On the occasion of a research visit to Thailand in my capacity as a member of the governing board of the South Asia Institute of the University of Heidelberg, I saw for the first time the severe clinical picture of dengue with haemorrhagic symptoms among Thai children. This visit had been made possible by Profes sor Dr. med. Dr. rer. nat. Ouay Ketusinh of Bangkok, to whom I wish to express my sincere thanks in this place. In 1972 the German medical literature - the periodical Medizinische Klinik, vol. 87, pp. 152-56, to be precise - had drawn attention to this new phenomenon in the disease panorama of South East Asia, indicating a change in dengue fever from being a relatively benign tropical dis ease to a form having serious clinical and epidemiological ramifications. During the ten years following my first publication the new clinical picture, described as "dengue haemorrhagic fever", has become a standard component in the Thailand's system of notifiable diseases. So too, the World Health Orga nization publishes regular reports in its Weekly Records. On March 30/31, 1981, its Regional Office for South East Asia convened a special conference in New Delhi, thus emphasizing the significance of the diffusion of this new clini cal picture in the states of South East Asia.
Inhalt
1 Introduction.- 1.1 The Virus.- 1.2 The Clinical Picture.- 1.3 Therapy and Prophylaxis.- 2 Thailand.- 2.1 Natural Regionalization.- 2.1.1 Central Plain.- 2.1.2 Western Highlands.- 2.1.3 Northern Mountain Ranges.- 2.1.4 Korat Plateau.- 2.1.5 South-Eastern Littoral.- 2.1.6 Southern Peninsula.- 2.2 The Climate.- 2.3 Vector Ecology and Human Settlement.- 3 The Dengue Haemorrhagic Fever Situation in Thailand until 1970..- 4 Study Findings.- 4.1 Material and Methods.- 4.2 The Incidence.- 4.3 The Endemic Area.- 4.4 Dengue Haemorrhagic Fever and the Main Transport Routes.- 4.5 Dengue Haemorrhagic Fever and the Urban Population.- 4.6 Density of Physicians and Incidence.- 4.7 Seasonality.- 5 Conclusions.- Acknowledgement.- References.- Appendix: Morbidity Notification Card.- Notification Changing Card.- Text Map 1. Dengue haemorrhagic fever, 1954-1981.- Text Map 2. Thailand. Natural regions (According to Asanachinda, P.: Economic Geography of Thailand. Bangkok 1971 (in Thai) and other authors).- Text Map 3. Dengue haemorrhagic fever hospitalization 1962-1964 in 9 health districts (According to Avril, 1972, cit. after Halstead, 1969).- Text Map 4. Railways and onset of epidemic spread of dengue haemorrhagic fever.- Text Map 5. Urban population and dengue haemorrhagic fever (Population after Sternstein 1976).