Investigation of the first confirmed Mpox case in Samut Sakhon Province, Thailand, May 2023

Abstract

Backgrounds: On May 25, 2023, the Joint investigation team of the Samut Sakhon Provincial Public Health Office received a report of monkeypox (Mpox). The affected individual was found to be residing in Samut Sakhon province. The patient was a 25-year-old male with a medical history of receiving treatment at a private clinic in Bangkok. The disease investigation activities were initiated to confirm the diagnosis of Mpox, study the characteristics of its spread among individuals, and identify risk factors associated with its occurrence. Additionally, the investigation aimed to track close contacts and provide appropriate disease control and prevention measures.
Methods: A descriptive epidemiological study was conducted by reviewing patient medical records and Mpox case reports of the Samut Sakhon Provincial Public Health Office. Patient interviews, additional patient search, tracking contacts, and collecting patient samples using Real-time PCR method were conducted. The study also examined the living environment of the patients and analyzed the surveillance system for monkeypox in the area.
Results: A Mpox confirmed case was identified in a 25-year-old Thai male with no underlying diseases. The patient belonged to a gender diversity group. His symptoms began on May 10, 2023, with fever and muscle pain. Subsequently, he developed red rashes and pustules around the anal area. He sought treatment at a private clinic in Bangkok on May 20, 2023. Genetic material of the Mpox virus was detected from samples collected from the pustules in the genital area. He received medical treatment and isolated in hospital until fully recovered. Three high-risk contacts and two low-risk contacts were identified during contact tracing, and all remained asymptomatic throughout the 21-day observation period. The patient's risk factors for contracting the disease were associated with same-sex relationships among males. The monkeypox surveillance system in Samut Sakhon Province was found to be effective.
Conclusions: The study identified and confirmed the first Mpox case in Samut Sakhon Province. The patient was a male, and the case was likely to have been domestically acquired. The Provincial Public Health Office should establish the surveillance in private clinics and pharmacies, as well as strengthen safe sex.