Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021.

In September 2021, a total of 25 patients diagnosed with COVID-19 developed acute melioidosis after (median 7 days) admission to a COVID-19 field hospital in Thailand. Eight nonpotable tap water samples and 6 soil samples were culture-positive for Burkholderia pseudomallei. Genomic analysis suggested contaminated tap water as the likely cause of illness.

An unusual diarrheal outbreak in the community in Eastern Thailand caused by Norovirus GII.3[P25].

BACKGROUND: Sentinel laboratory surveillance for diarrheal disease determined norovirus to be the most common cause of non-bacterial gastroenteritis in people during the COVID-19 pandemic in Thailand. An increase in patients presenting with diarrhea and vomiting in hospitals across Chanthaburi province between December 2021 and January 2022 led to the need for the identification of viral pathogens that may be responsible for the outbreak. METHODS: Fecal samples (rectal swabs or stool) from 93 patients, of which 65 patients were collected during the December 2021 to January 2022 outbreak, were collected and screened for viral infection by real-time RT-PCR. Positive samples for norovirus GII were then genotyped by targeted amplification and sequencing of partial polymerase and capsid genes. Full genome sequencing was performed from the predominant strain, GII.3[P25]. RESULTS: Norovirus was the most common virus detected in human fecal samples in this study. 39 of 65 outbreak samples (60%) and 3 of 28 (10%) non-outbreak samples were positive for norovirus genogroup II. One was positive for rotavirus, and one indicated co-infection with rotavirus and norovirus genogroups I and II. Nucleotide sequences of VP1 and RdRp gene were successfully obtained from 28 of 39 positive norovirus GII and used for dual-typing; 25/28 (89.3%) were GII.3, and 24/28 (85.7) were GII.P25, respectively. Norovirus GII.3[P25] was the predominant strain responsible for this outbreak. The full genome sequence of norovirus GII.3[P25] from our study is the first reported in Thailand and has 98.62% and 98.57% similarity to norovirus found in China in 2021 and the USA in 2022, respectively. We further demonstrate the presence of multiple co-circulating norovirus genotypes, including GII.21[P21], GII.17[P17], GII.3[P12] and GII.4[P31] in our study. CONCLUSIONS: An unusual diarrhea outbreak was found in December 2021 in eastern Thailand. Norovirus strain GII.3[P25] was the cause of the outbreak and was first detected in Thailand. The positive rate during GII.3[P25] outbreak was six times higher than sporadic cases (GII.4), and, atypically, adults were the primary infected population rather than children.

Availability and Price of Low-Sodium Condiments and Instant Noodles in the Bangkok Metropolitan Region.

INTRODUCTION: Excess sodium consumption can cause hypertension. One component of Thailand's 5-part strategy to reduce sodium intake is reform of the food environment to increase access to low-sodium foods. Our research aimed to describe the availability and price of low-sodium food products in retail stores in the Bangkok Metropolitan Region. METHODS: In June and July 2021, we used multistage cluster sampling to conduct a cross-sectional study of the availability of low-sodium foods. Availability referred to a retail store offering at least 1 version of low-sodium condiment or instant noodles. We applied the Thai Healthier Choice criteria and World Health Organization (WHO) global benchmark as the low-sodium criteria for these products. We surveyed 248 retail stores in 30 communities in 6 districts in the Bangkok Metropolitan Region. We observed store shelf availability and price by using a survey form and used the Fisher exact test and independent t test to compare availability and price by sodium content and store size. RESULTS: All subcategories of low-sodium condiments, except black soy sauce in small stores, were less available than regular-sodium condiments. The proportional difference ranged from 11.3% to 90.6% (P < .001). We found no difference in the 4 condiment subcategories, including fish sauce, thin soy sauce, seasoning sauce, and oyster sauce in large stores. Low-sodium versions of instant noodles were unavailable in either large or small stores. The price of low-sodium condiments was 2 to 3 times higher than that of regular-sodium condiments (P < .05). CONCLUSION: Low-sodium food options are not generally available in the Bangkok Metropolitan Region, and access to them is inequitable because of pricing. Instant noodles, a popular food, were unavailable in low-sodium versions. Their reformulation should be promoted. Government subsidies of the price of commonly used low-sodium condiments could increase their use and reduce sodium consumption overall.