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Thai Medical Authorities Concerned About Disease Outbreaks in Flood-Hit Areas

| Bangkok Residents staying at a concrete block, part of construction for an elevated train system, pass the time, in a flooded area on the outskirts of Bangkok November 11, 2011. Thai health authorities are on alert for outbreaks of disease as massive floods across the central plains show signs of receding. Medical specialists are especially concerned for communities inundated over several weeks, raising concerns of outbreaks of dengue fever, cholera and typhoid.The United Nations says the death toll from Thailand’s most severe floods in five decades now exceeds 530.
But medical authorities say the government needs to remain vigilant to ensure the death toll does not rise further due to disease outbreaks.
Dr. Wongwat Liulak, an epidemiologist with Bangkok’s health department, says people are starting to run out of food and water. He says the diseases that would be of the most concern would be diseases of the digestive system, such as acute diarrhea and food poisoning.
Dr. Rekha Hanvesakul, a spokeswoman for BNH Hospital in Bangkok, says Thailand’s health system is facing major challenges in coping with the flood’s aftermath.“It’s definitely a big challenge because of the quantity or mass of water that’s coming through. If it’s one or two days people can manage to deal with this. [But] because the quantity of or mass of water is so huge and a lot of people are living under these conditions for long periods of time disease becomes a real issue,” she said.
The Thai Public Health Ministry’s Department of Medical Sciences says a key concern is water-borne infections such as leptospirosis, due to water contaminated by animal urine. Other concerns include cholera and gastrointestinal diseases, such as typhoid. BNH also warns of poisonous snakes, scorpions, and centipedes pushed into people’s homes from the rising waters.Asian Disaster Preparedness Center public health emergencies head, Dr. Marilyn Go, says children and elderly are especially vulnerable.“The waterborne diseases are very common and acute diarrhea and e-coli or cholera will be the most common type as well as food poisoning and typhoid fever. The diarrhea can occur at anytime during the disaster,” she said.But Dr. Somsak Chunharas, secretary general of the National Health Foundation, says the Ministry of Public Health has surveillance teams monitoring for outbreaks of leptospirosis as well as diarrhea related infections.
“I think the Ministry of Public Health has been doing quite a good job because they have set up a disease surveillance network and they have identified seven major diseases in the Thai surveillance system,” Dr. Chunharas said.
So far city officials have not reported any outbreaks of cholera or leptospirosis. The main concern has been influenza spreading in the crowded conditions in flood evacuation centers.
But medical practitioners see further problems as the water recedes. The Thai Senate this week pressed the government to begin water treatment in contaminated areas and take measures to prepare for possible post-flooding outbreaks. Other environmental groups warn against releasing toxic waters from inundated industrial estates without prior testing. Obama: Asia-Pacific Region Critical to US Economic Recovery

Dan Robinson | Honolulu U.S. President Barack Obama looks over his shoulder was he arrives for the Asia-Pacific Economic Cooperation Summit leaders plenary session in Kapolei, Hawaii on Sunday, Nov. 13, 2011.In the Pacific state of Hawaii, U.S. President Barack Obama on Sunday told leaders of the 21 Asia Pacific Economic Cooperation economies that the region will be key to U.S. economic recovery. With much of the formal summit activity, including a working lunch, concentrated over a few hours, Mr. Obama underscored the importance of APEC's trade liberalization priorities for the global economy and the United States.Addressing the opening session, the president said the nearly three billion people in 21 APEC countries are looking to the three-decade-old organization to create opportunities through expanded trade that will boost economic growth and create jobs.
APEC's goals of slashing tariffs and removing trade barriers, Mr. Obama said, are critical for the U.S. economic recovery. "The Asia-Pacific region is absolutely critical to America's economic growth. We consider it a top priority. And we consider it a top priority because we are not going to be able to put our folks back to work and grow our economy and expand opportunity, unless the Asia-Pacific region is also successful," he said. Mr. Obama said the region is key to his objective of doubling U.S. exports, adding that APEC economies need to work together to spur "quicker, sturdy and sustainable" economic growth.A final APEC statement is expected to point to progress toward creating what Mr. Obama referred to as a "seamless regional economy," with agreements aimed at boosting trade and investment by promoting "green" jobs, innovation, and streamlining and coordinating regulations.The United States and eight other APEC nations already have announced agreement on "broad outlines" to create a new Trans-Pacific Partnership trade group, or TPP, that Mr. Obama says would be a model for broader open regional trade.In addition to the United States, other TPP participants include Australia, Brunei, Chile, Malaysia, New Zealand,Peru,Singapore and Vietnam. China has been critical of the grouping, saying it reflects protectionist tendencies in APEC.U.S. officials say Mr. Obama was expected to hold additional talks on the sidelines of the summit with Chinese President Hu Jintao. In their main meeting on Saturday, the two men discussed trade and differences over China's currency policies.
The issue of Iran's nuclear program and a recent International Atomic Energy Agency report that provided evidence of secret Iranian weapons development efforts have also been a focus of Mr. Obama's meetings with the leaders of China and Russia.U.S. officials say China and Russia remain supportive of continuing diplomatic steps aimed at preventing Iran from obtaining a nuclear weapons capability.
Mr. Obama says that he and Russian President Dmitry Medvedev agreed to work to "shape a common response" on Iran against the backdrop of the nuclear report. U.S. officials say consultations will continue about the next steps to increase pressure on Tehran.