By PRATCH RUJIVANAROM
NONG BUA LAMPHU
THE POTENTIALLY debilitating “flesh-eating disease” is under better control in Nong Bua Lamphu province this year, after an awareness campaign and increased regulation helped reduce the use of harmful herbicides, say medical officers.
The infection rate of necrotising fasciitis in the province is still the highest in Thailand, but the number of new patients and the prevalence of the disease has dropped compared to the same period last year, Nong Bua Lamphu Public Health chief Dr Surapong Phadungviang said.
The latest update found that 142 patients had the flesh-eating disease from the beginning of 2018 until July 8, which breaks down to a prevalence rate of 27.01 people per 100,000 population. Based on that, the total number of cases for the year should not exceed 170 for the province, Surapong added.
This is a significant improvement compared to 2017, which saw 254 necrotising fasciitis patients or a rate of 48.32 patients per 100,000 population.
The rate of infection has dropped in all six districts of the province, Surapong said, signifying greater awareness of the disease and a change in some people’s behaviour to avoid the disease.
Another contributor to the drop in infections is better enforcement of local regulations restricting the use of harmful agrochemicals, said Narongrit Channawa, head of Thailand Research Fund’s communal health charter research team at Tambon Nadi in Suwannakhuha District.
“Even though it is widely accepted that necrotising fasciitis is caused by bacterial infection, we suspect direct skin contact with a high concentration of herbicide in water and soil is another supporting factor,” Narongrit said.
A local regulation in the tambon prohibits farmers from spraying hazardous agrochemicals within a 300-metre radius of the communities and public places. They must also display a red flag as a warning to other people if they use these chemicals on their farm. Farmers failing to comply can be fined Bt1,000, while senior members or community members can be charged double that if caught violating the rules.
Narongrit said nobody had been caught violating this regulation since it was enforced in June.
According to the Disease Control Department, the main cause of necrotising fasciitis is direct contact between an open cut or wound and contaminated water and soil, leading to a serious infection at the infected area that destroys the tissue and causes gangrene. If proper medication is not administered in time, there is a very high chance that the patient will lose their limb or even die.
A research team from Naresuan University last year learned that the prevalence of necrotising fasciitis among Nong Bua Lamphu residents was far higher than in other parts of the country.
They also found that the high prevalence of the disease was coexistent with the high concentration of paraquat in local water sources. That discovery led to a vigorous debate about the connection between contamination in the area by the hazardous farm chemical and the uncommonly high infection rate of the flesh-eating disease.