# 7959
It has taken several days to be published online, but the joint statement issued by the World Health Organization and the Cambodian Ministry of health on Friday (see Cambodia: 24th H5N1 Case Of The Year (13th Fatality) has now been posted on the United Nation’s Cambodia webpage. It has yet to show up on the Cambodian MOH website.
This announcement was written on Friday, prior to the announcement of the child’s death.
The vague mention of the boy’s contact with dead poultry about a month before falling ill is a bit odd, since it is unlikely that an exposure that long ago would have caused his illness. The WHO has this to say about the incubation period of the virus:
The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around two to three days. Current data for H5N1 infection indicate an incubation period ranging from two to eight days and possibly as long as 17 days. WHO currently recommends that an incubation period of seven days be used for field investigations and the monitoring of patient contacts.
While this exposure may not represent his actual point of contact with the virus, it does serve to show that the virus may have been circulating (although no tests were conducted) in his village in the weeks prior to his illness.
24th New Human Case of Avian Influenza H5N1 in Cambodia in 2013
Joint Press Release From the Ministry of Health, Kingdom of Cambodia, and the World Health Organization (WHO)
Phnom Penh, 8 November 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 24th case this year and the 45th person to become infected with the H5N1 virus in Cambodia. The case, from Kampot province, is currently in a critical condition. Of the 45 confirmed cases, 34 were children under 14, and 27 of the 45 were female. In addition, only 12 cases out of the 24 cases this year survived.
The 24th case, a 10-year-old boy from Sdok Thlok village, To Tung commune, Dang Tong district in Kampot province, was confirmed positive for H5N1 human avian influenza on 7th November 2013 by Institute Pasteur du Cambodge. The boy developed fever on 28th October 2013. On 29th October 2013, his parents sought treatment at a local private practitioner in the village, but his condition worsened. The boy was admitted to Kantha Bopha Hospital, Phnom Penh, on 7th November 2013 with fever, cough, sore throat, a distended abdomen and dyspnea. Laboratory samples were taken on 7th November 2013 and Tamiflu administered the same day.
Investigations in Sdok Thlok village by the Ministry of Health’s Rapid Response Teams (RRT) and the Ministry of Agriculture, Forestry and Fishery’s Animal Health Task Force revealed that about a month before the 10-year-old boy’s illness, about 30 chickens had died suddenly in his village. The boy helped carry dead chickens for his brother who was preparing a meal from them. The Ministry of Health’s RRTs and the Ministry of Agriculture, Forestry and Fishery’s Animal Health Task Force are working together closely in Sdok Thlok village, in Kampot, to investigate and implement control measures. The RRTs are trying to identify the case’s close contacts, any epidemiological linkage among the 24 cases and initiate preventive treatment as required. The Animal Health Task Force is investigating cases of poultry deaths in the village.
"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. There have been 24 cases of H5N1 infection in humans this year. Children often care for domestic poultry by feeding them, cleaning pens and gathering eggs. Children may also have closer contact with poultry as they often treat them as pets and 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 thoroughly wash their hands with soap and water before eating and after any contact with poultry. Hands may carry the virus that cannot be seen by the naked eye. Soap cleans the virus on hands. If children have fast or difficult breathing, their parents 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.
A nationwide public health education campaign using radio has been launched in early October. Also, public health education campaigns are being conducted in Sdok Thlok village, Kampot province,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 with soap and water, before eating and after coming into contact with poultry; 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.
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
