Friday, February 08, 2013

Cambodia Reports 6th H5N1 Case of 2013



# 6915


Overnight Crof at Crofsblog and the newshounds at FluTrackers (see thread) carried early word of the 6th Cambodian H5N1 case of 2013 (and the fifth fatality).  All of the reports this year have come from 4 provinces in the extreme southern part of that nation.


Here is the official report published on the World Health Organization s Western Pacific Office website, after which I’ll return with a bit more.



Sixth New Human Case of Avian Influenza H5N1 in Cambodia in 2013

Joint news release of the Ministry of Health of the Kingdom of Cambodia and World Health Organization

Ministry of Health of the Kingdom of Cambodia

WHO epidemiologists interview villagers in Snao commune, Prey Kabass district, Takeo Province.

PHNOM PENH, 8 February 2013 - The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that one new more case of avian influenza has been confirmed positive for the H5N1 virus.


The sixth case is a a 5-year-old girl from Angk Krasang village, Prey Lvea commune, Prey Kabass district in Takeo province has been diagnosed with H5N1 influenza on 7th February 2013 by Institut Pasteur du Cambodge. She developed symptoms on 25th January 2013 with fever, cough, and vomiting. She was initially treated by local private practitioners. Her condition worsened and she was admitted to Kantha Bopha Hospital on 31st February with fever, cough, and dyspnoea. Unfortunately, despite intensive medical care, she died on 7th February. There is evidence of recent deaths among poultry in the village and the girl had history of coming into contact with poultry prior to becoming sick. The girl is the twenty-seven person in Cambodia to become infected with H5N1 virus, and the sixth person this year and the twenty-four person to die from complications of the disease. Of all the twenty seven cases, 18 were children under 14, and eighteen of the twenty seven confirmed cases occurred in females.


"Avian influenza H5N1 is still a threat to the health of Cambodians. This is the sixth case of H5N1 infection in human in early this year, and children still seem to be most vulnerable. I urge parents and guardians to keep children away from sick or dead poultry, discourage them from playing in areas where poultry stay and wash their hands often. If they have fast or difficulty breathing, they should be brought to medical attention at the nearest health facilities and attending physicians be made aware of any exposure to sick or dead poultry." said HE Dr. Mam Bunheng, Minister of Health.


The Ministry of Health's Rapid Response Teams (RRT) have gone to the hospital and the field to identify the girl’s close contacts, any epidemiological linkage among the six cases and initiate preventive treatment as required. In addition, public health education campaign is being conducted in the village to inform families on how to protect themselves from contracting avian influenza. The government's message is - wash hands often; keep children away from poultry; keep poultry away from living areas; do not eat sick poultry; and all poultry eaten should be well cooked.


H5N1 influenza is a flu that normally spreads between sick poultry, but it can sometimes spread from poultry to humans. Human H5N1 Avian Influenza is a very serious disease that requires hospitalization. Although the virus currently does not easily spread among humans, if the virus changes it could easily be spread like seasonal influenza. Hence, early recognition of cases is important.


Globally since 2003, there have been 616 laboratory confirmed cases of avian influenza with 365 related deaths.


The Ministry of Health will continue to keep the public informed of developments via the MoH website where relevant health education materials can also be downloaded.



Despite seeing 6 human infections in a matter of just a few weeks in Cambodia, there are no indications of person-to-person spread of the virus.  Each case has been plausibly linked to poultry exposure.


While the upcoming Lunar New Year’s is not an official national holiday in Cambodia (Cambodians celebrate a Khmer New Years in April), many people in Cambodia take part in the celebrations anyway. 


As I wrote last month in Health Vigilance For The Chinese New Years, this is a time across much of Asia where hundreds of millions of people are on the move, travelling to visit their families and to partake in a traditional family meal.


This annual return to one’s home -called Chunyun, or the Spring Festival travel season - begins about 15 days before the Lunar New Year and runs for about 40 days total.  


This year, the Lunar New Year will be observed across most of Asia between February 9th – 12th.


During this time, the transportation and consumption of poultry – some of which may carry the H5N1 virus - goes up as well, leading to a greater chance of human exposure. 


Earlier this week, the Ministry of Agriculture and Rural Development (MARD) in neighboring Vietnam issued a warning on bird flu risks during this New Year’s Holiday. 


This from Vietnam Bridge.



Bird flu recurs, urgent warning released

VietNamNet Bridge – The Ministry of Agriculture and Rural Development (MARD) has issued an urgent warning of bird flu after the deadly disease was recently detected in Tay Ninh Province.

At a February 5 meeting in Hanoi, the National Steering Committee for Bird Flu Control reported that bird flu recurred in Tay Ninh in late January, with outbreaks found at two farms in Ben Cau District and Tay Ninh Town.


The total number of dead, sick, and culled birds amounted to nearly 3,500, according to the Animal Health Department under the MARD.


Tay Ninh borders Cambodia where four out of five A/H5N1 human cases were confirmed dead in January 2013.


It is dangerous that all the four dead cases live in areas that share borders with Vietnamese localities.


There is growing concern about a recurrence of bird flu when large amounts of chickens are used for meat during the lunar New Year (Tet) holiday.

(Continue . . . )



The good news, so far at least, is that the H5N1 bird flu virus remains primarily an avian-adapted virus.  It only rarely infects humans, and human-to-human transmission is even rarer still.


Still, the concern remains that given enough opportunities, this virus might better adapt to human physiology and become more efficient in transmitting between people.


So we watch outbreaks such as we are now seeing in Cambodia with great interest, as we look for signs of changes in the virus.

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