COVID-19 in a remote village in a tropical forest – a note

Dear Editor

COVID-19 is an important pandemic disease affecting more than 200 countries around the world. Crowded areas in cities are places where there is high risk of disease spread. Nevertheless, this respiratory disease is also detectable in rural areas. Here, the authors would like to share an observation on local data on disease outbreak in Thailand, the second country in which the disease occurred¹.

The outbreak occurred in a rural forest village, more than 100 km from the nearest city centre. The village is in the Chachoengsao province of Thailand, in a tropical forest area known as Khao Ang Rue Nai Wildlife Sanctuary (GPS coordinates 13.596068, 101.688146). The village area is 153 km² and has a local population of 4305. The first COVID-19 case was a man returning from a Muay Thai fight at a boxing stadium (area 500 m², attendant capacity 5000), which was the starting point of the nationwide outbreak in Thailand.

The local Thai Center of Disease Control confirmed the outbreak using standard epidemiological techniques and stated that the infection was due to the crowded, contaminated environment in the stadium during the boxing fight. The first infected person went back to the forest village and spread the virus to 10 close contacts in the village; all people in this village were quarantined. A curfew was implemented by the local provincial administrator for 2 weeks and there has been no disease spread in the village.

Although the village is a loosely populated rural village, all villagers live in crowded family groups in a specific small part of the main area of the village (the remaining area is used for agricultural farming) and it might have been the starting point of a COVID-19 outbreak in this part of Thailand. Forested village areas in tropical countries are known for the possibility of outbreaks of some jungle-related diseases, especially for malaria^2,3. However, the occurrence of respiratory virus infection is infrequently mentioned.

To the best of the authors’ knowledge, this is the first report on a COVID-19 outbreak in a remote village in tropical forest. It shows that outbreaks of COVID-19 are possible in remote rural villages.

Won Sriwijitalai, Bangkok, Thailand; and Viroj Wiwanitkit, Dr DY Patil University, Pune, India; Hainan Medical University, China; and Joseph Ayobabalola University, Ikeji-Arakeji, Nigeria