# 7441
Yesterday, via media reports, we learned of Cambodia’s 13th H5N1 case of the year (see Cambodia Reports 9th H5N1 Fatality Of 2013), that of a young girl who died last week.
Today we have the World Health Organization (WPRO) / Cambodian MOH joint release statement on this latest case, along with details of two retrospectively identified cases - #11 that we learned about in late May (see H5N1: Cambodia Finds A Retrospective Case) – and the elusive #12 we’ve been missing until now.
Although nowhere near the leader for human H5N1 infections (a dubious honor still held by Indonesia), 2013 has seen a steep rise in human infections with the H5N1 virus in Cambodia.
2005 – 4 cases 2009 – 1 case
2006 – 2 cases 2010 – 1 case
2007 – 1 case 2011 – 8 cases
2008 – 1 case 2012 - 3 cases
2009 – 1 case 2013 - 13 cases
So far, all of the cases this year appear to be widely scattered, and are attributed to direct contact to infected poultry. There are no indications of human-to-human spread of the virus.
13th 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 Cambodia/WHO
PHNOM PENH, 2 July 2013 - The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that one more new human case of avian influenza has been confirmed positive for the H5N1 virus. This is 13th case this year and the 34th person to become infected with the H5N1 virus in Cambodia. Of the 34 confirmed cases, 23 were children under 14, and 21 of the 34 were female. In addition, there were only 4 cases out of 13 cases this year survived.
The 13th case, a six-year-old girl from Preyleu village, Bantheay Meas commune, Bantheay Meas district in Kampot province was confirmed positive for human H5N1 avian influenza on 28th June 2013 by Institut Pasteur du Cambodge. She developed fever and headache on 24th June. On 26th June her condition worsened with cough and dyspnea and she was taken to a private clinic. On 28th June, the girl was admitted to Kantha Bopha Hospital with fever, dyspnea and cough. In Kantha Bopha Hospital, the girl was treated with Tamiflu but died later in the night.
There have been recent poultry deaths in the village and the girl was likely to be exposed to sick and dead poultry before she became sick.
The 11th case, a five-year-old girl from Tep Rom village, Veal Ponn commune, Thpong district in Kampong Speu province tested positive for influenza A (H1N1) on 30 January 2013. After random retrospective re-testing of samples, it was confirmed on 2nd May that the girl was also infected with the H5N1 human avian influenza virus. The girl has recovered.
The 12th case, a 58-year-old man from Sangkat Chroy Chorng Va, Khan Roeusey Keo, Phnom Penh, tested positive for influenza on 9 January 2013. After routine retrospective testing of samples, it was confirmed on 21st June that the man was also co-infected with the H5N1 human avian influenza virus. He was discharged from the Khmer-Soviet Friendship Hospital and has recovered.
"Avian influenza H5N1 remains a serious threat to the health of all Cambodians. This is the 13th case of H5N1 infection in humans this year. Children also seem to be most vulnerable and are at high risk because they like to play where poultry are found. I urge parents and guardians to keep children away from sick or dead poultry and prevent them from playing with chickens and ducks. Parents and guardians must also make sure children wash their hands with soap and water after any contact with poultry. If they have fast or difficult breathing, they should seek medical attention at the nearest health facility and attending physicians must be made aware of any exposure to sick or dead poultry,” said H.E. Dr. Mam Bunheng, Minister of Health.
The Ministry of Health's Rapid Response Teams (RRT) are currently in the village to identify the girl’s close contacts, any epidemiological linkage among the 13 cases and initiate preventive treatment as required. In addition, a 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 dead or 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 632 laboratory confirmed human cases of H5N1 avian influenza with 376 related deaths.
The Ministry of Health will continue to keep the public informed of developments via the MoH website www.cdcmoh.gov.kh where relevant health education materials can also be downloaded.
For more information on human influenza please call the MoH Influenza Hotline numbers: 115 (free call); 012 488 981 or 089 669 567
Although it has taken a backseat to the more active H7N9 virus and MERS-CoV over the past few months, the H5N1 virus is still regarded as a potential pandemic threat by the World Health Organization.
For now, bird flu remains primarily a threat to poultry. The virus remains poorly adapted to human physiology, and despite ample opportunities to cause illness in humans, the virus 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.
