Usa Thisyakorn

Chulalongkorn University · Tropical Medicine Cluster

Invasive meningococcal disease (IMD) imposes a significant burden on the global community due to its high case fatality rate (4-20%) and the risk of long-term sequelae for one in five survivors. An expert group meeting was held to discuss the epidemiology of IMD and immunization policies in Malaysia, Philippines, Thailand, and Vietnam. Most of thes...

Commemorating the 2021 ASEAN Dengue Day and advocacy for World Dengue Day, the International Society for Neglected Tropical Diseases (ISNTD) and Asian Dengue Voice and Action (ADVA) Group jointly hosted the ISNTD-ADVA World Dengue Day Forum–Cross Sector Synergies in June 2021. The forum aimed to achieve international and multisectoral coordination...

The Global Pertussis Initiative (GPI) Roundtable Meeting held in 2019, which preceded the COVID-19 pandemic, focused on the incidence, surveillance, and immunization practices for pertussis in the Asian region. Participants from China, India, Indonesia, Malaysia, Pakistan, Philippines, South Korea, Taiwan, and Thailand presented country-specific in...

Background The dengue vaccine (Dengvaxia) is only recommended for individuals with prior dengue infection (PDI). This study aimed to perform a serosurvey to inform decision-making for vaccine introduction and identify appropriate target populations. We also evaluated the performance of the serological tests using plaque reduction neutralization tes...

Background When severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium is injured and barrier function is lost, bacterial products entering the circulation might contribute to the pathophysiology of COVID-19. Methods We studied 19 adults, severely ill patients wi...

The degree of surveillance data and control strategies for invasive meningococcal disease (IMD) varies across the Asia–Pacific region. IMD cases are often reported throughout the region, but the disease is not notifiable in some countries, including Myanmar, Bangladesh and Malaysia. Although there remains a paucity of data from many countries, spec...

Background: When severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium are injured and barrier function is lost, bacterial products entering the circulation might contribute to the pathophysiology of COVID-19. Methods: We studied 19 adults, severely ill patients...

Introduction Dengue infection is the most important mosquito-borne viral disease in the world. Most mosquito control methods currently available for public health use are not very efficacious. Dengue vaccine is required to control dengue diseases in the future through the use of a safe and effective vaccine. Areas covered This review covered dengu...

The Global Pertussis Initiative is an expert scientific forum that publishes consensus recommendations concerning pertussis for many regions of the world. Here, we give recommendations for the primary vaccination of infants in those countries where whole-cell pertussis (wP)- and acellular pertussis (aP)-containing combination vaccines are used in p...

Pertussis is a highly infectious respiratory disease caused by Bordetella pertussis. Infants and young children are particularly at risk of severe and life-threatening disease. Infectious older individuals may transmit Bordetella pertussis to unprotected infants. Pertussis control measures have even failed in some countries with high pertussis vacc...

Severe dengue cases have been increasingly reported in Thailand, and the under-reporting of acute kidney injury (AKI) in cases of dengue viral infection has become an obstacle in obtaining an accurate description of the true nature and epidemiology of AKI. Because AKI may lead to patient morbidity and mortality, an early diagnosis is important in p...

Typhoid and paratyphoid fever remain endemic diseases in Thailand with wide variation in subnational incidence trends. We examined these trends alongside contextual factors to study potential interactions and guide control strategies for this disease. Culture-confirmed typhoid and paratyphoid fever data from 2003 to 2014 were collected from the Min...

In 1988, the generalised HIV/AIDS epidemic in Thailand began and in the same year the first HIV-exposed infant in Thailand was born at King Chulalongkorn Memorial Hospital, Bangkok. From the early to mid-1990s, an epidemic wave of HIV-infected women and infants occurred. Heterosexual HIV transmission, as described in the Asian Epidemic Model, was t...

Dengue is one of the most important mosquito-borne viral infections caused by single-stranded RNA virus that are transmitted by the Aedes aegypti and Aedes albopictus mosquito species. Dengue is endemic in over 140 countries in Asia, the USA, the Eastern Mediterranean, and Africa. The World Health Organization (WHO) estimated that there are more th...

We described and quantified epidemiologic trends in dengue disease burden in 5 Asian countries (Indonesia, Thailand, Malaysia, Philippines, and Vietnam) and identified and estimated outbreaks impact over the last 3 decades. Dengue surveillance data from 1980 to 2010 were retrieved from DengueNet and from World Health Organization sources. Trends in...

Background: The live-attenuated Japanese encephalitis (JE) vaccine (JE-CV; IMOJEV(®)) induces a protective response in children. A shift in circulating JE virus strains suggests that a genotype shift phenomenon may occur throughout South-East Asia. We assessed the neutralization of wild-type (WT) JE virus isolates at distal time points post-vaccin...

Background: A single dose of live attenuated Japanese encephalitis chimeric virus vaccine (JE-CV) was shown to be immunogenic and well tolerated when given either as a booster to formalin-inactivated Japanese encephalitis (JE)-vaccine (mouse brain-derived vaccine [MBDV])-primed 2-5-year-olds, or as a primary vaccination to JE-vaccine-naïve 12-24-m...

p>Dengue is a mosquito-borne viral disease which is currently an important and rapid growing health problem across the globe. Four closely related dengue serotypes cause the disease, which ranges from asymptomatic infection to undifferentiated fever, dengue fever (DF), and dengue hemorrhagic fever (DHF). Specific antiviral medications are not avail...

Dengue virus infection (DVI)/dengue hemorrhagic fever (DHF) is a common febrile illness with a variety of severities. The mortality rate is high in dengue shock syndrome (DSS), caused by circulatory failure due to plasma leakage resulting in multi-organ failure. However, acute kidney injury (AKI) is rarely reported. In areas of endemic DVI, the pre...

Objective: To study the risk factors associated with severe enterovirus infection among hospitalized pediatric patients with hand, foot, and mouth disease (HFMD) at King Narai Hospital, Lopburi, Thailand. Material and Method: We reviewed all of the suspected enterovirus infection cases aged less than 15 years admitted to King Narai Hospital between...

Background: Dengue infection is the most common arboviral infection in the world while the HIV/AIDS epidemic remains a global concern. The pathogenesis of both diseases is rather on the contrary and it is generally observed that dengue diseases are uncommon in children with AIDS. Objective: To study the seroprevalence of dengue virus infection in H...

The prevalence of Listeria monocytogenes infection has been characterized as rare in Thailand. Within one month, 3 cases of listeriosis were seen at Vachira Phuket Hospital in Phuket, Thailand. Two cases were neonates with septicemia, of which one made an uneventful recovery and the other expired. The third case was an eleven-year-old boy with meni...

The 1st Workshop on National Immunization Programs and Vaccine Coverage in Association of Southeast Asian Nations (ASEAN) Countries Group (WNIPVC-ASEAN) held a meeting on April 30, 2015, Pattaya, Thailand under the auspices of the Pediatric Infectious Diseases Society and the World Health Organization (WHO). Reports on the current status and initia...

Background: Hepatic manifestations are one of the unusual manifestations of dengue infection. Objectives: We conducted this study in order to study the pattern of serum aminotransferases and sequential changes before and after shock in Thai children with dengue infection. Patients and Methods: Children who were clinically and serologically diagno...

Vertically infected children may progress rapidly to acquired immunodeficiency syndrome or progression of disease is much slower as demonstrated in our case report. This is a report of a 14-year-old boy with vertically transmitted slow progress human immunodeficiency virus (HIV) and pulmonary tuberculosis presented with a low-grade fever, chronic c...

Dengue infection has become one of the most important public health problems worldwide. It can be asymptomatic or cause illnesses ranging from a mild to a severe and sometimes fatal disease. The mechanism underlying disease severity is still not fully understood. Several studies, however, have suggested an immune-mediated process. There are three p...

We studied risk factors associated with severe hand, foot and mouth disease (HFMD) caused by enteroviruses among patients aged less than 15 years admitted to King Narai Hospital, Lopburi, Thailand during 2011-2013. Cases were divided into either mild or severe. Severe cases were those with encephalitis, meningitis, myocarditis, pneumonia, pulmonary...

Dengue, a mosquito-borne viral disease, is currently an expanding global problem. The disease is caused by four closely related dengue serotypes; it ranges from asymptomatic infection to undifferentiated fever, dengue fever (DF) and dengue hemorrhagic fever (DHF). DHF is characterized by fever, bleeding diathesis and a tendency to develop apotentia...

The WHO 'Global Strategy for Dengue Prevention and Control, 2012-2020' addresses the growing need for the treatment of dengue, and targets a 25% reduction in morbidity and 50% in mortality (using 2010 estimates as baseline). Achieving these goals requires future dengue prevention strategies that will employ both potential vaccines and sustainable v...

The dengue virus is the causative agent of a wide spectrum of clinical manifestations, ranging from mild acute febrile illness to classical dengue fever, dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). DHF and DSS are the potentially fatal forms of dengue virus infection, which has become an intractable public health problem in man...

The pathogenesis of hematologic changes in dengue patients is not clearly understood. Consistent hematological findings include vasculopathy, thrombocytopenia, and coagulopathy. There are evidences suggesting that dengue virus causes pathophysiological changes that involve all of the consistent hematologic findings resulting in vasculopathy, reduct...

Background: An estimated 100 million people have symptomatic dengue infection every year. This is the first report of a phase 3 vaccine efficacy trial of a candidate dengue vaccine. We aimed to assess the efficacy of the CYD dengue vaccine against symptomatic, virologically confirmed dengue in children. Methods: We did an observer-masked, random...

Dengue is a mosquito-borne disease which is currently an expanding global health problem. The disease is caused by four closely related viruses, the dengue virus. There are no specific dengue therapeutics and prevention is currently limited to vector control measures. Development of an effective tetravalent dengue vaccine would therefore represent...

The current study examined the safety and immunogenicity of 23-valent pneumococcal capsular polysaccharide vaccine (Pneumo23(®) [PPV23], Sanofi Pasteur) as a booster dose in 12- to 18-month-old children primed with heptavalent pneumococcal vaccine (PCV7; Prevnar(®), Pfizer). This was a randomized, observer-blinded, 2-arm, controlled, multicenter ph...

The independent, scientific and educational The Association of South East Asian Nations (ASEAN) Member States Dengue Vaccination Advocacy Steering Committee (ADVASC) was established in 2011 to address the practical challenges faced by ASEAN countries as they prepare for the eventual introduction of a dengue vaccine. ADVASC convened a workshop in Se...

Background: Epidemiological data of dengue patients in Ratchaburi, Thailand have been reviewed from the year 2000 through 2010. However, with the changes in population structure and lifestyle, a more detailed analysis is needed. Objective: We described the changes in the epidemiology of dengue patients in Ratchaburi province, Thailand. Materials an...

Sensitivity and specificity of the commercial laboratory test kits used to test sera for non-dengue causes of febrile illness in this study. (DOC)

STROBE statement. Checklist of items included in this cohort study. (DOC)

Common causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation and disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue and other causes of acute fever...

The Global Pertussis Initiative (GPI) is an expert, scientific forum that seeks to address the worldwide burden of pertussis. To reduce the global incidence of pertussis, the GPI recommends reinforcing and/or improving current infant and toddler immunization strategies, universal booster dosing of pre-school children, universal booster dosing of ad...

Existing clinical case definitions of pertussis are decades old and based largely on clinical presentation in infants and children, yet an increasing burden is borne by adolescents and adults who may manifest distinct signs/symptoms. Therefore, a “one-size-fits-all” clinical case definition is no longer appropriate. Seeking to improve pertussis dia...

The World Health Organization recommends a booster dose of a pertussis-containing vaccine for children aged 1-6 years, preferably during the second year of life. This study assessed the immunogenicity and safety of a pentavalent combination vaccine containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and conjugated-Hib polys...

To assess a new, fully-liquid, hexavalent DTaP-IPV-Hep B-PRP-T vaccine (diphtheria toxoid (D), tetanus toxoid (T), acellular pertussis (aP), inactivated poliovirus (IPV), hepatitis B (Hep B), and Haemophilus influenzae type b polysaccharide conjugated to tetanus protein (PRP-T) antigens) compared to a licensed DTaP-IPV-Hep B//PRP-T vaccine followin...

Safe and effective Japanese encephalitis (JE) vaccines are needed to protect populations living in or visiting endemic areas. A live-attenuated JE-chimeric virus vaccine (JE-CV) has been developed with a single-dose regimen. In an open-label, crossover study, 100 children aged 2 to 5 years with a history of 2-dose primary vaccination with mouse-bra...

Streptococcus pneumoniae is a rarely recognized cause of neonatal sepsis. We report invasive pneumococcal infection in three neonates. The infections were abrupt, severe, and rapidly progressive in two neonates with fatal outcome despite antibiotic therapy. There was no identifiable risk factor. Maternal colonization should be further studied.

Streptococcus pneumoniae is an important cause of morbidity and mortality worldwide, it is responsible for invasive pneumococcal disease (IPD) (e.g. meningitis, bacteremic pneumonia and bacteremia) and non-IPD (e.g. pneumonia, acute otitis media, and sinusitis). IPD is preceded by nasopharyngeal colonization with high incidence of disease among you...

This study assessed clinical differences between invasive pneumococcal disease (IPD) caused by penicillin-resistant and penicillin-sensitive Streptococcus pneumoniae. Patients with IPD confirmed during January 1996-December 2007 at three hospitals were included. Clinical characteristics and outcomes were compared between patients infected with peni...

Streptococcus pneumoniae is the most common cause of bacteremia, sepsis, meningitis, pneumonia, sinusitis and otitis media in children worldwide. Several studies have shown that the heptavalent pneumococcal conjugate vaccine (PCV7) is highly immunogenic, safe and effective against disease caused by serotypes contained in the vaccine. To determine t...

The objective of this study was to evaluate the immunogenicity and safety of a pentavalent vaccine (Pentaxim) containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and Hib polysaccharide-conjugate (DTaP-IPV//PRP-T) antigens, in Thai children. One hundred eighty-six infants who had received a hepatitis B vaccine at birth were...

Background: Currently, there is no standard recommendation of fluid resuscitation in dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The types of fluid as initial choice for resuscitation are still questionable. It is important to review what type of fluid is used for clinical outcome improvement. Objective: To assess the effectiveness...

This study assessed the booster immune response to a pentavalent combination vaccine containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and conjugated-Hib polysaccharide antigens, (DTaP-IPV//PRP-T, Pentaxim, an AcXim family vaccine) at 18-24 months of age. Study subjects received a three-dose primary vaccination at 2, 4 an...

Streptococcus pneumoniae (S. pneumoniae) is the major pathogen that causes health problems worldwide. Invasive disease includes meningitis, bacteremia with or without focus and pneumonia. It causes morbidity and mortality, especially in children. In Thailand, no relevant study was done to estimate the exact incidence of invasive pneumococcal diseas...

Purpose: To evaluate the safety and efficacy of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) infected pregnant women to prevent mother-to-child transmission of HIV. Design of the study is observational retrospective evaluation of a prospective cohort. Setting of the study is King Chulalongkorn Memorial Hospital...

Highly pathogenic influenza A/H5N1 has caused outbreaks in wild birds and poultry in Asia, Africa and Europe. It has also infected people, especially children, causing severe illness and death. Although the virus shows limited ability to transmit between humans, A/H5N1 represents a potential source of the next influenza pandemic. This study assesse...

Trial Protocol (1.12 MB PDF)

CONSORT checklist (0.06 MB DOC)

Background: Dengue disease encompasses a wide spectrum of clinical presentations. While the severity of dengue disease can vary from patient to patient, it is, however, still unclear as to what factors determine dengue disease severity. Objective: To analyze the potential risk factors such as: sex, age, nutritional status, dengue serotypes, D-dimer...

INTRODUCTION: Dengue viral infection has a wide range of severity levels and requires different levels of medical attention. Early severity prediction using clinical features is difficult. Certain lymphocytic subtypes can be used to predict severity; we postulate that peripheral blood counts can also predict severity, which would be more useful in...

INTRODUCTION: Dengue is the most prevalent mosquito-borne viral disease and one of the most serious infectious diseases worldwide. Infection by any of the serotypes of dengue viruses (DEN-1–DEN-4) may result in different severities ranging from a relatively benign fever, called dengue fever (DF), to fatal dengue shock syndrome. The pathogenesis of...

Dengue infection, one of the most devastating mosquito-borne viral diseases in humans, is now a significant problem in several tropical countries. The disease, caused by the four dengue virus serotypes, ranges from asymptomatic infection to undifferentiated fever, dengue fever (DF), and severe dengue hemorrhagic fever (DHF) with or without shock. D...

This report documents a case of infiltrating cervical spinal mass, most likely a spinal tumor, in a girl with HIV infection that regressed following HAART and without treatment of the tumor or any anti-infectives.

Background and objective: Rabies is still a serious public health problem in much of Asia. Management of severe exposures includes use of immunoglobulin which is expensive and scarce in regions where needed the most. Pre-exposure vaccination of subjects at risk eliminates need for immunoglobulin in case of an exposure. Pre-exposure vaccination sche...

41 dengue patients, 22 girls and 19 boys were recruited in the study. The mean age was 9.68 years. There were 12 (29.3 %) cases of dengue fever (DF) and 29 (70.7 %) cases of dengue hemorrhagic fever (DHF). DD was more significantly present in the DHF group (87 %) than in the DF group (13%) (P<0.03). The sensitivity and specificity of DD in predicti...

Dengue virus causes a febrile illness: Dengue fever (DF), and less frequently a life-threatening illness: Dengue hemorrhagic fever (DHF). Although severe bleeding remains a major cause of death in DHF, the pathogenesis of bleeding is poorly understood. This prospective cohort study was designed to determine the extent of activation of endothelial c...

An 8-month-old girl presented with fever, rash, and diarrhea. Physical examination revealed multiple well-circumscribed, brownish-black, purpuric-like rashes on the face, arms, and legs with cervical and suboccipital lymphadenopathy. Laboratory findings showed mild anemia with thrombocytopenia and positive polymerase chain reaction for parvovirus 8...