# 7974
Although we picked up an FAO EMPRES-i report on these cases two days ago (see H5N1: Watching Cambodia Again), this morning the Cambodian Ministry of Health has posted a joint statement (with the World Health Organization) detailing their 25th and 26th H5N1 case of the year.
The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that two new human cases of avian influenza have been confirmed for the H5N1 virus. These are the 25th and 26th cases this year and the 46th and 47th people to become infected with the H5N1 virus in Cambodia.
Case 25 is from Kampong Speu province and case 26 was from Pailin province. The Kampong Speu case is currently in a critical condition whereas the Pailin case has died. Of the 47 confirmed cases, 35 were children under 14, and 27 of the 47 were female. In addition, only 13 cases out of the 26 cases this year survived.
The 25th case, a 3-year-old boy from Veal Vong village, Sendey commune, Samrong Tang district, Kampong Speu province, was confirmed positive for H5N1 human avian influenza on 9"November 2013 by Institut Pasteur du Cambodge. The boy had onset fever on 5th November 2013, his parents sought treatment at a local private practitioner on 6th November, but his condition worsened.The boy was admitted to KanthaBopha Hospital, Phnom Penh, on 8th November 2013 with fever, cough, and dyspnoea. Laboratory samples were taken on 8th November and Tamiflu administered the same day.The 26' case, a 29-year-old male from KaunDemrei village, SteungTrang commune, Salakrao district, Pailin province, was confirmed positive for H5N1 human avian influenza by Institut Pasteur du Cambodge on 9th November 2013. The man had onset fever, chills and headache on 26' October 2013 where he sought treatment at the local health centre. Treatment was provided to the case at a private clinic on 1st November until his condition continued to deteriorate. On 3rd November the case was admitted to Battambang Provincial hospital with fever, chills, headache, cough, chest pain. Laboratory samples were taken and Tamiflu was administered on 6th November. He continued to deteriorate with further symptoms of diarrhoea, vomiting, and seizures; he died at the hospital on the 6 th November.
Epidemiological investigations by the RRT and MAFF revealed that the case had direct contact with sick and dead poultry one week prior to illness onset. During the investigation multiple influenza like illness cases were detected in the village; laboratory testing of those cases to date indicated human influenza A/H1N1.The Ministry of Health's RRTs and the Ministry of Agriculture, Forestry and Fishery's Animal Health Task Force are working together closely inboth villages to investigate and implement control measures. The RRTs are trying to identify the case's close contacts, any epidemiological linkage among the 26 cases and initiate preventive treatment as required.The Animal Health Task Force is investigating cases of poultry deaths in
the village.
This makes five cases reported out of Cambodia over a period of a little more than two weeks.
Since these cases have all come from different provinces, it makes it likely that these are sporadic transmissions from birds or the environment rather than a sign of increased human-to-human transmission.
2005 – 4 cases 2010 – 1 case
2006 – 2 cases 2011 – 8 cases
2007 – 1 case 2012 - 3 cases
2008 – 1 case 2013 – 26 cases
2009 – 1 case
For now, H5N1 remains poorly adapted to humans - only rarely being passed from one person to another - and is primarily a threat to poultry.
But when we see upticks in human cases like this one, it is a reminder that emerging influenza viruses are an ongoing threat, and that we need to watch them closely for any signs that they may be becoming better adapted to humans.
