The investigation into the deaths of these five foreign tourists and one Thai guide, and illnesses of three foreign tourists in Chiang Mai earlier in 2011 involves many actors including national and international experts in public health.
The role of public health authorities is to determine:
1) The cause(s) of death and illness;
2) The reason for exposure to the cause of death or illness (eg. pest control or other toxic products);
3) Linkages, if any, between these deaths and illnesses;
4) Depending on the cause, measures required to reduce future risks.
Law enforcement officials are responsible to investigate the scene of death (outside the hospital) to determine if there were any criminal actions.
Chiang Mai Provincial Authority: overall event management, leading the investigation into the six deaths at the beginning of 2011. The deputy provincial health officer is the focal point for the investigation and coordinates the collection and analyses of all information. He acts as spokesman for the investigation committee and speaks with the media on its behalf.
Chiang Mai Police: investigation at scene of death (outside the hospital) to determine if there are any criminal causes involved. Handles forensic probe at scene of death.
Chiang Mai Hospital: treats patients and gives diagnosis where death occurs.
Department of Disease Control, MOPH: gives support to the provincial authority to determine cause of death and take measures to reduce the risk of further death or illness. Handles medical investigation into possible causes. Invites additional expertise as required and coordinates expert input with provincial authorities. Ensures all obligations under the International Health Regulations (IHR) are met. Keeps relatives of the tourists and the relevant embassies informed and provides public updates as required.
WHO: The Ministry of Public Health has formally requested WHO to assist in the areas of epidemiology, toxicology and communication. Provides technical advice and expertise in Thailand and coordination with overseas experts and laboratories. Ensures all obligations under the IHR are met.
US-CDC: provides technical advice and coordination with overseas experts and laboratories. Carries out some of the testing in its laboratories in the US.
Ramathibodi Hospital: carried out some laboratory tests on samples from patients.
Siriraj Hospital: carried out some laboratory tests on samples from patients.