Israel to send medical expert for discussion on sudden unexpected death syndrome in Thai workers

[webfact]

Israel to send medical experts to Thailand for discussion on sudden unexpected death syndrome in Thai workers

BANGKOK, 2 June 2015 (NNT) - Director-General of the Employment Department Sumet Mahosot said at a press conference which was co-chaired by Amnon Ben Ami, Director-General of Population Immigration and Border Authority (PIBA) of Israel that Israel would send medical experts to Thailand to figure out causes of sudden unexpected death syndrome which have killed 66 Thai workers during the past four years.

The press conference came at the end of the visit to Thailand of Mr. Amnon Ben-Ami and his delegation to boost the Thai-Israeli cooperation in labour in 2015.

Mr. Sumet said the discussion focused on four issues, one of which was the sudden unexpected death syndrome of Thai workers. In 2015 alone, ten Thai workers died from the syndrome, prompting Israel to send medical experts to discuss with Thai Public Health Ministry about effective prevention from the syndrome. The Israeli delegates agreed that Thai workers should have their cardiography checked before departure to Israel.

Drug use among Thai workers was another issue. Israel will cooperate with the Office of the Narcotics Control Board of Thailand to strengthen prevention of drug use among Thai workers. Both sides agreed that workers must pass health check and drug test before their departure. Any who use drug while working in Israel must be sent back to Thailand immediately.

The third issue involved tax payment of foreign workers in Israel. He said Thai workers were likely to get exemption of tax payment. However, this will be confirmed by Israeli authorities soon.

The last issue was benefits for workers. Both countries agreed to set up a joint committee working in Israel to further discuss the matter. The Thai Embassy and the Office of Labour Affairs in Tel Aviv will be Thai representatives in the committee.

Regarding the three workers who have died in accidents in Israel, PIBA would give their families compensation and benefits based on Israeli Social Insurance.

Amnon Ben-Ami said that all agreements done in the meeting will be pushed forward including the effort to tackle delay of payment. He said Israel has fined employers of Thai workers for over ninety million baht for the delay of payment.

-- NNT 2015-06-02

[harryfrompattaya]

It is about time no Thai is allowed to work in Israel.

[Always18]

A cynic might say it was the thought of actually having to work that laid these poor Thai souls to rest..............

[Prbkk]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

[ChrisY1]

Should be explained here also.........many people here die of unexpected causes!!

[seajae]

the unexpected causes of death in Thailand are usually related to face or having to actually work

[geriatrickid]

It is about time no Thai is allowed to work in Israel.

Why? Thais should be allowed to work in Israel if they qualify.

Are you in favouring of not allowing non Thais to work in Thailand too?

[geriatrickid]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

It was identified. It is a heart defect common in males from the Isan region. It is well know in Thailand but not discussed.

[falang07]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

It was identified. It is a heart defect common in males from the Isan region. It is well know in Thailand but not discussed.

Do you have any more details about this defect?

[TheAppletons]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

Sudden Unexpected Death Syndrome (SUDS). Beer, perhaps?

[dageurreotype]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

Many Hmong, predominantly young men, died of SUDS when they were evacuated to Minnesota after the bombing of Laos. Also, it's a little known fact that many Thais died of SUDS after the tsunami.

Wasn't this a 'news' item just a few months ago? They running out of stuff they can actually report on?

[geriatrickid]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

It was identified. It is a heart defect common in males from the Isan region. It is well know in Thailand but not discussed.

Do you have any more details about this defect?

We had an discussion of this in the earlier thread. I believe I had provided the study citations at the time.

One of the problems Singapore investigators had was the reluctance of Thai medical personnel to acknowledge a genetic component to the syndrome. Thailand doesn't invest much in respect to genetic linked illness research. It's quite a contrast to the Chinese and Europeans. I suppose it's culture related. Every region in the world and every "ethnic" group has its own unique genetically driven illnesses. Classic examples are sickle cell anemia in Africans, Latinos who have had acne are often subject to hyperpigmentation where the acne was, an island in the Orkneys has the highest incidence of multiple sclerosis in the world etc.

[dageurreotype]

A similar syndrome appeared in Thai workers in Singpore about 20 years ago. It was never fully explained but many deaths ( unrelated to drugs though).

It was identified. It is a heart defect common in males from the Isan region. It is well know in Thailand but not discussed.

Do you have any more details about this defect?

We had an discussion of this in the earlier thread. I believe I had provided the study citations at the time.

One of the problems Singapore investigators had was the reluctance of Thai medical personnel to acknowledge a genetic component to the syndrome. Thailand doesn't invest much in respect to genetic linked illness research. It's quite a contrast to the Chinese and Europeans. I suppose it's culture related. Every region in the world and every "ethnic" group has its own unique genetically driven illnesses. Classic examples are sickle cell anemia in Africans, Latinos who have had acne are often subject to hyperpigmentation where the acne was, an island in the Orkneys has the highest incidence of multiple sclerosis in the world etc.

Doesn't actually address the Hmong and after Tsunami Thais though. Does it. They all had 'genetic heart defects'? All dying at the same time?

[mikebell]

This ailment is caused by the total deprivation of Som Tam and Lao Kao. The shock of having to work more than two hours in a day is a contributing factor.

Farangs also suffer from 'Sudden Unexpected Death Syndrome' or to give it its more common name - balconyitis. The disease can often be caught from sick buffaloes.

[dave_boo]

Can I point out that a fatality rate of ~4.35/1,000 (28,000 total Thai workers in Israel / 122 deaths / 5 years) is well under the Thai crude death rate and actually beats out Thailand's rate of road deaths?

[Sayonarax]

It is about time no Thai is allowed to work in Israel.

its about time we set Israel in to hellfire

[MockingJay]

Severe homesickness perhaps? No pun intended! I also heard that there can be epidemic losses of life in local villages, especially north east Thailand. The village people say it is a ghost of a woman who comes to take men away in her sleep, they simply go to sleep and never wake up again, young and healthy men... as soon as a proper cleansing ceremony has been performed by monks, the dying stops... very strange indeed.

Edited June 3, 2015 by MockingJay

[Strangebrew]

It is called "exercise" case closed next.

[AlQaholic]

The sudden death syndrome is a widespread phenomenon in Thailand particularly in Isan. Many people die every year mostly male in Isan during sleep and so far not much effort have been made to investigate the causes.

Sorry Prbkk and Geriatrick, I did not read you posts before posting, your posts says the same.

Edited June 3, 2015 by AlQaholic

[timmyp]

I have never heard of "sudden death syndrome", I thought it was an unchecked error from the National New Bureau.

Here's the Wikipedia link for those who haven't already looked it up:

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

Truly bizarre.

[Bruce404]

Sudden Unexplained Death Syndrome (SUDS, also known by local terms such as "bangungut", "lai tai", and "pokkuri") is a not well-understood phenomenon kn own for decades among Asian men in Thailand, Philippines, Japan, and elsewhere. Ronald G. Munger, among others, has published extensively on this. Attached is one of his papers.

Other articles in the biomedical literature are listed below, including some of their abstracts:

Otto, C.M., Tauxe, R.V., Cobb, L.A., Greene, H.L., Gross, B.W., Werner, J.A., Burroughs, R.W., Samson, W.E., Weaver, W.D., Trobaugh, G.B.

Ventricular fibrillation causes sudden death in Southeast Asian immigrants

(1984) Annals of Internal Medicine, 101 (1), pp. 45-47.

Baron, R.C., Thacker, S.B., Gorelkin, L., Vernon, A.A., Taylor, W.R., Choi, K.

Sudden death among Southeast Asian refugees. An unexplained nocturnal phenomenon

(1983) Journal of the American Medical Association, 250 (21), pp. 2947-2951.

In the period July 15, 1977, through March 30, 1982, there were at least 51 sudden, unexplained deaths in the United States among refugees from Southeast Asia. These deaths involved relatively young (median age, 33 years), previously healthy persons. All except one were male, and all died at night. Available data from studies among young adults in this country suggest that this specific phenomenon has an unusually high incidence among Laotian and Kampuchean refugees and, furthermore, has not previously been observed in the United States. Interviews with families of the decedents and a case-control study have failed to establish causal factors, but emotional stress cannot be ruled out as a contributing element. While reviews of the forensic investigations have confirmed the absence of important common pathological or toxicological findings, preliminary findings of special postmortem cardiac studies, now in progress, suggest that at least some of these deaths may be associated with developmentally abnormal conduction system pathways. Further studies are required to confirm this association, to define the apparently sleep-induced mechanism that triggers these deaths, and to explain the male preponderance in this disorder.

Luke, J.L., Helpern, M.

Sudden unexpected death from natural causes in young adults. A review of 275 consecutive autopsied cases.

(1968) Archives of pathology, 85 (1), pp. 10-17.

Nimmannit, S., Malasit, P., Vasuvattakul, S., Nilwarangkur, S., Chaovakul, V., Susaengrat, W.

Pathogenesis of sudden unexplained nocturnal death (lai tai) and endemic distal renal tubular acidosis

(1991) The Lancet, 338 (8772), pp. 930-932.

Sudden unexplained nocturnal death (SUND), a disorder of unknown cause that occurs in otherwise healthy young adults, mostly male, during their sleep, is prevalent in the north-east region of Thailand, where it has been known for generations as lai tai. It occurs in the same population and area where hypokalaemic periodic paralysis (HPP), endemic distal renal tubular acidosis (EdRTA), and renal stones are also endemic. SUND has occurred in families of patients with EdRTA, and HPP can present as sudden onset of muscle paralysis with potentially lethal cardiac arrhythmias and respiratory failure from severe hypokalaemia occurring in the middle of the night. Surveys in which serum and urinary potassium have been measured indicate a deficiency of the electrolyte in the population. Potassium deficiency is probably the prime factor responsible for SUND and HPP. Low urinary citrate concentrations and the high prevalence of acidification defects in the population indicate that potassium deficiency is also responsible for the prevalence of EdRTA and for renal stones. © 1991.

Kirschner, R.H., Eckner, F.A.O., Baron, R.C.

The cardiac pathology of sudden, unexplained nocturnal death in Southeast Asian refugees

(1986) Journal of the American Medical Association, 256 (19), pp. 2700-2705.

Tatsanavivat, P., Chiravatkul, A., Klungboonkrong, V., Chaisiri, S., Jarerntanyaruk, L., Munger, R.G., Saowakontha, S.

Sudden and unexplained deaths in sleep (laitai) of young men in rural northeastern Thailand

(1992) International Journal of Epidemiology, 21 (5), pp. 904-910.

Sudden and unexplained death in sleep (SUDS) is a significant cause of death of young adults in several Asian populations, but its distribution and incidence are not well known. We conducted a survey by mail of SUDS (known as 'laitai' in the local dialect) that occurred in adults during 1988-1989 in 3867 villages in northeastern Thailand with a total population of 5.42 million. Headmen of 2651 villages (68.6%) returned the questionnaire and sudden deaths of adults 20-49 years old were reported in 396 of these villages. The validity of reports was assessed by interviewing next of kin and witnesses in a sample of 92 villages reporting sudden deaths; 60 of 127 reports of SUDS from these villages were verified (47.2%). Officials and villagers in seven villages that did not respond to the questionnaire were also interviewed and no cases of sudden death were found. The verified SUDS victims were all men with a mean age of 35.9 years (SD 7.8). A family history of SUDS was reported in 40.3% of index cases and 18.3% had brothers who had died similarly; no such deaths were reported among sisters. The estimated annual rate of death from SUDS among men 20-49 years was 25.9 per 100000 person years (95% confidence interval (CI): 21.0-30.7). The sudden deaths were seasonal with 38% occurring during March-May and 10% during September-October (?2=9.45, P = 0.02). Sudden death in sleep is a leading cause of death of young men in rural northeastern Thailand and the characteristics of Thai victims are similar to those of other Asian victims of this unexplained syndrome.

Gotoh, K.

A histopathological study on the conduction system of the so called 'Pokkuri disease' (sudden unexpected cardiac death of unknown origin in Japan)

(1976) Japanese Circulation Journal, 40 (7), pp. 753-768.

APONTE, G.E.

The enigma of "bangungut".

(1960) Annals of internal medicine, 52, pp. 1258-1263.

Parrish, R.G., Tucker, M., Ing, R., Encarnacion, C., Eberhardt, M.

Sudden unexplained death syndrome in Southeast Asian refugees: a review of CDC surveillance.

(1987) MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries / Centers for Disease Control, 36 (1), pp. 43SS-53SS.

Adler, S.R.

Refugee stress and folk belief: Hmong sudden deaths

(1995) Social Science and Medicine, 40 (12), pp. 1623-1629.

Sudden, unexpected, nocturnal deaths among Southeast Asian refugees.

(1981) MMWR. Morbidity and mortality weekly report, 30 (47), pp. 581-584, 589.

Goh, K.T., Chao, T.C., Chew, C.H.

Sudden nocturnal deaths among Thai construction workers in Singapore

(1990) The Lancet, 335 (8698), p. 1154.

Munger, R.G., Jones, M.P., Prineas, R.J., Crow, R.S., Changbumrung, S., Wangsuphachart, V., Keane, V.

Prolonged QT interval and risk of sudden death in South-East Asian men

(1991) The Lancet, 338 (8762), pp. 280-281.

Sudden death in sleep occurs in substantial numbers among young men in South-East Asia. The frequencies of electrocardiographic abnormalities were measured in groups with varying risks of such sudden death. The mean heart-rate-corrected QT interval (QTc) was significantly (p<0·05) greater among 123 Laotian refugees in Thailand at high risk (405 [95% confidence interval 397-413] ms) than in 77 Laotian refugees in the United States at lower risk (364 [359-369] ms) and 199 non-Asian US residents at negligible risk (358 [354-362] ms). Among refugees in Thailand, prolonged QTc interval was associated with poor thiamine status and a history of seizure-like episodes in sleep. Thiamine deficiency may be a cause of prolonged QT interval and sudden death in this region. © 1991.

Sugai, M.

Pathological study on sudden and unexpected death, especially on the cardiac death autopsied by medical examiners in Tokyo

(1959) Acta Pathol Jpn, 9 (SUPPL.), pp. 723-752.

Adler, S.R.

Ethnomedical pathogenesis and Hmong immigrants' sudden nocturnal deaths

(1994) Culture, Medicine and Psychiatry, 18 (1), pp. 23-59.

Goh, K.T., Chao, T.C., Heng, B.H., Koo, C.C., Poh, S.C.

Epidemiology of sudden unexpected death syndrome among Thai migrant workers in Singapore

(1993) International Journal of Epidemiology, 22 (1), pp. 88-95.

Tobin, J.J., Friedman, J.

Spirits, shamans, and nightmare death: Survivor stress in a Hmong refugee

(1983) American Journal of Orthopsychiatry, 53 (3), pp. 439-448.

Munger, R.G.

Sudden death in sleep of Laotian-Hmong refugees in Thailand: A case-control study

(1987) American Journal of Public Health, 77 (9), pp. 1187-1190.

Munger, RonaldG., Booton, ElizabethA.

Thiamine and sudden death in sleep of South-East Asian refugees

(1990) The Lancet, 335 (8698), pp. 1154-1155.

Update: sudden unexplained death syndrome among southeast Asian refugees--United States.

(1988) MMWR. Morbidity and mortality weekly report, 37 (37), pp. 568-570.

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001278.htm

Park, H.-Y., Weinstein, S.R.

Sudden unexpected nocturnal death syndrome in the Mariana Islands

(1990) American Journal of Forensic Medicine and Pathology, 11 (3), pp. 205-207.

Wong, M.L., Ong, C.N., Tan, T.C., Phua, K.H., Goh, L.G., Koh, K., Lee, H.P., Chawalit, S., Orapun, M.

Sudden unexplained death syndrome. A review and update

(1992) Tropical and Geographical Medicine, 44 (4), pp. S1-S19.

Blackwell, C.C., Busuttil, A., Weir, D.M., Saadi, A.T., Essery, S.D.

Sudden unexpected nocturnal deaths among Thai immigrant workers in Singapore. The possible role of toxigenic bacteria

(1994) International Journal of Legal Medicine, 106 (4), pp. 205-208.

Tatsanavivat, P., Chirawatkul, A., Klungboonkrong, V., Saowakontha, S.

Familial clustering of presumptive sudden unexplained death syndrome (PSUDS).

(1991) The Southeast Asian journal of tropical medicine and public health, 22 (2), pp. 195-199.

Munger, RonaldG., Weniger, BruceG., Warintrawat, S., Kunasol, P., Van Der Werff, H., Bruggen, G.V., Paquet, C., Holtan, NealR.

SUDDEN DEATH IN SLEEP OF SOUTH-EAST ASIAN REFUGEES

(1986) The Lancet, 328 (8515), pp. 1093-1094.

NOLASCO, J.B.

An inquiry into bangungut.

(1957) A.M.A. archives of internal medicine, 99 (6), pp. 905-912.

Bliatout, B.T.

(1982) Hmong sudden unexpected death syndrome: A cultural study.

SOURCE: Scopus

Melles, R.B., Katz, B.

Night terrors and sudden unexplained nocturnal death

(1988) Medical Hypotheses, 26 (2), pp. 149-154.

MAJOSKA, A.V.

Sudden death in Filipino men; an unexplained syndrome.

(1948) Hawaii medical journal, 7 (6), pp. 469-473.

Nimmannit, S., Malasit, P., Chaovakul, V., Susaengrat, W., Nilwarangkur, S.

Potassium and sudden unexplained nocturnal death

(1990) The Lancet, 336 (8707), pp. 116-117.

Guazon, M.P.H.

Algunas notas sobre bangungut

(1917) Revista Filipina Med Y Fam, 8, pp. 437-442.

Parrish, G., Tucker, M., Downes, D.

Surveillance for sudden unexplained death syndrome.

(1986) JAMA : the journal of the American Medical Association, 255 (21), p. 2893.

Oalmann, M.C., Palmer, R.W., Guzman, M.A., Strong, J.P.

Sudden death, coronary heart disease, atherosclerosis and myocardial lesions in young men

(1980) American Journal of Epidemiology, 112 (5), pp. 639-649.

CRUZ, J.Z.

The pathology of "bañguñgut".

(1951) Journal of the Philippine Medical Association, 27 (7), pp. 476-481.

Charoenpan, P., Muntarbhorn, K., Boongird, P., Puavilai, G., Ratanaprakarn, R., Indraprasit, S., Tanphaichitr, V., Likittanasombat, K., Varavithya, W., Tatsanavivat, P.

Nocturnal physiological and biochemical changes in sudden unexplained death syndrome: a preliminary report of a case control study.

(1994) The Southeast Asian journal of tropical medicine and public health, 25 (2), pp. 335-340.

Sudden nocturnal deaths among "healthy" workers in Southeast Asia have been termed "sudden unexplained nocturnal death syndrome (SUNDS)" or "sudden unexplained death syndrome (SUDS)". The pathogenesis is still unknown. The paucity of publications on nocturnal monitoring and scientific data stimulated us to perform this study, which included biochemical tests and physiological monitoring during the night in 11 males north-eastern Thai workers. Group 1 (G1) consisted of 5 subjects with neither a previous history of near-SUDS (NSUDS) nor a familial history of SUDS (FHSUDS). Group 2 (G2) consisted of 6 subjects with a family history of either SUDS or NSUDS. Two subjects in G2 presented with NSUDS. Two-day nocturnal monitoring included blood sugar, electrolytes, and respiratory parameters. 24-hour Holter ECGs were monitored for 2 days. The subjects underwent exercise stress tests on the 2nd day of this study. Significant nocturnal hypoxia was more common in G2 than G1 and this abnormality was aggravated by exercise. There were no significant findings in sleep apnea (apnea indices) or in nocturnal biochemical changes, eg blood sugar, electrolytes, thiamine. The recordings of the Holter-ECGs were within normal limits in both groups. We conclude that nocturnal hypoxia might be the primary abnormality in SUDS, and this abnormality was aggravated by the day-time exercise. The cause of nocturnal hypoxia requires further studies.

Munger, R.G.

(1987) Sudden Death in Sleep Among Asian Adults..

SOURCE: Scopus

Tatsanavivat, P., Bhuripanyo, K., Klungboonkrong, V., Tanomsup, S.

Sudden unexplained nocturnal death syndrome

(1990) Intern Med, 6, pp. 67-69.

Talens, E.V.

Bangungut: Philippine acute hemorrhagic pancreatitis

(1967) Bulletin VLGH (Manila), 8, pp. 21-23.

Nolasco, J.B.

Clinical reconstruction of the bangungut syndrome

(1959) J Phil Med Assoc, 24, pp. 371-376.

Nolasco, J.B.

Studies on the bangungut syndrome

(1959) J Phil Med Assoc, pp. 330-350.

KALUAG-LIBORO, F., LIBORO, A., LIBORO, O.L.

A new approach to the etiology of bangungot or sleeping death.

(1956) Journal of the Philippine Medical Association, 32 (11), pp. 648-652.

MungerWenigerEtal-SuddenDeathSEAsiaRefugees-Lancet-8Nov1986viin8515pp1093-94.pdf

Edited June 4, 2015 by Bruce404