IRIN (Integrated Regional Information Networks)was founded in 1995, and is part of the UN Office for the Coordination of Humanitarian Affairs. While technically a part of the UN, it maintains editorial independence, and its reports do not necessarily reflect the views of the United Nations and its agencies, not its member states.
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UPDATED : We now have a second news source on this story VOA News On 4th Cambodian H5N1 Case
Burying the lede just a little, a report appears in Irin News this morning on an awareness campaign on bird flu prevention in Cambodia, that bumps the number of new cases from the three we learned about on Friday (see WHO/ Cambodian MOH Statement On H5N1 Cases) to four.
Caveat: A quick scan of the Cambodian MOH and Cambodian CDC sites, and other news sources this morning, has yet to turn up confirmation of this report.
Irin News, is generally a pretty reliable source, but I would view this report with caution until we get official confirmation (see update VOA News On 4th Cambodian H5N1 Case).
The story indicates that a second case was confirmed yesterday (Jan 27th) from Kampong Speu Province, when a 17-month old girl tested positive.
We have no word on her condition, although the article continues to cite two fatal cases.
Some excerpts from the report, but follow the link to read it in its entirety. I’ll have more when you return.
Cambodian bird flu deaths prompt awareness drive
PHNOM PENH, 28 January 2013 (IRIN) - Health authorities in Cambodia will bolster public awareness campaigns on H5N1 avian influenza after four people became infected in January, resulting in two fatalities.
“Ongoing public awareness campaigns need to be reinforced through TV and radio,” Sok Touch, director of Cambodia’s Communicable Disease Control Department (CDC), told IRIN on 28 January, calling on people to be vigilant. “We’re planning on doing this immediately as there is no room for complacency.”
The four cases of H5N1 avian influenza, commonly known as bird flu, are the first confirmed in Cambodia this year. There were three recorded cases (all fatal) in 2012.
Since 2005, 24 people have been infected resulting in 21 deaths, according to WHO, with over half of the infections in children under 14.
According to a joint statement from the Ministry of Health and World Health Organization (WHO) on 25 January, an eight-month-old boy from the capital Phnom Penh recovered after being infected with bird flu, while a 15-year-old girl from southwestern Takeo Province and a 35-year-old man from southwestern Kampong Speu Province died after contracting the virus.
The CDC said the boy had contact with chickens at a market, but the girl from Takeo and the man from Kampong Speu both fell ill after cooking dead chickens gathered from their villages.
A fourth case, also in Kampong Speu, was confirmed by the Ministry of Health on 27 January, when a 17-month-old girl tested positive for H5N1.
“We are working closely with the Ministry of Health to enhance surveillance of H5N1,” said Sonny Krishnan, communications officer with WHO in Phnom Penh, adding that WHO did not know yet if there was a link between the cases of the girl and 35-year-old man.
If confirmed by the World Health Organization, this 4th reported case will make the 25th known human infection from Cambodia, 21 of which have been fatal.
How many human H5N1 infections (and deaths) have really occurred in Cambodia, and around the world, is a matter of some debate.
While the evidence for there being a lot of mild cases is sparse (see The Great CFR Divide), it does seem likely that we are missing some number of cases.
Last year, in WHO: 2012 World Health Statistics Report, we looked at the lack of disease and mortality information available from many low-resource countries.
Among low income countries, only about 1% of deaths (and their causes) are recorded, while just 34 countries – representing 15% of the world’s population – produce high quality cause-of-death documentation.
The truth is there much ambiguity regarding the true prevalence of nearly all diseases around the world.
In 2010, at a time when the WHO estimated there to be roughly 15,000 malarial deaths each year in India, a study appeared in The Lancet which claimed the real death toll was likely 10-fold higher (see Lancet: India's Invisible Malaria Burden).
Millions of people die each year around the world without ever receiving modern medical care, much less sophisticated lab testing for exotic diseases. Living in mostly rural areas of developing countries, they are often buried quickly with no cause of death identified.
So while we carefully track individual cases of H5N1 infection, we do so with the knowledge that we are probably not counting all of the cases that occur.
Although we continue to see scattered human infections around the globe, and the virus continues to evolve (see H5N1: An Increasingly Complex Family Tree), for now H5N1 is primarily a threat to poultry and to a lesser extent (in parts of Asia and the Middle East) to people who have direct contact with infected birds.
The virus remains poorly adapted to human physiology, and despite ample opportunities to cause illness in humans, only causes rare, sporadic infections.
The concern, of course, is that over time the virus will adapt further and pose a pandemic threat to humans. So we watch its progress with great interest, looking for any signs that the virus is better adapting to human hosts.
