Sompone Punyagupta (Former President of the Infectious Disease Association of Thailand)
** Vichaiyuth Hospital, Set-Siri Road, Phaya Thai, Bangkok, 10400
In Thailand, infectious diseases were historically called “dangerous contagious diseases”—five were included in the Act of B.E. 2477: the plague, cholera, smallpox, cerebrospinal fever (now known as meningococcal meningitis), and yellow fever. Cholera has long since been well-known among Thais, who called the disease “Roke Haa,” due to the numerous occurrences of outbreaks. The first recorded outbreak happened in B.E. 1900, and the second one was in B.E. 2363; both were concurrent with global epidemics.1 At present, most of the aforementioned diseases have been eradicated, and yellow fever has never been a problem for our country. During World War II (B.E. 2485), typhus was added to the list at the request of Japan, who occupied Thailand at the time. After the war, relapsing fever was also added to the list—Dr. Pramern Chantawimol had written about it in the Thai Medical Council Bulletin.1
These diseases, known as tropical diseases to the international medical community, have been a priority of Thai doctors since the birth of modern medicine in Thailand. At Siriraj, Thailand’s oldest medical school, the Tropical Diseases Unit was created under the Department of Medicine. Later, the Faculty of Tropical Medicine was established at Mahidol University. When I still served as a government officer, I helped found the Division of General Medicine and Tropical Diseases at Phramongkutklao Hospital, then when I moved to the newly established Faculty of Medicine, Ramathibodi Hospital, I was assigned the responsibility of managing the Gastrointestinal Unit, which became the Gastrointestinal Disease and Tropical Medicine Unit, due to the nature of gastrointestinal diseases here being mostly associated with infections in tropical climates, where Thailand lies.
The founding of the Faculty of Medicine Ramathibodi Hospital was a collaboration between the Faculty of Science at Mahidol University and the Rockefeller Foundation’s support. They sent Dr. William A. Sawyer to assist in setting up the Department of Microbiology. The first collaborative meeting was held at the Siriraj Hospital Library (Ramathibodi Hospital was still under construction at the time), where they discussed the importance of infectious diseases in Thailand, which is why they should be prioritized in Thai medical schools. This covers all tropical diseases, including other infections such as urinary tract infections, nosocomial infections, etc. Thus, it was decided in B.E. 2515 to establish the discipline of infectious diseases named “the Infectious Diseases Group”, which consisted of myself, the late Dr. Michael M. Stewart from the Rockefeller Foundation, Dr. Somsak Lolekha from the Department of Pediatrics, and Dr. Jidbhong Jayavasu and Dr. Panida Chaiyanate from the Department of Microbiology. We started teaching on the subject for interns and residents through ward rounds, grand rounds, seminars, and symposiums, which became of great interest of doctors and medical students. Furthermore, on 25 May 2516, the faculty also established the first Sub-Committee for Infection Control in Thailand, where I was the president and Dr. Somsak Lolekha was the secretary.
Later, on 29 October 2517, an international symposium by Mahidol University and Rockefeller Foundation was held, titled “Southeast Asia Addresses Its Health Problem: Current Research and Educational Activities” at the Faculty of Science, Mahidol University. At the symposium, I spoke about the “Learning of Infectious Diseases in Medical Schools in Thailand”2, emphasizing that it is not important to imitate the curriculums of medical schools from abroad, because even in America, it had not been very long since infectious diseases were accepted as a specialty (The Infectious Disease Society of America was founded in B.E. 2506). In addition, the teaching about infectious diseases was done by instructors in multiple departments, which led to redundancy of shared diseases and neglect of diseases that do not fall under other departments’ responsibilities, such as septicemia and nosocomial infections. Therefore, it was necessary to have Infectious Diseases Working Groups in every medical school, as it was done at Ramathibodi. This talk was criticized by leaders of some medical schools, arguing that the existing system works well enough. However, not long after, almost every medical school in Thailand had an infectious disease unit.
For interns and residents, for whom a specialization in infectious diseases was new, we had organized post-graduate training courses on the Treatment of Common Infectious Diseases for the first time at the Faculty of Medicine Ramathibodi Hospital during 11-15 March 2517. We had planned for 30 attendants, but had to accommodate for 68, due to a high demand. The courses were taught by a team of 15 instructors, and 270-page mimeographs of the material were printed.
Due to the success of the first year’s training courses, we then began to organize them regularly each year. In the first ten years, we focused on diagnosing infectious diseases. After having trained approximately 1,000 doctors, we transitioned to a focus on treatment, using the name “Current Therapy of Common Infectious Diseases.” Demand for the courses and their material was very high—each year there were more and more applicants, due to the high practicality of the course, as well as the quality of the instructors.
However, after the Infectious Diseases Group had operated for three years and requested approval for a fellowship training project, the subject was not able to be fully supported yet. Nevertheless, the young doctors who had undergone the training courses went on to establish the subject in other medical schools, namely, Dr. Prasit Asawapokee, Dr. Nalinee Asawapokee, Dr. Amorn Leelarasamee, and Dr. Surapol Suwanagool from Siriraj; Dr. Thira Sirisanthana from Chiang Mai; and Dr. Khachornjakdi Silpapojakul from Songkhla, for example.
In the year of B.E. 2518 Dr. Mukda Trishnananda, Dr. Somsak Lolekha, and I founded the Infectious Disease Group of Thailand, where I was the temporary president. The first meeting was held at the Children’s Hospital on 10 March 2519 with 20 attendees. Eight committee members were chosen, and requested Dr. Mukda to be the president. We convened an academic conference titled “Is Melioidosis a Problem among Thais?” Later, the Group increased to 62 members, and offered postgraduate training on infectious diseases instead of the Faculty of Medicine, Ramathibodi. On 18 December 2523, we applied the Infectious Disease Association of Thailand for officiation with the National Culture Commission, of which we were officially recognized on June B.E. 2525. We received the documentation from the Police Department on 17 August B.E. 2526. The first major conference was held on 18 November B.E. 2525, when we elected Dr. Mukda Trishnananda as the president of the association and myself as the secretary. Key events in the history of the Association are summarized in Table 1.
|1||B.E. 2514||Began planning an infectious disease curriculum at the Faculty of Medicine, Ramathibodi Hospital, with the support of the Rockefeller Foundation|
|2||B.E. 2515||Establishment of the Infectious Disease Group at the Faculty of Medicine, Ramathibodi Hospital|
|3||25 May 2516||The first infection control sub-committee was established at the Faculty of Medicine, Ramathibodi Hospital|
|4||11-15 Mar 2517||Organized a post-graduate training course on Treatment of Infectious Disease for the first time at Ramathibodi Hospital|
|5||29 Oct 2517||International Symposium: Southeast Asia Addresses Its Health Problem at Mahidol University|
|6||10 Mar 2519||Founded the Infectious Diseases Group of Thailand, with 40 members and held the first meeting: “Is Melioidosis a problem among Thais?”|
|7||1 Jan 2521||Began publishing the Infectious Diseases Group of Thailand booklets, which were printed for five years|
|8||18 Dec 2523||Established the Infectious Disease Association of Thailand, which was officially registered on 24 Jun 2525|
|9||18 Nov 2525||First election of committee members from 112 members|
|10||1 Jan 2527||Released the quarterly “Infectious Diseases and Antibiotics” journal|
|11||23-24 Nov 2528||Organized the National Workshop on Melioidosis at the Ambassador Hotel with 60 attendees|
|12||10-13 Dec 2529||Organized the International Congress on Bacterial and Parasitic Drug Resistance at Shangri La Hotel with 533 attendees from 30 countries; the start of the Western Pacific Congress on Chemotherapy|
|13||24-25 Aug 2532||Organized a Workshop on Laboratory Diagnosis of Infectious Diseases with 180 attendees|
|14||11 Dec 2533||Organized the Second Western Pacific Congress on Infectious Diseases and Chemotherapy at Ambassador City, Jom Tien, with 1,500 attendees from 50 countries|
|15||28-30 Oct 2535||Ten-year anniversary meeting at Hin Suay Nam Sai, Rayong|
|B.E. 2519-2525||Infectious Disease Group||Mukda Trishnananda||Sompone Punyagupta|
|Infectious Disease Association of Thailand||Mukda Trishnananda||Sompone Punyagupta|
|B.E. 2530-2535||Infectious Disease Association of Thailand||Sompone Punyagupta||Somsak Lolekha|
|B.E. 2535-2536||Infectious Disease Association of Thailand||Somsak Lolekha||Boonmee Satapatayavong|
Apart from the postgraduate training of 1,600 personnel (Table 2), we also hosted academic conferences with keynote speakers from around the world, with the cooperation of medical supply companies. From 10 to 13 of December 2529, the Association held its first international conference “Congress on Bacterial and Parasitic Drug Resistance” at Shangri La Hotel, with Dr. Panida Chaiyanate as the secretary. It was a great success, with 533 attendees from 30 countries. It was also the start of another international academic organization: The Western Pacific Congress on Chemotherapy, which is a branch of the International Congress on Chemotherapy (ICC). Later, the Association hosted the Second Western Pacific Congress on Infectious Diseases and Chemotherapy at Ambassador City Hotel, Jom Tien on 11-14 December 2533 with 1,500 attendees from 50 countries; Dr. Panida Chaiyanate was the secretary. We were greatly honored to have Her Royal Highness Princess Chulabhorn Walailak deliver the opening lectures at both conferences. The Association also became a partner with the ICC.
|1.(1)||11-14 Mar 2517||68||15||Ramathibodi|
|2.||24-28 Mar 2518||47||16||Ramathibodi|
|3.(2)||22-26 Mar 2519||57||10||Bamrasnaradura|
|4.||21-25 Mar 2520||81||20||Rajavithi|
|5.||13-17 Mar 2521||76||25||Siriraj|
|6.||1-5 Oct 2522||86||23||Chulalongkorn|
|7.||20-24 Oct 2523||81||12||Chiang Mai|
|8.||12-16 Oct 2524||92||27||Phramongkutklao|
|9.(3)||15-19 Nov 2525||123||30||Siriraj|
|10.||17-21 Oct 2526||118||29||Ramathibodi|
|11.(4)||21-25 Jan 2528||111||29||Rajavithi|
|12.||20-24 Jan 2529||118||34||Chulalongkorn|
|13.||2-6 Feb 2530||105||33||Siriraj|
|14.||8-12 Feb 2531||116||35||Ramathibodi|
|15.(5)||6-10 Feb 2532||120||34||Chulalongkorn|
|16.||5-9 Mar 2533||84||33||Phramongkutklao|
|17.||9-13 Mar 2535||169||30||Phramongkutklao|
Aside from international recognition, the Association was also accepted by domestic organizations, including the Medical Council of Thailand and the Royal College of Physicians of Thailand. The Association has also sent official representatives to national conferences regularly, such as the National Hepatitis Control Committee and the National AIDS Control Committee.
Financial Status of the Association We had started from nothing, but when the Infectious Disease Group was established, I had donated 5,229 baht, which was the remaining budget from the first two training sessions. We were also assisted by donations from those who had attended them. When we changed from a Group to an Association seven years later, the remaining funds (297,706.83 baht) were transferred. Eventually, by B.E. 2535, we had accumulated over 11 million baht (See Table 3), most of which were acquired from training sessions, selling books, and crucially, two international conferences.
|B.E.||Total Assets (Baht)|
When we were still the Infectious Disease Group, we began to publish quarterly booklets in B.E. 2521, with Professor Amorn Leelarasamee as the editor. During B.E. 2523 to 2525, Professor Somwang Danchaivijitr assumed the role instead. Then when we became an Association, we started publishing the “Infectious Diseases and Antibiotics” journal since B.E. 2527, and Professor Amorn Leelarasamee resumed the role of editor again. With the cooperation of doctors and researchers on infectious diseases, it became one of the most popular medical journals in Thailand.
At the National Workshop on Melioidosis at the Ambassador Hotel, 23-24 November 2528, we compiled information on the disease, which we published as an English-language monograph, titled Melioidosis5. It was printed by Bangkok Wetchasan Printing House and released for purchase in B.E. 2532. The Association also planned for the diagnosis and treatment of this disease; Dr. Mondej Sukpranee, Dr. Wattanachai Susaengrat, and Dr. Paitoon Boonma, and their research team from Khon Kaen produced research results that were highly beneficial to the doctors and the patients of this disease6. Then, we found an interest in the pathology of intracellular infections, which yielded an interesting study by Professor Nalinee Asawapokee, Professor Panida Chaiyanate, and Professor Malai Vorachit on “Glycocalyx”. In addition, the Association also organized a workshop on diagnosing infectious diseases with the Department of Medical Sciences on 24-25 August 2532.
The aforementioned information showed that the Infectious Disease Association of Thailand had been outstanding in the establishment of the discipline in the country. What I wish to see in the second decade are as follows.
As one of the team member in establishing the discipline of infectious disease and founding the organization, I am proud to be part of the Infectious Disease Association of Thailand which is now well recognized by medical society. I have been on duty for almost 20 years. It is the time for backing off and transferring this responsibility to the younger generation. I hope in the next decade I shall see significant advancement of the organization for all.