#18,756
Normally, Cambodia announces H5N1 cases within hours of their confirmation, but today we have the belated announcement of a case from a month ago, involving a 65 year-old woman from Takeo province who reportedly tested positive on May 12th, and remains under medical care.
This is the 5th case reported by Cambodia in 2025, and the first non-fatal outcome of the year.
Unlike many previous case reports, the patient did not have contact with sick or dying poultry, and none were reported in her village.
The announcement (see screen shot below) was made on the Cambodian MOH Facebook page. I've provided a translation (emphasis mine).
Ministry of Health
Kingdom of Cambodia Nation Religion King
Press Release on
Avian Flu Case in 65-Year-Old Woman
The Ministry of Health of the Kingdom of Cambodia would like to inform the public that there is 1 case of avian flu in a 65-year-old woman and was confirmed positive for the H5N1 avian influenza virus by the Pasteur Institute of Cambodia on May 12, 2025, residing in Kraing Ampil Village, Taing Yap Commune, Prey Kabas District, Takeo Province. The patient has symptoms of fever, cough, shortness of breath, and difficulty breathing. The patient is currently receiving careful medical care from the medical team.
While the clade of this infection has not yet been specified, recent cases in Cambodia and Vietnam have stemmed from a resurgent older, and more virulent, clade (formerly clade 2.3.2.1c but recently redubbed as 2.3.2.1e).Investigations showed that the patient had not come into contact with sick or dead chickens. The patient's neighbor's house next to the patient's house has 10 family chickens, but no chickens are sick or dead, and there are no sick or dead chickens in the village where the patient lives.
The emergency response team of the Ministry of Health at the national and sub-national levels has been collaborating with the teams of the provincial departments of agriculture and local authorities at all levels to actively investigate the outbreak of bird flu and respond according to technical methods and protocols, continue to search for sources of infection in both animals and humans, continue to search for suspected cases and contacts to prevent further transmission to others in the community, and distribute the medicine Tamilu to close contacts and conduct a health education campaign for citizens in the villages where the incident occurred.
The Ministry of Health would like to remind all citizens to always pay attention to bird flu because the H5N1 bird flu continues to threaten the health of our citizens. We would also like to inform you that if you have a fever, cough, sputum or difficulty breathing and have a history of contact with sick or dead chickens in the 14 days before the start of the outbreak, do not go to crowded places or towns and seek consultation and treatment at the nearest health center or hospital immediately, avoiding delay, which puts you at high risk of eventual death.
Of the 21 Cambodian cases reported since early 2023, only 5 have been in adults and 4 of those survived. But among the 16 children and adolescents infected - while several had mild symptoms - most were severe and half (n=8) have died.
Over the past 20+ years, H5N1 has taken a disproportionately heavy toll on younger individuals, a topic we've revisited often (see Nature Comms: Immune history shapes human antibody responses to H5N1 influenza viruses).
The lack of poultry exposure - or sick birds in the village - is a bit of a red flag, but the absence of additional cases over the past month is reassuring.
This case reminds us, however, that there are numerous iterations of HPAI H5 viruses circulating around the globe - with new ones emerging at an increasing rate - each on their own evolutionary trajectory.
While most won't ever rise to the level of being a pandemic threat, it only takes one lucky overachiever to change our world overnight.
