Case Investigation Report of Monkeypox Infection in Bangkok

Abstract

On March 11^th, 2023, Bamrasnaradura Infectious Diseases Institute received a referral for a confirmed Monkeypox case. The patient was a Thai male, aged 40 years old. He was admitted as an inpatient. The Bamrasnaradura Infectious Disease Investigation Team, in collaboration with the Department of Health (Bangkok Metropolitan Administration) and Public Health Service Center 11, Pradiphat, conducted an investigation the disease from 21st to 22nd on March 2023 to describe the clinical characteristics of the patient, studied the distribution of the disease according to the characteristics of individuals place and identify the source of infection and associated risk factors, and recommend disease prevention and control measures. 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 24th to 26th on February 2023, the patient went hiking at Genting, where there were many monkeys and squirrels, but they did not have any direct contact with the animals, had a history of hugging and kissing with a strange Thai man at Chatuchak Park on March 2nd, 2023. Onset of the illness was on March 5th 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. the patient is likely to be infected in Thailand because no epidemiological link was found in Malaysia. Since there were no confirmed cases of mpox reported in Malaysia during that period, and the patient denied any history of close contact with individuals exhibiting mpox-like symptoms while 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.