifos as a cause," it said, adding that toxicologists were investigating whether other pest control chemicals might have been involved.

Acting hotel manager Vinai Julsiri told AFP in March that the deaths were a coincidence.

"The news about the hotel's mystery deaths is really bad for our business. It was not true," he said. "There is nothing wrong or dangerous in our hotel."

-- (c) Copyright AFP 2011-05-25

[The Snark]

Cause of Thai tourist deaths 'may never be found'

Acting hotel manager Vinai Julsiri told AFP in March that the deaths were a coincidence.

"The news about the hotel's mystery deaths is really bad for our business. It was not true," he said. "There is nothing wrong or dangerous in our hotel."

-- (c) Copyright AFP 2011-05-25

Khun Vinai Julsiri, it is in yours and your employers best interest to demand that all the facts regarding this case are brought to light. Simply making that statement serves no purpose. Insist that every possible avenue of investigation be capably and transparently followed up.

Deaths did occur at your hotel. The initial investigation was highly questionable. Answers need to be provided. Denial is not an option. In this instance the hotel is guilty, that mysterious deaths did happen on your premises, and the guilt shall remain until the cause has been found. Establish your credibility.

Edited May 24, 2011 by The Snark

[kennalder]

Rather predictable outcome.

I'm talking about the TV posters' response. Major incident happens; TV response - it will be covered up. Authorities launch investigation; TV response - it's too late and they'll find nothing. Coming soon, authorities provide findings; TV response - they are lying, you can't trust them.

Laughable

I always said "95% of the people that get stereotyped deserve it."

[rodcourt49]

Call me cynical, but my feeling all the evidence has been "sanitized" / contaminated / removed by Thailands finest and associated prior to any international bodies getting involved....international bodies investigate find nothing conclusive or definitive...All is happy again in Chang Mai....

Thailand saves "face" by stating international body investigates and finds no connection in these deaths and they were all unrelated....inclusive of the elderly couple who died a few hours apart in the same room.....

..they did use some 'big' words in the article..you obviously have no expertise in forensics else you'd accept what has been stated. How much more information do you need before you accept what has eventuated.

To put the minds of the community at ease (including all the arrm-chair CSI experts),the Thai Health Dept sought the asistance and expertise of International specialists ie epidemiologists, toxicologists, forensic pathologists etc..(who might i add are not there to just satisfy your doubts).

Once the Coroner reads all this he/she will most probably make an 'open finding' (this means the cause of death is undetermined but appears to be by natural causes, seeing as no raised levels or any substance, compound, chemical have been detected).

Each case has to be examined independently and not a sweeping decision made for all those concerned, after all the deaths at that premise were spread out over 2 months, with only the elderly couple presumed to have died on the same day).

You can't just make up a story. Some of the patrons appear to have been sick or carrying whatever virus/bacterium prior to arriving at these premises, one died elsewhere.

So how do you expect the judiciary to make a clear decision.

You may imply contamination/sanitization/removal..seems you're hinting on inteference of evidence, which is a very serious matter.

IMO the Thai Forensic Science officers are up there with the world's best.

[Lizard2010]

Interesting Report.

We still do not know what happened.

We probably will never know.

As it looks as though what ever causes the deaths have disappeared from the bodies and the rooms.

[Nisa]

Same story as how many licks to get to the center of a tootsie pop ... the world may never know.

[ginjag]

Same story as how many licks to get to the center of a tootsie pop ... the world may never know.

A What ??? tootsie pop, :lol:guess this is a U.S.of A (candy lollypop). But I understand what you mean-- MAY never know, is better than Will, at least there is a chance -small glimmer-Hope so.

Wouldn't it be lovely for it all to come out in the wash. !!!!

[toybits]

It Thailand would just admit that they have been quietly "promoting Suicide Tourism" like they are doing in Zurich (Switzerland), all of these problems would just go away?

[Nisa]

Same story as how many licks to get to the center of a tootsie pop ... the world may never know.

A What ??? tootsie pop, :lol:guess this is a U.S.of A (candy lollypop). But I understand what you mean-- MAY never know, is better than Will, at least there is a chance -small glimmer-Hope so.

Wouldn't it be lovely for it all to come out in the wash. !!!!

Wow, I figured this was a global candy and they used the same commercial they did, way back in the day, in the US.

Just noticed this is so old it is a minute commercial opposed to the standard 30-second ones today.

Edited May 25, 2011 by Nisa

[Thaddeus]

IMO the Thai Forensic Science officers are up there with the world's best.

They usually have less to discover tho'