#17,919
Nine days after reporting their 4th H5N1 case of 2024 - a mild case in the 16-y.o. brother of the fatal 3rd case (a 9-y.o. boy, both from Kratie province), we learn of a 5th case; this time in a 17-y.o. girl who appears to be in stable improving condition from Kampot province.
Over the past 4 weeks we've seen 5 new human H5N1 infections reported out of Cambodia (see also here, and here) - which when added to 6 cases reported in 2023 - make 11 cases in the past 12 months after an absence of reports during the previous years.
All of these cases have been due to the older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4, which began spreading in earnest in early 2014 in South Korean poultry. Exactly what is behind its resurgence after nearly a decade isn't clear.
The Cambodian statement and translation on today's case follows, after which I'll have a bit more.
Translation:
Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
On
Press Release on Avian Influenza in 17-Year-Old Girl
The Ministry of Health of the Kingdom of Cambodia would like to inform the public that there is another case of bird flu in a 17-year-old girl and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute. Public health on February 20, 2024, residing in Damnak Trop Khang Tbong village, Kraing Svay commune, Chhuk district, Kampot province.
The girl had a fever, cough, tiredness, and difficulty breathing. At present, the patient's condition has improved and he is receiving intensive care by doctors. According to the survey, about 5 days before the onset of illness at home, the patient had seven dead chickens.
The National and Sub-National Emergency Response Team of the Ministry of Health has been cooperating with the working groups of the Ministry of Agriculture, Forestry and Fisheries and the Ministry of Environment, local authorities at all levels to actively investigate the outbreak of bird flu and respond. In accordance with the methods and technical protocols, continue to search for sources of transmission in both animals and humans, and continue to search for suspected and affected cases to prevent transmission to others in the community, and distribute Tamiflu to close contacts. And conduct health education campaigns for the people in the above-mentioned villages.
The Ministry of Health would like to remind all citizens to be careful about bird flu because H5N1 bird flu continues to threaten the health of our people and also would like to inform you if there are symptoms. Fever, cough, runny nose or shortness of breath and a history of contact with sick or dead chickens during the 14 days prior to the onset of symptoms, do not visit crowded places and seek consultation and examination. Get treatment at the nearest health facility as soon as possible.
Transmission: The H5N1 bird flu virus is a flu virus that is usually transmitted from sick birds to other birds, but can sometimes be transmitted from birds to humans through close contact with birds.
Who is sick or dead. Avian influenza in humans is a serious disease that requires timely hospitalization. Although it is not easily transmitted from person to person, if it can metabolize it can be as contagious as the seasonal flu.
Preventive measures: Government educational messages include: Wash hands frequently with soap and water before eating and after contact with birds, keep children away from birds and keep birds away from living, do not eat birds. Sick or dead and all birds made for eating must be well cooked.The Ministry of Health will continue to inform the public about information related to public health issues through the Telegram Channel and the official Facebook page of the Ministry of Health, as well as the official Facebook page of the Department of Infectious Diseases and the website www.cdcmoh.gov.kh, which has Health education materials that can be downloaded, viewed and used. For more information, please contact the Ministry of Health Hotline 115 toll-free.
Prior to the emergence of (the now ubiquitous) clade 2.3.4.4 in 2014, clade 2.3.2.1c managed to successfully wing its way from Asia to West Africa (see 2016's EID Journal: HPAI A(H5N1) clade 2.3.2.1c In West Africa), meaning it could conceivably spread to nations outside of Cambodia.Wednesday, May 12, 2021, Phnom Penh
The good news is, we haven't seen any evidence of sustained or efficient human-to-human transmission of H5N1, but this recent uptick in clade 2.3.2.1c infections warrants our attention.
