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Impact of a Food Safety Campaign on Streptococcus suis Infection in Humans in Thailand

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  • 1 Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
  • | 2 Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Campus, Sakon Nakhon, Thailand.
  • | 3 Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan.
  • | 4 Phayao Provincial Hospital, Phayao, Thailand.
  • | 5 Chiang Kham General Hospital, Phayao, Thailand.
  • | 6 Phayao Public Health Office, Phayao, Thailand.
  • | 7 Food Safety Operation Center, Nonthaburi, Thailand.
  • | 8 Global Collaboration Center, Osaka University, Osaka, Japan.
  • | 9 Department of Clinical Epidemiology and Biostatistics, Graduate School of Medicine, Osaka University, Osaka, Japan.
  • | 10 Institute of Statistical Mathematics, Tokyo, Japan.
  • | 11 National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand.
  • | 12 Infectious Disease Surveillance Center, National Institute of Infectious Disease, Tokyo, Japan.

Streptococcus suis is an important zoonotic pathogen in swine and humans that causes sepsis and meningitis. Our previous study in Thailand showed that the prevalence of S. suis infection in humans, especially in northern areas of Thailand, and the transmission of the pathogen occurred mainly through the consumption of traditional raw pork products. Considering the high incidence proportion and mortality rate of the disease as an important public health problem, we implemented a food safety campaign in the Phayao Province in northern Thailand in 2011. We evaluated the effects of a food safety campaign by comparing the sociodemographic, clinical, and bacteriological characteristics of cases before and after the campaign. The follow-up study showed a marked decrease of the incidence proportion in the first 2 years, indicating the effectiveness of the campaign. In the third year, however, the incidence proportion slightly increased again, indicating the existence of deep-rooted cultural behaviors and the necessity of continuous public health intervention. Furthermore, epidemiological analysis of the cases made it possible to estimate the infectivity of the pathogen via the oral route of infection. In the present study, we showed the effectiveness of the food safety campaign for controlling the S. suis infection, and we present a role model public health intervention for prevalent areas affected by S. suis infection in humans.

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Author Notes

* Address correspondence to Dan Takeuchi, Section of Bacterial Drug Resistance Research, Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita, Osaka, Japan 565-0871, E-mail: dantake@biken.osaka-u.ac.jp or Yukihiro Akeda, Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan 565-0871, E-mail: akeda@hp-infect.med.osaka-u.ac.jp.

Financial support: We thank the Department of Medical Sciences, Ministry of Public Health of Thailand, Japan Society for the Promotion of Science (KAKENHI 21406027), and Japan Initiative for a Global Research Network on Infectious Diseases launched by the Ministry of Education, Science, and Culture of Japan for providing financial support for this work.

Authors' addresses: Dan Takeuchi and Shigeyuki Hamada, Section of Bacterial Drug Resistance Research, Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan, E-mails: dantake@biken.osaka-u.ac.jp and hamadas@biken.osaka-u.ac.jp. Anusak Kerdsin, Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Campus, Sakon Nakhon, Thailand, E-mail: noksak99@gmail.com. Yukihiro Akeda, Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan, E-mail: akeda@hp-infect.med.osaka-u.ac.jp. Piphat Chiranairadul, Phacharaphan Loetthong, and Nutchada Tanburawong, Phayao Provincial Hospital, Phayao, Thailand, E-mails: ayapiphat@yahoo.com, phacha0037@gmail.com, and wnithita@yahoo.com. Prasanee Areeratana, Panarat Puangmali, Kasean Khamisara, Wirasinee Pinyo, and Rapeepun Anukul, Chiang Kham General Hospital, Phayao, Thailand, E-mails: lekprass2@hotmail.com, puangli_1@hotmail.com, kasian04@hotmail.com, wirasinee_loy@hotmail.com, and ra.peepan111@hotmail.com. Sutit Samerchea, Phayao Public Health Office, Phayao, Thailand, E-mail: sutit2007@hotmail.com. Punpong Lekhalula, Food Safety Operation Center, Nonthaburi, Thailand, E-mail: punpong.fsoc@gmail.com. Tatsuya Nakayama, Global Collaboration Center, Osaka University, Osaka, Japan, E-mail: t.nakayama-glocol@outlook.com. Kouji Yamamoto, Department of Clinical Epidemiology and Biostatistics, Graduate School of Medicine, Osaka University, Osaka, Japan, E-mail: yamamoto-k@stat.med.osaka-u.ac.jp. Masayo Hirose, Institute of Statistical Mathematics, Tokyo, Japan, E-mail: masayo@ism.ac.jp. Surang Dejsirilert, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand, E-mail: surang_dej@yahoo.com. Kazunori Oishi, Infectious Disease Surveillance Center, National Institute of Infectious Disease, Tokyo, Japan, E-mail: oishik@nih.go.jp.

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