U Thaung, MB.BS, DPH (Calcutta), DECD (Prague), Epidemiologist and Public Health Specialist, Director (Disease Control), Department of Health, Rangoon
U Thaung was one of the four Founding Members of the Myanmar Journal of Current Medical Practice and served as its Editorial Secretary for many years before its publication was interrupted.
U Thaung needs no introduction to the older generation of practitioners because he was well-known as an epidemiologist of high calibre and a long-serving academic. The younger generation would not know who he was, but should learn about a respected pioneer in the field.
He began his career as Assistant District Health Officer in Hantharwaddy District and also as team leader of anti-VD team from 1956 to 1962. He was later promoted to District Health Officer of Insein District and Team Leader, Aung San Health Demonstration Unit and Training Centre which was pivotal in the development of public health system in that era. Rural healthcare delivery system was initiated, with rural health centres being set up throughout the country. Guidelines for rural health centres was published by the-then government printing house and a vertical system of disease control for specific disease like leprosy, malaria and tuberculosis and BCG was developed (though smallpox vaccination was integrated into basic healthcare services).
U Thaung served as Assistant Director (Epidemiology), Deputy Director (Epidemiology) in the early 1960s to late 1970s after which he was assigned as Divisional Health Director, Sagaing Division for 1978-79. Then he resumed his duty as Assistant Director (Epidemiology), Deputy Director (Epidemiology) from 1964 to 1972. He was promoted to Director (Disease control), Department of Health, Rangoon from 1990 to 1992 until his retirement from service.
U Thaung’s forte’ was dengue fever, and his publications were largely focused on this area. Dengue fever in adults was first detected as far back as 1968 and later among children presenting with haemorrhagic manifestations. Serological and epidemiological studies were done in collaboration with international experts like Halstead. Clinical presentation of dengue encephalitis was also reported and widely cited.
A major achievement of his career was the eradication of smallpox. The campaign was led by Dr. KoKo, Director (Disease Control) and later Regional Director, South East Asia Region but U Thaung initiated the economy method of smallpox eradication, and selection strategies for small pox immunization. Smallpox was last reported in Maungdaw, in 1967 and declared eliminated in 1970, seven years ahead of global eradication. A chapter is dedicated to this exercison smallpox eradication in the book ‘Conquest of the Scourges of the Diseases’, edited by Dr. KoKo and Dr. U Thaung.
Cholera was highly endemic in Myanmar during U Thaung’s time as Director. The Eltor type of cholera of Indonesian origin was reported in Yangon in the water festival period of 1963. One case reported in Insein district (now Hlaingtharyar), was diagnosed after exhumation. Plague outbreaks had been reported since colonial times and was still rife in the country especially in districts upcountry, in places like Myingyan, Mandalay and Meiktila in the 1960s and 70s. Plague had shifted to upper Burma and remained endemic. A Plague Unit was established in Myingyan and a Rodent Control and Demonstration Unit (RCDU) was established in Yangon, as a WHO collaborating centre. Rodent and ecto-parasite studies were done and it became possible to forecast and detect the epizootics in endemic areas. Plague control was successfully carried out, and the last human case was reported in Yangon in 1984. Although localized epizootics were reported, plague was contained in Myanmar. Studies were made to detect plague in small mammals and humans in Yangon. Surveillance of rodent plague was malso in endemic areas by special disease control units, by plague serology and ecto-parasites studies. Pesticide susceptibility of some vector fleas and mosquitoes was studied.
U Thaung and colleagues addressed the problem of identification and magnitude of certain viral infections and reported their findings in the J. Tropical medicine and Hygiene. At that time, an outbreak of Japanese encephalitis was reported in the eastern part of the country and a regular surveillance system was put in place in addition to vector studies and animal infections in pigs and other mammals. Those studies and records served as a strong justification or evidence and laid the grounds for the recent introduction of vaccination against Japanese encephalitis(JE) which remains a regional health problem in the Southeast Asia region and China.
A large outbreak of Poliomyelitis occurred in Yangon city in 1964 and type 1 poliovirus was isolated in a laboratory in Singapore. Oral poliomyelitis vaccine was introduced in the 1980s in Yangon and in the whole country by 1987. Under the guidance of U Thaung, lameness survey or residual paralysis of school children was studied by school health teams, Yangon pediatricians and epidemiology team of Yangon Health, The prevalence of poliomyelitis among school children was estimated to be around 4 per thousand children, posing a significant public health problem of significant morbidity, mortality and disability. Similar studies were done in other parts of the country. Global initiative of poliomyelitis eradication (GIPE) was launched in 1996.
U Thaung and international consultants studied the pattern of ‘unchanging epidemiology of measles in Burma’ from clinical hospital studies, serology, vital statistics and data on cause of death. Measles vaccine was introduced in childhood immunization schedule in 1987. Other vaccine- preventable diseases were highly prevalent and diphtheria skin infections were studied. Following the successful global eradication of smallpox in 1977, the Expanded Programme on Immunization (EPI) was begun in 1994 as a project under the People’s Health Plan. The EPI programme ensured development of cold chain system, and outreaching to remote hard-to- reach areas. A major achievement was the Universal Coverage for Immunization (UCI) milestone when immunization coverage reached over 90 per cent in 1990. Laying cornerstones towards elimination of maternal and neonatal tetanus and eradication of poliomyelitis.
In his post-retirement period, he volunteered to be a working editor of the Myanmar Journal of Current Medical Practice (MJCMP) and a founding member of the Journal together Dr. Aung Than Batu, Dr. U MaungMaungSein And Dr.DawKhinNyunt.
Present and future generations of personnel working in the field of EPI and disease control we a great deal to Dr. U Thaung who had dedicated work for three decades on the disease control, surveillance and outbreak response to major communicable diseases which had devastated the country and also for establishment of EPI system and surveillance towards the goal of polio eradication and measles elimination. The peoples of the country who now enjoy better health also owe U Thaung a huge debt for his efforts in upgrading the preventive aspects of healthcare.
Author Information
Ye Hla
Director (Research) (Rtd)
