#18,339
H5N1 reports out of Cambodia have slowed the past 6 months, but for the 2nd time since the first of the year we are hearing (h/t FluTrackers) of a fatal case - this time of a toddler - and this time from Prey Veng Province.
January's fatal case involved a 28-year-old male from Kampong Cham Province.
After going 9 years without a reported case, over the past 24 months Cambodia has reported 18 cases - mostly involving children, adolescents, or young adults - with roughly 50% being fatal.
Cambodia's avian flu resurgence appears to have begun with an older (2.3.2.1c) clade of H5N1, but last April in - FAO Statement On Reassortment Between H5N1 Clade 2.3.4.4b & Clade 2.3.2.1c Viruses In Mekong Delta Region - we learned that a new genotype - made up of this older clade and the newer 2.3.4.4b clade of H5N1 - had emerged in Southeast Asia.
Last November, in Preprint: Emergence of a Novel Reassortant Clade 2.3.2.1c Avian Influenza A/H5N1 Virus Associated with Human Cases in Cambodia, we looked at an analysis of this new genotype, where the authors wrote:
In conclusion, these recurrent zoonotic infections caused by a novel reassortant A/H5N1 viruses in Cambodia serve as a reminder of the ever-present threat of AIV to global health security. Despite the recent focus on global dissemination and expanded host range of clade 2.3.4.4b 45-47 341 , clade 2.3.2.1c viruses remain a significant concern, particularly in Asia, where the two clades co-circulate.
Today's announcement was made around midnight Cambodia time, on their MOH Facebook page (see screenshot & translation below). I'll have a bit more after the break.
Ministry of Health of the Kingdom of Cambodia
News announcement on the death of bird flu on a 2 years and 7 months old boy
Kingdom of Cambodia, Nation, Religion, King
Government Press Release
The Ministry of Health of the Kingdom of Cambodia would like to inform the public that one case of bird was born in a boy aged 2 years and 7 months and was confirmed positive for H5NL virus from the National Institute of Public Health on February 25, 2020 in Ta Ngok village, Romchek commune, Preah Sdach district, Prey Veng province. Despite the care and medical attention of the children, the child died on February 25, 2025, when the parents arrived at the hospital, causing the child to have serious conditions, including fever, cough, fatigue and severity. According to the investigation, the patient's house has 15 family chickens and devils, some are sick and the children are sleeping and playing under the house near the chicken coop.
It is not easily transmitted from person to person, but if it can be metabolized, it can be transmitted like the common cold.
How to prevent:
Do not touch or eat sick or dead chickens and wear gloves and a mask or tie a scarf, hold chickens, cook them and soak them in boiling water before plucking. Wash your hands often. Do not accept duck or duck eggs and keep raw and cooked foods separate, clean cooking utensils properly.
If there are many sick or dead chickens at home or in the village and have a fever, cough, runny nose, shortness of breath, seek immediate consultation and treatment at the nearest center or hospital to avoid delaying the risk of eventual death.
Therefore, the public is kindly requested to know and take care of health in the above prevention. The Ministry will continue to provide information on public health issues through the Ministry of Health's National and Sub-National Emergency Response Network and the Ministry of Health, as well as the official Facebook pages of the Department of Infectious Diseases and the working groups of the Provincial Department of Agriculture and local authorities at all levels conducting research at dcmoh.gov.kh.
Outbreaks appear to be exacerbated during animal and human transmission, and continue to search for suspected and affected cases in the community, as well as distribute Tamiflu to those affected, educating and educating the people in the affected villages.
For more information, please contact the hotline of the Ministry of Health! Free.
The Ministry of Health would like to remind all people to be careful about bird flu because H5N1 bird flu continues to threaten our people and also to inform you if you have a fever, cough, shortness of breath and have a history of contact with sick or dead chickens during the 14 days before the day, do not go to a crowded hospital or seek medical attention. Avoid delaying the high risk of eventual death.
Transmission: H5N1 bird flu is a common flu that is usually transmitted from one bird to another, but it can sometimes be transmitted from bird to human through close contact with birds.
Tuesday, 13 Roch Khemak, Rong Chhasak, B.E.
Ministry of Health
Address: Lot 180 in (289), Sangkat Boeung Kak II, Khan Toul Kork, Phnom Penh.
Tel: -855) 23 888 9
Of the 18 H5N1 cases reported by Cambodia over the past 24 months, 4 have been in adults and 3 of them survived. Among the 14 children infected - while several had mild symptoms - most were severe and half (n=7) have died.
Although Cambodia continues to do an admirable job of reporting hospitalized cases, it is entirely possible that some milder infections are going unreported. Severe or critical cases are far more likely to be hospitalized, tested, and confirmed as H5N1 positive.H5's well known predilection for the young is a topic we've revisited many times over the years, including in last November's Preprint: Immune History Shapes Human Antibody Responses to H5N1 Influenza viruses.
While we are understandably focused on H5N1 clade 2.3.4.4b - clade 2.3.2.1c in Cambodia, the recently imported (ex India) clade 2.3.2.1a case in Australia, and > 90 H5N6 cases in China - remind us that HPAI H5 continues to evolve along multiple concurrent pathways.
