Spring 2006 Issue
CDC Team in Thailand Combats Emerging Infections at the Source
The CDC field station in Thailand is one of CDC’s largest overseas outposts. The CDC Foundation’s new partnership with the GM Foundation will provide reliable vehicles and ready transportation to support activities at the Thailand field station such as those described below.
On March 11, 2003, Dr. Carlo Urbani stepped off a plane at the Bangkok airport and was met by two of his colleagues. Instead of a hearty handshake, Urbani greeted them with a warning to keep their distance. During his flight from Hanoi, Vietnam, Urbani had developed a fever and knew his condition might be serious and contagious. In the last several days he had treated several Vietnamese patients with a fever and what was labeled “atypical pneumonia.” He, in fact, was the first health official to identify SARS as the culprit.
The colleagues Urbani met at the airport were Sonja Olsen, Ph.D., and Scott Dowell, M.D., M.P.H., both epidemiologists at the CDC field station in Thailand. Dowell and Olsen accompanied Urbani to the hospital and immediately helped Thai health officials establish critical infection control procedures to protect hospital staff and the other patients.
“Because of our experience with infection control, we were able to help the hospital there care for him safely,” recalls Dowell. “While more than 100 hospital staff were exposed to Dr. Urbani, none were infected.”
Unfortunately, no effective treatment for SARS was available at that time, and after an 18-day battle, Urbani died. But, the CDC-supported rapid response at the hospital and the tireless efforts of the Thai Ministry of Public Health to contain SARS regionally paid off - only 12 cases of SARS were reported in Thailand, despite it being at the geographic epicenter of the outbreak.
Dowell cites the SARS outbreak as a prime example of the importance of CDC’s presence overseas. “We can’t just stay here and wait for these infections to arrive in the U.S.,” says Dowell. “We really need to go to the source and help control emerging infections before they become global problems.”
Dowell arrived in Thailand in 2001 to establish an International Emerging Infections Program at the CDC field station in Bangkok. CDC had partnered with the Thai Ministry of Public Health for more than 25 years. The partnership began with the development of a field epidemiology training program and grew with the establishment of an HIV/AIDS research station. Today, the CDC field station in Thailand is one of CDC’s largest overseas outposts with approximately 15 CDC personnel and 180 Thai nationals employed as managers and support staff. The outpost houses the Global AIDS Program and the Global Disease Detection and Response Center, which includes the field epidemiology training and emerging infections programs.
CDC staff working with the Global Disease Detection and Response Center in Thailand must maintain constant vigilance for signs of emerging diseases. CDC experts also work with the Thai Ministry of Public Health to ensure that local laboratories are prepared and equipped to quickly analyze specimens and accurately characterize pathogens that cause illness.
Recently, all other investigations have been dwarfed by the looming threat of avian influenza. CDC disease detectives have been scouting remote Thai villages and the crowded markets of Bangkok for cases of avian influenza and other influenza strains. CDC staff are also training and preparing rapid response teams, so that if avian flu began to transmit easily between humans in Thailand or a nearby country, the outbreak could be contained before it reached pandemic proportions.
Dowell recently returned to the U.S. after working with the CDC field station in Thailand for four years. His task now is to run CDC's Global Disease Detection Program, which includes the Thailand Emerging Infectious Diseases Program and several similar programs around the world. One of his hopes is “to see my colleagues in Thailand and these other new international sites make meaningful contributions to controlling a global infectious disease threat, whether it is the next AIDS, SARS or a new strain of influenza.”