Case Investigation Report of Monkeypox Infection in Bangkok

Abstract

On March 11th 2023, Bamrasnaradura Infectious Diseases Institute received a referral for a confirmed of Monkeypox case. The patient was a Thai male, aged 40 years old. He was admitted as an inpatient. Bamrasnaradura Infectious Disease Investigation Team in conjunction with Department of Health (Bangkok Metropolitan Administration) and Public Health Service Center 11, Pradiphat conducted an investigation of the disease since 21^st to 22^nd on March 2023 to be confirmed the diagnosis and outbreaks, study the distribution of the disease according to the characteristics of individuals place and time, find a source of infection, factors associated with disease, and prevention and control of disease outbreaks by descriptive epidemiological study was conducted by reviewing data from medical records, interviewing patients, doctor and staff, finding active cases Including surveillance and monitoring symptoms in close contacts, along with studying the environment of the residence and various hospitals where patients received treatment. The results of the investigation found that the patient had sexual orientation with men, had a history of traveling to Malaysia from 24^th to 26^th on February 2023, had a history of hugging and kissing with a strange Thai man at Chatuchak Park on March 2^nd, 2023. Onset of illness was on March 5^th 2023. His symptoms included fever and body rash. West African lineage B.1.3 was found in the lesion swab from the case. 20 contact cases were follow-ups. There was no infection found. From the investigation of the disease, it was found the patient is likely to be infected in Thailand because no epidemiological link was found in Malaysia. it is expected that the infection was caused by the behavior of intimate contact with a strange, unidentified Thai man at a public park in Chatuchak area. Additionally, the patient denied a history of sexual intercourse which was inconsistent with the clinical characteristics of the patient. It is possible that patients may not disclose all personal information because they may be concerned about social stigma and impact on work responsibilities.