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Cambodia continues to report the most human H5N1 infections this year, adding two more cases in a joint statement issued by their MOH (Ministry of Health) and the World Health Organization, posted on the Cambodian CDC website today.
Although nowhere near the global leader for human H5N1 infections (a dubious honor still held by Indonesia), since 2011 Cambodia has seen an abrupt rise in the number of reported cases.
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 – 16 cases
Despite this sudden spike in cases, all appear to be widely scattered, and have been attributed to direct contact to infected poultry. There are no indications of human-to-human spread of the virus.
Battambang Province – Credit Wikipedia
While the rest of the cases reported this year in Cambodia have all come from the southern provinces – one of today’s cases comes from Battambang Province in the country’s northwest - along the border with Thailand.
Here are some excerpts from the joint Cambodian-WHO statement.
15th and 16th New Human Cases of Avian Influenza H5N1 in Cambodia in 2013
13 August 2013The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that two more new human cases of avian influenza have been confirmed for the H5N1 virus. These are the 15th and 16th cases this year and the 36th and 37th persons to become infected with the H5N1 virus in Cambodia. Of the 37 confirmed, 26 were children under 14, and 22 of the 37 were female. In addition, only 7 cases out of the 16 cases this year survived.
The 15th case, a 9-year-old boy from Damnak Dangkor Village, Raing Kesey commune, Sang Ke district in Battambang province was confirmed positive for human H5N1 avian influenza on 9th August 2013 by Institut Pasteur du Cambodge.
The boy developed fever and vomiting on 26th July. He was given home-treatment by a health centre staff. On 2nd August, his condition became worse and his parents took him to a private clinic in Battambang. The private clinic referred him to the Battambang Provincial Hospital the same day. On 4th August, he was transferred to the Jayavarman V11 Hospital in Siem Reap with fever, cough, vomit, abdominal pain and dyspnea and treated with Tamiflu on 9th August. The boy is currently in a stable condition. There were recent deaths among chickens and ducks in the village. The boy carried dead and sick ducks and chickens from a cage for food preparation by his sister before he became sick.
The 16th case, a 5-year-old girl from Knong Prek Village, Prek Koy commune, Saang districk in Kanda province was confirmed positive for human H5N1 avian influenza on 10th August 2013 by Institut Pasteur du Cambodge.
The girl developed fever on 1st August and her parents first sought treatment for her at the health center. On 2nd August she was taken to a private clinic. Her condition worsened and she was admitted to KanthaBopha Hospital on 9th August with fever, cough, sore throat, abdominal pain, diarrhea, and dyspnea. The girl was treated with Tamiflu on 10th August and is currently in critical condition. There were recent deaths among poultry in her village.
Although it has been largely supplanted in the media by the more active H7N9 virus and MERS coronavirus in recent months, the H5N1 virus is still endemic in some regions of the world, occasionally jumps to humans, and is still regarded as posing a potential pandemic threat by the World Health Organization.
For now, H5N1 remains primarily a threat to poultry, and to a far lesser extent, people who come in close contact with infected birds. Countries most affected include Indonesia, Egypt, China, Nepal, India, Bangladesh, and Cambodia.
The virus remains poorly adapted to human physiology, and despite ample opportunities over the past 15 years to infect 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.
