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Background Tha Song Yang District, located on the Thai-Myanmar border, contributes to the second highest cases of amoebic dysentery due to intestinal parasitic infections (IPI). However, there were limited disease prevalence data, specific surveillance systems, and interventions available. Objective This study aimed to explore the epidemiological features of the IPIs and apply the One Health (OH) approach to solve IPI-related problems. Methods Prevalence of asymptomatic infections in human and animals, yearly symptomatic cases, and associated risk factors were investigated. The OH intervention included improving the knowledge, attitude, and practice (KAP) of the community, microscopic diagnosis training, and stakeholder engagement for IPI prevention designs. Results The prevalence of asymptomatic cases was much higher than that of the symptomatic cases. Infective stages of the intestinal parasites were discovered in animal stool and water samples, indicating possible transmission routes. One year after the intervention, there were significant declines in asymptomatic IPIs and symptomatic cases of amoebic dysentery. Significant improvements in KAP and awareness regarding water and manure-waste management of the community were observed. Conclusion We reported the successful application of the OH intervention in reducing the IPI prevalence and mitigating disease-related risks. The intervention might be applied to address other infectious diseases in the future.

This sequential explanatory mixed-method study consisted of analytical, cross-sectional, and qualitative studies. The research was conducted in the Khao Nor and Khao Kaew areas of the Banphot Pisai districts of Nakhon Sawan Province in 2019. Here, we examined the rodent contact characteristics of villagers in these areas and determined the potential characteristics/risk factors associated with rodents using a semi-structured questionnaire, key informant interview (KII), and focus group discussion (FGD). Results of the quantitative study (N1 = 372) characterized participants that contacted rodents per gender, age, occupation, knowledge, attitude, and practice (KAP), including their cultural contexts, and beliefs. Ninety participants (24.2%) reported contact with rodents, and the reasons for their direct physical rodent contact were hunting (35, 9.4%), killing (41, 11.0%), preparing rodents as food (33, 8.9%), consuming cooked meats (12, 3.2%), feeding food (4, 1.1%), cleaning feces (17, 4.6%), and cleaning carcasses (33, 8.9%). Moreover, logistic regression results showed that males encountering rodents were statistically significant (Adjusted OR = 3.137, 95% CI 1.914–5.139, p < 0.001). Low monthly household income (

BACKGROUND/OBJECTIVES: Chronic malnutrition in adolescents may result in significant academic difficulties at school. This study aimed to determine the impact of nutritional status and related factors on the academic achievement of adolescents in secondary/high schools in Myanmar. SUBJECTS/METHODS: A cross-sectional survey was performed in two high schools in Hlaing Tharyar District, Yangon using a self-administered questionnaire on food intake and other factors potentially affecting nutritional status. Grade-point averages (GPA) in the previous academic year were recorded to identify any association between nutritional status and academic achievement. RESULTS We enrolled 301 students aged 13–17 years (mean ± SD, 14.43 ± 0.95). Over half of the respondents were female (65.1%). Most of the respondents showed normal body mass index values, followed by underweight, overweight and obesity. Regarding academic achievement, a GPA of A, B, C and D was seen in 41.5%, 36.2%, 15.3%, and 7.0% of the respondents, respectively. Nutritional status was significantly associated with academic achievement. Underweight students had a 1.96 times higher likelihood of achieving mediocre grades (C, D) compared to normal-weight students (OR = 1.960, 95% CI: 1.063–3.614). Among other factors examined, only the number of meals per day was associated with nutritional status. Apart from the number of meals per day, the duration of walk to school, the duration of watching or playing games, and the parents’ socioeconomic status were associated with academic achievement. CONCLUSIONS There is a relationship between nutritional status and related factors on levels of academic achievement of adolescent students in the Yangon metropolitan area.

Wastewater-based epidemiology (WBE) is a beneficial tool for comprehensive health information on communities, especially during the COVID-19 pandemic. In developing countries, including Thailand, the application of WBE is limited. Few SARS-CoV-2 detections and variants have been monitored in wastewater in these countries. This is because of the time-consuming, low recovery of viruses in the concentration techniques and difficulties in finding the proper primers and amplification kits. Therefore, this study aimed to quantify SARS-CoV-2 RNA concentration using a commercial clinical kit. We identified the SARS-CoV-2 variants and estimated the detection costs in the wastewater samples. One hundred and fifty hospital wastewater samples were filtered with commercial ultrafiltration (UF) and then detected for the SARS-CoV-2 concentration using a Sansure Biotech SARS-CoV-2 kit. The recovery of the virus concentration technique in UF was studied using a surrogate (porcine epidemic diarrhea virus). The virus detection in wastewater was quantified by RT-qPCR. In addition, the mutation sites in the partial spike glycoprotein (S) gene of SARS-CoV-2 were verified using short nested RT-PCR. The results showed a high recovery of the commercial UF (80.53%), and 24.6% of hospital wastewater contained SARS-CoV-2. The detection of SARS-CoV-2 in wastewater cost USD 35.43 per sample. The virus variants revealed V70del, H69del, and V144del mutations in the partial S gene of SARS-CoV-2 in B.1.1.7 (SARS-CoV-2 Alpha variant), and T95I and G142D mutations in B.1.617.2 (Delta variant).

BackgroundUtilization of oral health services has been low among rural populations in Thailand, especially for minority ethnicity populations living along the borders. The aim of this study was to increase understanding of the determinants of the underutilization of oral health services among these populations.MethodsA qualitative study using in-depth interview and semi-structured interview was conducted among participants of Karen ethnicity living in Mae Tan Sub-district, Thasongyang District, Tak Province, Thailand. The interviews focused on exploring the participants’ perceptions of oral health problems, oral health and hygiene, and oral health-seeking behaviors. The verbatim-transcribed interviews were analyzed using thematic analysis.ResultsA total of 101 participants (50 adults and 51 children) with a Karen ethnic background took part in the interviews. Most participants could not identify oral health problems and did not perceive dental disease as a problem unless there was severe pain that could not be relieved by painkillers. The Karen ethnic community worked as subsistence farmers, and their busy daily activities consisted of farming, going to the forest to hunt and gather, performing housework, and taking care of their children. Dental health was given a lower priority compared with general health. The perceived value of primary teeth was low, which was identified as an underlying factor resulting in delayed oral health care seeking among this population. The participants had relied on self-care throughout their lifetimes, using either traditional medicines or modern painkillers to relieve toothaches. Fear of dental procedures among children was also described as a barrier to seeking dental health care.ConclusionsThis study found that the lifestyle and traditions of Karen people living in this area influence their oral health care and hygiene activities as well as their health-seeking behaviors. Further research should emphasize how to improve oral health promotion by providing necessary services and health education appropriately to Karen ethnic populations living along the Thai-Myanmar border.

Background: Thailand has recently experienced large cross-border migration from nearby countries, in particular from Myanmar that have different lifestyle and health behaviors compared with the local community. The aim of this study was to explore the prevalence of health-risk behaviors and related factors amongst Myanmar migrant workers in Thailand. Methods: The cross-sectional secondary data analysis was performed by using the primary data from questionnaire survey obtained from Samut Sakhon Hospital. This study explored the health-risk behaviors amongst 1,205 Myanmar migrant workers in Thailand by using a structured questionnaire, and analyzing the related factors by using logistic regression. Results: Lack of exercise was considered to be the most common unhealthy behavior (81.5%) followed by smoking (22.5%), betel quid chewing (18.9%) and alcohol drinking (10.2%). Advancing age (AOR = 1.03, 95%CI 1.02-1.05)) and being male (AOR = 8.29, 95%CI 5.54-12.40)) were significant risk factors for workers having a smoking habit. Additionally, being Mon ethnic led to a lower chance of having a smoking habit compared with the Burmese ethnic group (AOR= 0.518, 95% CI: 0.315-0.851). The odds of having a smoking habit was four times greater in workers who drank alcohol (AOR = 4.08, 95%CI 2.58-6.47)). Additionally, odds of drinking alcohol increased with advancing age, 1.03 (95%CI 1.00-1.05), male gender, 9.30 (95%CI 4.39-19.73), having a smoking habit, 4.23 (95%CI 2.67-6.70) and being a fisherman, 3.08 (95%CI 1.51-6.29). Conclusions: The findings can be used for developing appropriate policies, special health promotion programs and mass communication to prevent treated diseases in migrant workers. Keywords : Exercise, Smoking, Alcohol drinking, Betel quid chewing, Myanmar migrant workers

Additional file 2. Questionnaire for obtaining demographic information of adult participants used in this study.

Hand, foot, and mouth disease (HFMD) is a contagious childhood illness and annually affects millions of children aged less than 5 years across the Asia–Pacific region. HFMD transmission mainly occurs through direct contact (person-to-person) and indirect contact with contaminated surfaces and objects. Therefore, public health measures to reduce the spread of HFMD in kindergartens and daycare centers are essential. Based on the guidelines by the Department of Disease Control, a school closure policy for HFMD outbreaks wherein every school in Thailand must close when several HFMD classrooms (more than two cases in each classroom) are encountered within a week, was implemented, although without strong supporting evidence. We therefore conducted a prospective cohort study of children attending five kindergartens during 2019 and 2020. We used molecular genetic techniques to investigate the characteristics of the spreading patterns of HFMD in a school-based setting in Bangkok, Thailand. These analyses identified 22 index cases of HFMD (symptomatic infections) and 25 cases of enterovirus-positive asymptomatic contacts (24 students and one teacher). Enterovirus (EV) A71 was the most common enterovirus detected, and most of the infected persons (8/12) developed symptoms. Other enteroviruses included coxsackieviruses (CVs) A4, CV-A6, CV-A9, and CV-A10 as well as echovirus. The pattern of the spread of HFMD showed that 45% of the subsequent enteroviruses detected in each outbreak possessed the same serotype as the first index case. Moreover, we found a phylogenetic relationship among enteroviruses detected among contact and index cases in the same kindergarten. These findings confirm the benefit of molecular genetic assays to acquire accurate data to support school closure policies designed to control HFMD infections.

The identification and characterization of viruses of the genus Enterovirus in healthy and infected livestock, including cattle and goats, have been increasing. Enterovirus E (EV-E) and Enterovirus F (EV-F) are commonly found in cattle, whereas Enterovirus G (EV-G) is found in goats. In this study, molecular and phylogenetic analyses were performed to determine the prevalence of EVs in cattle and goat feces from Kanchanaburi Province, Thailand. The presence of EVs in water samples and the feces of other animals collected from the areas surrounding cattle and goat farms was also investigated. By use of 5′-untranslated region (5′ UTR) real-time reverse transcription-PCR (RT-PCR), EVs were detected in 39.5% of cattle samples, 47% of goat samples, 35.3% of water samples, and one pool of chicken feces. Phylogenetic analysis revealed the presence of EV-E and EV-F in cattle, EV-E and EV-G in goats, and EV-F in water samples and chicken feces. Analysis of enteroviral VP1 sequences from cattle revealed that the EV-E genotypes circulating in the study region were EV-E1, with a possible new genotype that is closely related to EV-E2. Analysis of enteroviral VP1 sequences from goats suggested the circulation of EV-G5 and a possible new genotype that is closely related to EV-G20. Sequence analyses also suggested that although the VP1 sequences from goats were closely related to those of EV-G, which were considered porcine enterovirus sequences, their 5′ UTRs form a separated cluster with sequences of sheep and goat origin, suggesting a new classification of the ovine/caprine-specific enterovirus group. IMPORTANCE Possible new EV-E and EV-G genotypes were identified for EVs detected in this study. The EV-E viruses were also successfully isolated from MDBK cells. The goat EV sequence analysis suggested the presence of an ovine/caprine-specific EV group that is different from EV-G of porcine origin. The significance of our research is that it identifies and characterizes possible novel EVs, thereby indicating that enteroviruses in animals are continually evolving. The facts that enteroviruses can persist in the environment, contaminate it for long periods, and be transmitted between animals raise serious concerns regarding this group of viruses as emerging livestock pathogens.

International audience; Infections caused by arboviruses such as dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) frequently occur in tropical and subtropical regions. These three viruses are transmitted by Aedes (Ae.) aegypti and Ae. albopictus. In Thailand, the highest incidence of arbovirus infection and the high circulation of Aedes mosquito mainly occurs in the Southern provinces of the country. Few studies have focused on the incidence of co-infection of arboviruses in this region. In the present study, a cross-sectional study was conducted on a cohort of 182 febrile patients from three hospitals located in Southern Thailand. Surveillance of DENV, CHIKV and ZIKV was conducted from May to October 2016 during the rainy season. The serological analysis and molecular detection of arboviruses were performed by ELISA and multiplex RT-PCR respectively. The results demonstrated that 163 cases out of 182 patients (89.56%) were infected with DENV, with a predominance of DENV-2. Among these DENV positive cases, a co-infection with CHIKV for 6 patients (3.68%) and with ZIKV for 1 patient (0.61%) were found. 19 patients out of 182 were negative for arboviruses. This study provides evidence of co-infection of arboviruses in Southern Thailand and highlight the importance of testing DENV and other medically important arboviruses, such as CHIKV and ZIKV simultaneously.

Chikungunya virus (CHIKV), a mosquito-borne pathogen, consists of three genotypes: East/Central/South African (ECSA), West African (WA), and Asian. Although a current rapid immunochromatographic (IC) test detecting CHIKV E1-antigen showed high sensitivity to ECSA-genotype viruses, it showed poor performance against the Asian-genotype virus that is spreading in the American continents. To understand the basis for the low performance of this IC test against Asian-genotype virus, we re-examined the anti-CHIKV monoclonal antibodies (mAbs) used in the assay for their interaction with E1-antigen of the three CHIKV genotypes. We found that the reactivity of one mAb for Asian-genotype virus was lower than that for ECSA virus. Comparison of E1 amino acid sequences revealed that the ECSA virus used to generate these mAbs possesses glutamic acid (E) at position 350, in contrast to WA and Asian, which possess aspartic acid (D) at this position. Site-directed mutagenesis confirmed that the mutation altered mAb reactivity, since E-to-D substitution at position 350 in ECSA reduced recognition by the mAb, while D-to-E substitution at this position in Asian and WA increased affinity for the mAb. Taken together, these results indicate that residue 350 of the CHIKV 6K-E1 is a key element affecting the performance of this IC assay.

Background Human papillomavirus (HPV) infections in Thailand are a public health concern but information on HPV infection in sex workers and men who have sex with men (MSM) is limited. The aim of this study was to measure the prevalence and genotype distribution of HPV among low- and high-risk, HIV-negative populations.

Background The prevalence of obesity has increased globally, with childhood and adolescent obesity being more common in developed countries. There has been no study on teenage obesity in Bhutan. In this study, we aimed to assess the prevalence of obesity in Bhutan for the first time in order to provide a baseline for future researchers. Methods The investigation, which included 392 adolescents, aimed to identify the prevalence of overweight and obesity and its contributing factors. Anthropometric measurements, food recall and knowledge, attitude, behaviour and environment questionnaires were administered. The body mass index (BMI) cut-off points for adolescents matched with those of the US Centers for Disease Control and Prevention. Results The prevalence of overweight and obesity among the participants were 7.1% and 1.5%, respectively. The prevalence of obesity was 1.0% in females and 0.5% in males (p 2 test uncovered no significant associations. BMI also had no significant associations with attitude, behaviour, environment and distance travelled to school. Food recall results revealed the following findings for average food consumption: total energy intake, 3522.6 kcal; fat, 47.6 g; carbohydrate, 690.2 g; protein, 90.5 g; fibre, 20.3 g; and sodium, 12.5 g. Conclusion The results of this study clarified the prevalence of obesity among adolescents in Bhutan, who require appropriate strategies for combating overweight and obesity.

From regional and global perspectives, Thailand has progressed toward lymphatic filariasis transmission-free zone in almost entire endemic provinces, being verified by WHO by the end of 2012 after the 5-year implementation of mass drug administration (MDA) with diethylcarbamazine and albendazole as part of the National Program to Eliminate Lymphatic Filariasis (PELF) (2002–2006) and a 4-year expansion of post-MDA surveillance (2007–2010). However, Thai PELF has been challenging sensitive situations of not only border crossings of local people on Thailand-Myanmar border where focal distribution of forest- and forest fringe-related border bancroftian filariasis (BBF) is caused by nocturnally subperiodic Wuchereria bancrofti in local people living in pockets of endemic villages, but also intense cross-border migrations of Mon and Tanintharyi workers from Myanmar to Thailand who harbor nocturnally periodic W. bancrofti microfilaremic infection causing the emergence of imported bancroftian filariasis (IBF). Thus, this paper discusses the apparent issues and problems pertaining to epidemiological surveillance and postgenomic MDA evaluation for 2010–2020 convalescent BBF and IBF. In particular, the population migration linked to fitness of benzimidazole-resistant W. bancrofti population is a topic of interest in this region whether the resistance is associated with pressure of the MDA 2 drugs and the vulnerabilities epidemiologically observed in complex BBF or IBF settings.

This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread ofPlasmodium falciparumandPlasmodium vivaxmultidrug resistance (MDR) malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world’s most MDR falciparum and vivax malaria on these chaotic borders.

Dengue and malaria infections are two very common vector-borne diseases annually affecting millions of people around the world. Both diseases show a variety of clinical presentations, ranging from mild symptoms of dengue fever (DF) to severe dengue hemorrhagic fever (DHF) in dengue infection, and low and high parasitemia in malaria infection. T helper (Th)1 and Th2 cytokine expressions in mild and severe forms of dengue virus type-2 (DENV-2) and Plasmodium falciparum infection, were compared to normal human sera using high throughput magnetic bead-based Bio-Plex assay. A significant elevation of Th1 and Th2 cytokines expression [interleukin (IL)-2, IL-4, IL-5, IL-10, IL-13, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha] was detected in DENV-2 and P. falciparum malaria infections compared with normal controls (p0.05). DENV-2 infection showed a slight higher expression of Th1 and Th2 cytokines in DHF than DF, except for IL-13. In P. falciparum infection, high parasitemia showed a significantly higher expression of IL-4, IL-10, GM-CSF, and TNF-alpha (p0.05). Both DENV-2 and P. falciparum malaria infections manifested high IL-10 expression, greatest among the cytokines examined, and in the severe forms of infection. The results of this study should lead to a better understanding of pathogenesis of dengue infection and P. falciparum malaria.

Transovarial dengue virus infection status of two forms of adult Aedes aegypti (dark or Ae. aegypti type form and pale or form queenslandensis), reared from field-collected larval and pupal stages, was determined by one-step RT-PCR and dengue viral serotype by nested-PCR. Natural transovarial transmission (TOT) of dengue virus was detected in the two Ae. aegypti forms, and in both adult males and females. Male Ae. aegypti had a higher rate of TOT dengue virus infection than female. The overall minimum infection rate among the male and female populations was 19.5 and 12.3 per 1,000 mosquitoes, respectively. All four dengue serotypes were detected in mosquito samples, with DEN-4 being the predominant serotype. Thus, both male and female Ae. aegypti have influences on the epidemiology of dengue virus transmission.

Mosquito salivary glands (SG) play an essential role in food digestion and pathogen transmission. The function of the salivary components during infection is poorly understood. In this study, female Aedes aegypti mosquitoes were infected with dengue virus serotype 2 (DENV-2) via an artificial membrane feeding apparatus. The mosquito SGs were examined for DENV-2 infection for 14 days post-infection (dpi). The amount of dengue virus increased throughout the 14 dpi. Three different meals were provided for the Ae. aegypti mosquitoes. SG protein expression was compared among sugar-fed (SF), blood-fed (BF), and dengue-infected blood-fed (DF) mosquitoes using SDS-PAGE coupled with densitometric analysis. The SG of SF mosquitoes had fewer protein bands than those of BF and DF mosquitoes. The major SG proteins seen among BF and DF mosquitoes had molecular weights of 12-15, 25-30, 35-40, 45-50, 55-60 kDa and 61-67 kDa. We compared the SG protein band expression profiles in BF and DF mosquitoes. Two bands (35-40 and 61-67 kDa) were expressed more by DF mosquitoes and 3 different bands (25-30, 45-50, and 55-60 kDa) were expressed more by BF mosquitoes. These SG proteins may have some role in facilitating blood-feeding and dengue infection. We speculate these specific SG proteins in dengue-infected mosquitoes may increase the chance of blood-feeding and virus transmission by infected mosquitoes. These results may be useful for designing additional tools to investigate the interaction between Ae. aegypti SG and the dengue virus.

Silk sericin is a natural macromolecular protein derived from the silkworm, Bombyx mori. It is also a by-product of silk-making. From previous reports, many cosmeceuticals and other cosmetic products have been developed with silk sericin. This study aimed to investigate an anti-aging property of silk sericin by in-vitro characterization using fibroblast cell culture model. The results showed that silk sericin can stimulate collagen type I synthesis, suppress the regulation of nitrite, which nitrite may induces oxidative stress, and up-regulate the expression of b-cell lymphoma 2 (bcl-2) to inhibit cell apoptosis, without altering fibroblast growth kinetics or cellular ultrastructure. Sericin anti-aging properties were comparable to vitamin C, except for oxidative stress, where silk sericin was superior. The results suggested that silk sericin possesses anti-aging properties that could be usefully incorporated into high-quality cosmetics, cosmeceuticals, and food supplements.

Rubber forestry is intentionally used as a land management strategy. The propagation of rubber plantations in tropic and subtropic regions appears to influence the economical, sociological and ecological aspects of sustainable development as well as human well-being and health. Thailand and other Southeast Asian countries are the world's largest producers of natural rubber products; interestingly, agricultural workers on rubber plantations are at risk for malaria and other vector-borne diseases. The idea of malaria-associated rubber plantations (MRPs) encompasses the complex epidemiological settings that result from interactions among human movements and activities, land cover/land use changes, agri-environmental and climatic conditions and vector population dynamics. This paper discusses apparent issues pertaining to the connections between rubber plantations and the populations at high risk for malaria. The following questions are addressed: (i) What are the current and future consequences of rubber plantations in Thailand and Southeast Asia relative to malaria epidemics or outbreaks of other vector-borne diseases? (ii) To what extent is malaria transmission in Thailand related to the forest versus rubber plantations? and (iii) What are the vulnerabilities of rubber agricultural workers to malaria, and how contagious is malaria in these areas?

A prospective field study was conducted to determine transovarial dengue-virus transmission in two forms of Aedes aegypti mosquitoes in an urban district of Bangkok, Thailand. Immature Aedes mosquitoes were collected monthly for one year and reared continuously until adulthood in the laboratory. Mosquitoes assayed for dengue virus were processed in pools and their dengue virus infection status was determined by one-step RT-PCR and nested-PCR methods. Of a total 15,457 newly emerged adult Ae. aegypti, 98.2% were dark and 1.8% of the pale form. The results showed that the minimum infection rate (MIR) by transovarial transmission (TOT) of dengue virus during the one-year study ranged between 0 to 24.4/1,000 mosquitoes. Dengue virus TOT increased gradually during the hot summer months, reaching a peak in April-June, while dengue cases peaked in September, a rainy month near the end of the rainy season. Therefore, mosquito infections due to TOT were prevalent four months before a high incidence of human infections. TOT dengue virus infections occurred in both forms of Ae. aegypti. All four dengue serotypes were detected, with DEN-4 predominant, followed by DEN-3, DEN-1, and DEN-2, respectively.

This study evaluated a single-tube multiplex RT-PCR with a primer focusing on nonstructural protein region 5 (NS5) and a highly conserved region for dengue virus serotyping. The method was compared with conventional PCR. This new method had a sensitivity of 96.7% and a specificity of 96.7% for disease detection. The new method also proved suitable for use in the field as it reduces time and decreases risk of contamination.

The post-tsunami health and nutritional statuses of survivors were surveyed three months after the disaster struck. Non-participant observations and questionnaires were used to study the effects of the disaster on their lifestyles and health while residing in temporary shelters provided by the government and private donors. Anthropometrics were measured and dietary surveys conducted to elicit nutritional status. Our findings indicated good management of drinking water in the temporary shelters. Toilet construction and water supply were adequate, but wastewater and sewage systems were poorly managed. The study group still suffered from injuries after the disaster, and complained of back pain, stress, and sleep disorders. Most in the study group had unsatisfactory health behaviors, and obesity was an increasing problem among female participants.

Chikungunya fever (CHIKF) is an acute febrile illness caused by a mosquito-borne alphavirus, chikungunya virus (CHIKV). This disease re-emerged in Kenya in 2004, and spread to the countries in and around the Indian Ocean. The re-emerging epidemics rapidly spread to regions like India and Southeast Asia, and it was subsequently identified in Europe in 2007, probably as a result of importation of chikungunya cases. On the one hand, chikungunya is one of the neglected diseases and has only attracted strong attention during large outbreaks. In 2008–2009, there was a major outbreak of chikungunya fever in Thailand, resulting in the highest number of infections in any country in the region. However, no update of CHIKV circulating in Thailand has been published since 2009. In this study, we examined the viral growth kinetics and sequences of the structural genes derived from CHIKV clinical isolates obtained from the serum specimens of CHIKF-suspected patients in Central Thailand in 2010. We identified the CHIKV harboring two mutations E1-A226V and E2-I211T, indicating that the East, Central, and South African lineage of CHIKV was continuously circulating as an indigenous population in Thailand. Electronic supplementary material The online version of this article (doi:10.1007/s11262-014-1105-5) contains supplementary material, which is available to authorized users.