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On September 2017, Maechai district, Phayao province were a suspected case and a fatal case of paper wasp envenomation. The team were conducted an investigation to verify the diagnosis and recommend measures for preventing severe injuries and deaths.The descriptive study was performed by medical records reviewed, interviewed public health officer, case’s family, witnesses, local people and searching for the previous cases from medical database during the year 2015–2017. Environmental studies were conducted by survey the event place.From investigated, two wasp envenomation cases, a 57-years-old man and a 63-years-old woman (death) who were a sibling; they contacted wasp while searching bamboo shoots in the forest on 15th September 2017. Their signs and symptoms compatible with injuries from paper wasp (Vespa sp.). They were paper wasp sting at head, back, lek and arms. A man visited the Maechai hospital and admitted 1 day. He had lesion more than 10 points. While the woman had lesion more than 100 points and she was admitted at the same hospital. She was to cardiac arrest and death on the same day. For the environmental study, the event place was a rubber plantation where had the nest of the paper wasp on a tree. During 2015 – 2017, there were 218 previous cases but could not identify the type of wasp or bee due to inadequate information. Local people often bring the wasp nest for the food or sell. Measures to prevent severe injury and death from wasp envenomation are included in hospital care only. Prevention measures and surveillance system of paper wasp injury should be implemented in this location and nearby, especially for health education of first aid and health promoting for all people, which is exactly lack of information for the fatal envenom report in Thailand.