#18,948
Three years ago an older clade of H5N1 (2.3.2.1.x) reemerged in Cambodia's population after a 9 year absence, spilling over into 6 humans in 2023. The following year, an additional 10 people were infected, and so far in 2025, we've been notified of 18 new cases (see map above).
The majority of these cases have been in children and adolescents, and sadly, roughly half have died. Contact with sick or dead poultry has often been cited as the source of infection.Unlike H5N1 cases reported in the United States - which are due to a milder clade 2.3.4.4b - recent Cambodian cases have been caused by a new reassortment of an older clade of the H5N1 virus (recently renamed 2.3.2.1e) - which appears to be spreading rapidly through both wild birds and local poultry.
Overnight the Cambodian MOH Facebook page (below) announced their latest (fatal) case, that of a 22-year-old man from the Capital, Phnom Penh. This is the first case in this series reported from the Capital district.
Unlike most of the other cases we've seen, the MOH has apparently not yet determined the source of this man's exposure.
First a (machine) translation, after which I'll have a bit more.
(Translation)
While we continue to focus on clade 2.3.4.4b H5N1 viruses, this case reminds us that there are many other incarnations HPAI H5 circulating around the globe - with new ones emerging at an increasing rate - each on their own evolutionary trajectory.Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release
Death from bird flu in 22-year-old man
The Ministry of Health of the Kingdom of Cambodia would like to inform the public: There is 1 case of bird flu in a 22-year-old man who was confirmed positive for avian influenza virus type H5N1 by the National Institute of Public Health on November 15, 2025. The patient resides in Kien Khleang Village, Chroy Changvar Sangkat, Chroy Changvar District, Phnom Penh. Despite the care and rescue efforts of the medical team, the patient died on November 15, 2025 at 9:41 am due to serious conditions including fever, cough, shortness of breath, and difficulty breathing.
The emergency response teams of the national and sub-national ministries of health have been collaborating with the provincial agriculture departments and local authorities at all levels to actively investigate the outbreak of bird flu and respond according to technical methods and protocols, find sources of transmission in both animals and humans, and search for suspected cases and contacts to prevent further transmission in the community, as well as distribute Tamiflu to close contacts and conduct health education campaigns among residents in the affected villages.
The Ministry of Health would like to remind all citizens to always pay attention to and be vigilant about bird flu because 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 discharge, or difficulty breathing and have a history of contact with sick or dead chickens or ducks within 14 days before the start of the symptoms, do not go to gatherings or crowded places and seek consultation and treatment at the nearest health center or hospital immediately. Avoid delaying this, which puts you at high risk of eventual death.
How it is transmitted: H5N1 bird flu is a type of flu that is usually spread from sick birds to other birds, but it can sometimes be spread from birds to humans through close contact with sick or dead birds. Bird flu in humans is a serious illness that requires prompt hospital treatment. Although it is not easily transmitted from person to person, if it mutates, it can be contagious, just like seasonal flu.
Address: Lot No. 80, Samdech Pen Nut Street (289)
Sangkat Boeung Kak 2, Khan Toul Kork, Phnom Penh
Phone: (+855) 23 885 970
Email: info@moh.gov.kh
Website: www.moh.gov.kh
Telegram: t.me/MOHCambodia
This week's first report of a human H5N5 case in the United States, 2024's report of an H5N2 case in Mexico, and a small but rising number of clade 2.3.2.1a infections in humans and cats India/Bangladesh continue to illustrate HPAI H5's ability to evolve and diversify.Even if we get lucky, and H5Nx faces some type of insurmountable species barrier (see Are Influenza Pandemic Viruses Members Of An Exclusive Club?), nature's laboratory is open 24/7, and new emerging threats are inevitable (see Sci. Advances: Assessing the Risk of Diseases with Epidemic and Pandemic Potential in a Changing World).
