Thursday, November 3, 2016
Thailand - Asia’s Scientific Trailblazers: Usa Thisyakorn
Professor Usa Thisyakorn, chairman of the Asian Dengue Vaccine Advocacy, hopes to present a united front against dengue in Thailand.
Dengue outbreaks are common in Asia, and Thailand often sees the worst of it. A tropical climate is just one of the factors contributing to the spread of dengue across the country, which saw 140,000 cases of infection in 2015—the highest since the 1987 dengue epidemic, the year that Thailand clocked a staggering 170,000 cases of infection.
According to Professor Usa Thisyakorn, chairman of the Asian Dengue Vaccine Advocacy, 2016 is shaping up to be an even worse year, with public health officials expecting the number of cases to increase by more than 16 percent from 2015.
Fortunately, a dengue vaccine developed by Sanofi Pasteur is in the testing stages, with Thailand also carrying out their own studies on its efficacy. How will testing and future deployment of the vaccine fit into existing dengue control strategies? Thisyakorn tells Asian Scientist Magazine below.
What first attracted you to the field of infectious diseases?
Years ago when I was a medical student, I saw many patients who were infected with infectious diseases during my shifts at the hospitals. Infectious diseases, such as Japanese encephalitis, were ravaging our country and especially Northern Thailand. The suffering I witnessed then spurred me to pursue my studies and research in the field of infectious diseases.
We have come a long way since those days, but I feel more can still be done in terms of prevention methods and treatment so that such cases are minimized and patient suffering can be alleviated. Seeing patients struggle and suffer with infectious diseases, something which we can prevent and control with early diagnosis, is something I hope to one day eradicate.
What are the major challenges that Thailand faces when attempting to control dengue outbreaks?
Thailand has had nearly 70 years of experience with dengue, but our efforts to reduce the incidence of the disease have not yielded the results we have hoped for. 2015 was a bad year for Thailand, with 140,000 infections—the highest number since the 1987 dengue epidemic which saw 170,000 cases.
2016 is shaping up to be even worse, with public health officials expecting the number of cases to increase by more than 16 percent this year.
The reasons for the explosion in dengue cases are similar to those faced by other countries in the region. Thailand has undergone rapid urbanization and rising population density, leading to problems with essential services such as sanitation and waste management, which are leading causes of the spread of dengue. Climate change is another significant challenge to limiting the spread of dengue, as mosquitoes reproduce more quickly and bite more frequently at higher temperatures.
Thailand has drafted a national strategic plan on climate change and health; hopefully the strategies under this plan will help to mitigate the problem of dengue in the country.
Like other dengue-endemic countries, Thailand relies heavily on vector control measures such as larvicides; however, mosquito populations in Thailand have developed resistance to all three classes of insecticidal active ingredients that are currently used for vector control.
All of these challenges point to the critical need to implement new solutions, such as dengue vaccination, to address the problem of dengue in Thailand, as well as to evaluate current prevention and control programs.
With regards to dengue prevention, what are some public health initiatives currently ongoing in Thailand that we should know about?
We are focused on early detection, proper diagnosis and proper treatment. To this end, we are focused on public education and awareness, stringent vector control measures, quality surveillance and data collection programs. We are also keen on research on the dengue vaccine, and assessing its feasibility for Thailand.
Thisyakorn giving Dr. Thawat Suntrajarn, vice minister for public health in Thailand,
a tour of the Dengue Mission Buzz Barometer. Photo: Usa Thisyakorn
What is the Asian Dengue Vaccination Advocacy trying to achieve?
The Asian Dengue Vaccination Advocacy (ADVA) was set up in 2011 to identify opportunities and make practical recommendations for improving surveillance and laboratory capacity for dengue disease confirmation. We reinforce the importance of a united front against dengue, and present a collaborative model for joint effort in the region focused on the prevention of the disease through the introduction and implementation of dengue vaccination.
To this end, we organized the Asia Dengue Summit in 2016, which brought together health leaders and leading experts for the first time, to support Asian countries in their fight against dengue. As part of the summit, ADVA announced the region’s first call-to-action charter urging prioritization of efforts to combat the burden of dengue in Asia.
We also want to emphasize the importance of public education in the prevention of dengue. To this end, we have launched the Dengue Mission Buzz Barometer, a tool that measures ASEAN community engagement for the prevention of dengue. The Dengue Mission Buzz Barometer features a Dengue Readiness Quiz to help site visitors gauge their level of dengue prevention readiness. We aim to educate at least 25,000 citizens in the six participating countries, Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam, with the quiz.
The Dengue Mission Buzz portal also presents valuable news, videos and information about dengue prevention, and is available in multiple languages.
How will the widespread use of a vaccine in Thailand fit in with existing dengue control strategies?
The introduction of the dengue vaccine will boost existing efforts to control dengue such as vector control, disease surveillance and public education. The introduction of a public immunization program for dengue, such as was introduced in the Philippines for one million ten-year-olds in three dengue endemic regions in April this year, would help to confer increased protection and to minimize the occurrence of large-scale outbreaks, if communities at large are immunized against the disease.
This would help Thailand move closer to achieving the World Health Organization’s strategic objective to reduce mortality and morbidity from dengue by 2020 by at least 50 and 25 percent respectively.
Do you foresee a time when Thailand is entirely rid of dengue, and what are the steps needed to get there?
That certainly is our goal, and I hope I’ll live to see that day! However, realistically speaking, it isn’t quite possible, just because there are too many factors beyond our control. For example, one cannot control the weather. But we can and are doing better in our fight against dengue in Thailand, with proper surveillance measures and new tools such as the dengue vaccine, in our arsenal.