Thursday, February 23, 2023

Cambodia: Media Reports Of An H5N1 Death (11 y.o. Child)


While I've yet to find any official word on the Cambodian Ministry of Health website, overnight numerous media sources have carried a detailed report of the recent death of a child from HPAI H5N1 in Prey Veng Province. 

Typical of the coverage overnight is this report from Xinhua News.
Cambodian girl dies of H5N1 bird flu
Xinhua, February 23, 2023

PHNOM PENH, Feb. 22 (Xinhua) -- An 11-year-old girl from southeast Cambodia's Prey Veng province had died of H5N1 human avian influenza, the Ministry of Health's Communicable Disease Control Department said Wednesday.

The girl fell ill on Feb. 16, with the symptoms of a high temperature of 39 degrees Celsius, cough and sore throat, the department said in a news release, adding that she first sought local health service, but her condition had worsened, having rapid breathing, so she was then transferred to the National Pediatric Hospital in Phnom Penh.

"On Feb. 21, the doctor took her samples for diagnosis at the National Institute of Public Health and the results came out on Feb. 22, confirming that she was positive for H5N1 bird flu, while the girl died," the news release said.

The news release called on people not to touch ill or dead poultry and if suspected of having been infected with the virus, they should consult with doctors or make a hotline call to 115.

H5N1 influenza is a flu that normally spreads between sick poultry, but it can sometimes spread from poultry to humans, according to the World Health Organization (WHO).

The WHO said from 2003 until 2014, there were 56 cases of infected humans and 37 people died in Cambodia. However, between 2015 and 2022, no humans were infected by the virus in the country. Enditem

Cambodia was once a hot spot for H5N1, and between 2005 and 2014 recorded the world's 4th highest number of human infections (n=56).   It is suspected, however, that many cases - in Cambodia and elsewhere - went unreported. 

In 2016's Sci Rpts: Intense Circulation Of A/H5N1 In Cambodian LBMs & Evidence Of Subclinical Human Infectionwe looked at a seroprevalence study conducted at four live bird markets (LBMs) in Cambodia during the height of their 2013 outbreak. 

Researchers not only found an incredibly high incidence of H5N1 infected poultry (35%), they found a plethora of other LPAI subtypes (HA1, HA2, HA3, HA4, HA6, HA7, HA9, HA10 and HA11) as well. 
Seroprevalence studies also found evidence of sub-clinical H5N1 and H9N2 infection in LMB workers. Of the 125 subjects in the study's cohort, 4.5% showed antibodies to H5N1, while 1.8% showed antibodies to H9N2.

Assuming today's case is confirmed by the WHO, this will become the 8th reported human infection since the uptick in H5N1 began 18 months ago.  

To date we've seen 4 mild/asymptomatic cases (1 in the UK, 1 in the US, 2 in Spain), along with two severe illnesses (1 Vietnam, 1 Peru), and two fatalities (1 China, 1 Cambodia).  

Given the limits of surveillance, testing, and reporting around the globe, it quite possible there have been others that have gone unreported in recent months. The good news is - so far - we've not seen any signs of clusters of infections, which could indicate human-to-human transmission. 

The bad news is, the virus keeps trying.