# 7595
On Wednesday (see Xinhua News: 17th Cambodian H5N1 Case This Year) we saw a brief news report on Cambodia’s latest avian flu infection, but details were sparse.
Yesterday the World Health Organization’s WPRO published a joint statement with the Cambodian Ministry of Health, that provides more details on the case, along with the steps being taken to combat this virus.
While its likely we aren’t getting comprehensive reporting from all of the H5N1 endemic countries around the globe (due to censorship, lack of surveillance, and/or political turmoil), Cambodia – increasingly over the past three years – has grown to become a hotspot for human H5 infection.
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 – 17 cases
Of the 27 cases reported globally this year, Cambodia has reported 17 of them (63%). Unknown, of course, is how accurately this depicts the total burden of the disease in Cambodia (or around the world).
This from the WHO/Cambodian MOH.
Seventeenth case of avian influenza H5N1 in Cambodia in 2013
Joint news release between the Ministry of Health of the Kingdom of Cambodia and the World Health Organization
WHO Cambodia
Improper transport of poultry risks the spread of the H5N1 virus.
22 August 2013 - The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that one new human case of avian influenza has been confirmed for the H5N1 virus. This is the 17th case this year and the 38th person to become infected with the H5N1 virus in Cambodia. Of the 38 confirmed, 27 were children under 14, and 22 of the 38 were female. In addition, only 7 cases out of the 17 cases this year survived.
The 17th case, a 6-year-old boy from Prey Tathuk Village, Prek Sleng commune, Kandal Stung district in Kandal province confirmed positive for human H5N1 avian influenza on 17th August 2013 by Instiut Pasteur du Cambodge. The boy developed fever on 21st July and his parents tried to treat him with medicine purchased from a drug store in the village. His condition worsened and he was brought to the Beung Khyang Health Centre on 22nd July with fever, headache, abdominal pain, vomiting, cough and lethargy. On 23rd July, the boy was enrolled in an Acute Febrile Illness Surveillance (FSS) study, in Kandal, and samples were collected from him. Initial testing in the surveillance study indicated a possible H5N1 infection. On 16th August, the boy’s samples were sent in a batch to Instiut Pasteur du Cambodge for testing of H5N1. The boy has now recovered. The boy came into contact with sick poultry.
"Avian influenza H5N1 remains a serious threat to the health of all Cambodians and more so for children, who seem to be most vulnerable and are at high risk. This is the 17th case of H5N1 infection in humans this year. Parents and guardians must take special care to make sure their children are not playing with poultry, or in any areas that may be contaminated with poultry faeces, or feathers or liquid wastes. 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 Prey Tathuk Village in Kandal to identify the boy’s close contacts, any epidemiological linkage among the 17 cases and initiate preventive treatment as required. In addition, a public health education campaign is being conducted in the village using information, education and communications materials 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.
While we have been preoccupied this summer with H7N9, MERS-CoV, and even a new strain of H7N7 (see Nature: Genesis Of The H7N9 Virus) – H5N1 remains a legitimate concern.
It is endemic in a number of countries (China, Egypt, Nepal, India, Bangladesh, Indonesia, Egypt, Cambodia, Vietnam, et al.), it kills large amounts of domesticated poultry each year, and it occasionally jumps to human hosts.
Most importantly, the virus continues continues to evolve.
Which is why the World Health Organization warns that the H5N1 virus still retains pandemic potential.
The current WHO phase of pandemic alert for avian influenza A(H5N1) is: ALERT
Alert phase: This is the phase when influenza caused by a new subtype has been identified in humans. Increased vigilance and careful risk assessment, at local, national and global levels, are characteristic of this phase. If the risk assessments indicate that the new virus is not developing into a pandemic strain, a de-escalation of activities towards those in the interpandemic phase may occur.
