#18,219
For the third time in the month of July, and the 14th case over the past 18 months, Cambodia's Ministry of Health is reporting a new H5N1 case, this time in a 4 y.o. boy from Svay Rieng Province.
All of the cases reported in Cambodia to date have been from an older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b which has spread across much of the rest of the world.
The following announcement was posted on the MOH's facebook page earlier today (translation follows).
Kingdom of Cambodia, Nation, Religion, King *
Ministry of Health
Press Release on Avian Influenza Cases in 4-Year-Old BoysThe Ministry of Health would like to inform the public that there was one case of bird flu in a 4-year-old boy and that it was confirmed as H5N1 bird flu virus from the National Institutes of Public Health and the Institut Pasteur. On July 30, 2024, living in Chrung Popel village, Meam commune, Romeas Hek district, Svay Rieng province. The boy had a fever, a cough, tiredness, difficulty breathing and drowsiness. At present, the patient's condition has improved and he is receiving intensive care by doctors.According to the interrogation, about 12 days before the onset of illness in the village and at home, the patient had a large number of dead chickens and flowed and brought food to eat, the boy touched and held the dead chickens and liked to play With chicken and duck.
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 people to always pay attention to bird flu because H5N1 bird flu continues to threaten the health of our people and also would like to inform you if you have a fever, cough. Sneezing or shortness of breath and a history of contact with sick or dead chickens during the 14 days before the onset of symptoms, do not go to crowded places or towns and seek consultation and treatment at the local level. Health nearest you as soon as possible.
Transmission: H5N1 bird flu 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 sick or dead birds. 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: Wash your hands often with soap and water before eating and after contact with birds. Keep children away from birds and birds away from living. Do not eat sick or dead birds and all birds. Made for eating, must be cooked well.
The Ministry of Health will continue to inform the public about information related to the problem.
Public health 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.For more information, please contact the Ministry of Health Hotline 115 for free.
Of the 14 H5N1 cases reported by Cambodia over the past 18 months, only 3 have been in adults and all of them survived. Among the 11 children infected - while several had mild symptoms - nearly half (n=5) have died.
We've seen this affinity of H5N1 to preferentially infect younger people often over the years, although the reasons behind it are poorly understood.
One possibility we've explored, however, is that your first flu exposure may affect your future response to novel flu viruses (see Science: Protection Against Novel Flu Subtypes Via Childhood HA Imprinting).
H5 is an HA Group type 1 while H7 viruses fall in group 2.
- Those born prior to the mid-1960s were almost certainly first exposed to Group 1 flu viruses (H1N1 or H2N2)
- Those born after 1968 and before 1977 would have been exposed to Group 2 (H3N2)
- After 1977, both Group 1 and 2 viruses co-circulated, meaning the first exposure could have been to either one.
This suggests that those born before 1968 may carry some degree of limited protection against H5 infection.
That said, any advantage of being born in the 1950s or early 1960s is probably being gradually offset by advancing age and comorbidities, and may not be as pronounced today as it was 20 years ago.
Today's report is a reminder that while we are heavily focused on clade 2.3.4.4b of H5N1, there are a number of other novel flu viruses with zoonotic potential that have pandemic potential, and deserve our attention.
