Cambodia reports 9 human cases of bird flu (H5N1) in 2024 - Aug 3rd, 2024 +

[tetano]

A three-year-old boy from southeast Cambodia's Prey Veng province has been confirmed for H5N1 human avian influenza, the first case of this year, the Ministry of Health said in a statement on Friday.

"The boy was confirmed positive for H5N1 bird flu virus by the National Institute of Public Health and the Pasteur Institute in Cambodia on Thursday," the ministry said. "The patient is currently receiving intensive care from a team of doctors."

Investigations from the patient's village found that chickens and ducks had died in the village and around his house about 10 days ago, the ministry said.

"A team of health experts is investigating the source of the infection and are examining any suspected cases or people who have been in contact with the victim in order to prevent an outbreak in the community," the ministry added.

Tamiflu (oseltamivir), an antiviral drug to prevent the bird flu from spreading, was also handed out to people who had direct contact with the boy, the ministry said.

H5N1 influenza is a flu that normally spreads between sick poultry but can sometimes spread from poultry to humans. Its symptoms include fever, cough, runny nose, and severe respiratory illness.

From 2003 to date, there were 63 cases of human infection with H5N1 influenza, including 41 deaths in the Southeast Asian country, according to the ministry.

https://english.news.cn/20240126/5d82a1921d5e45f5a1acfe5f0e3209c4/c.html

[Michael Coston]

Cambodia MOH Reports Another H5N1 Infection


#17,880

Overnight the Cambodian MOH posted an announcement on their Facebook page (see below) indicating that they have detected another H5N1 infection - the first of 2024 and the 7th in the past 12 months - this time in a 3 y.o. boy who is currently being treated in the ICU.



It is worth noting that this case is being reported from Prey Veng province, which reported 2 cases in 2023 (one in October and another in February). Four other cases were reported in 2023 after a 9 year hiatus.

As with the previous 6 cases, this is most likely another clade 2.3.2.1c H5N1 infection - an older lineage of avian flu which predates our current clade 2.3.4.4b epizootic.

The translation of today's announcement follows. I'll have a postscript after the break.

Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release

On Cases of bird flu in 3-year-old boys

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 3-year-old boy and was confirmed positive for H5N1 bird flu virus from the National Institute. Public Health and Institut Pasteur du Cambodge on January 25, 2024, located in Ta Bruy village, Prek Poun commune, Kampong Trabek district, Prey Veng province. The patient is currently receiving intensive care from a team of doctors. According to inquiries, about 10 days ago, there were dead chickens in the village and around the patient's house.

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, the police and partner organizations, to actively investigate the occurrence of Avian Influenza will respond to 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 the spread of the disease to others in the community, as well as distribute Tamergo. Educate the health of the people in the village where the incident took place.

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 before the onset of symptoms, do not visit crowded places or seek consultation and examination. Get treatment at the nearest health facility 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 treatment at Hospital on time. 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 education 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 for free.

Friday, January 1, 2024, Phnom Penh, January 26, 2024
Rochak King saute

Office of the Ministry of Health, Lot 80, Samdech Pen Nuth (St. 289), Phnom Penh Tel: Fax: (855-23) 885 970/884 909

While the reasons behind this sudden resurgence after 9 years remain a mystery, a recent study (see Preprint: A Timely Survey of Knowledge, Attitudes, and Practices Related to Avian Influenza (H5N1) in Rural, Cambodia) found very lax attitudes regarding avian flu among the rural population(e.g. 23% of participants cooked sick or dead poultries for their families).

Despite our recent preoccupation with HPAI H5N1 clade 2.3.4.4b, which has been spreading with remarkable speed via migratory birds for the past couple of years, HPAI H5Nx viruses remain a diverse, and evolving threat.

All of which makes this resurgence of clade 2.3.2.1c infections very much worthy of our attention.



https://afludiary.blogspot.com/2024/01/cambodia-moh-reports-another-h5n1.html

[sharon sanders]

Please see:

FluTrackers 2016+ Global H5N1 Human Cases List

[Michael Coston]

Cambodia: MOH Announces 2nd H5N1 Case of 2024




#17,883



Two days ago Cambodia reported their 1st H5N1 infection of 2024 - detected in a 3 y.o. boy in Prey Veng Province - and today their MOH has announced a 2nd case - this time in a 69 y.o. man - residing more than 150 miles to the north and west of Friday's case, in Siem Reap Province.

After having gone 9 years without reporting any H5N1 infections, this makes the 8th case to be reported by Cambodia in less than a year.

The reasons behind this recent uptick are unknown, but a recent study (see Preprint: A Timely Survey of Knowledge, Attitudes, and Practices Related to Avian Influenza (H5N1) in Rural, Cambodia) found very lax attitudes regarding avian flu among the rural population(e.g. 23% of participants cooked sick or dead poultries for their families).

As with the previous 6 cases, these two latest infections most likely stem from a clade 2.3.2.1c H5N1 virus - an older lineage of avian flu which predates our current clade 2.3.4.4b epizootic.

The translated Press Release from the Cambodian MOH follows, after which I'll return with more.

Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release
On

69-year-old man infected with bird flu

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 69-year-old man and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute of Health. Public on January 27, 2024, residing in Pbat village, Prey Chrouk commune, Puok district, Siem Reap province. The patient is currently receiving intensive care from a team of doctors. According to the survey, the patient has raised about 50-60 chickens at home and has been dying for about two weeks.

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. Respond to methods and technical protocols, continue to search for sources of transmission on both animals and humans, and continue to search for suspected cases and affected people to prevent transmission to others in the community, and distribute Tamiflu to affected people. Close and conduct health education campaign for the people in the village where the incident occurred.

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: 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 treatment at Hospital on time. Although it is not easily transmitted from person to person, if it can metabolize it can be as contagious as the seasonal flu.Cambodia:

Preventive measures: Government education 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.

This site has health education materials that can be downloaded and used. For more information, contact the Ministry of Health's hotline number 115 for free.

Days Sunday, 3 Roach Khe Bos, Chhnang Thao, Panchasak, BE 2567, Phnom Penh, January 28, 2024

So far, 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. The more times the virus spills over into humans, the more opportunities it will have to `figure us out', and better adapt to a human host.

As we've seen the past few years with clade 2.3.4.4b, the `right' reassortment or combination of antigenic changes can breathe new life into an existing lineage.

Whether that has happened with clade 2.3.2.1c remains to be seen. But this is a reminder that while we are watching one threat (H5N1 clade 2.3.4.4b), we could always get blindsided by something unexpected (e.g. H5N6, H10N3, H3N8, etc.) coming from out of left field.

https://afludiary.blogspot.com/2024/01/cambodia-moh-announces-2nd-h5n1-case-of.html

[Pathfinder]

Map of Cambodia highlighting Siem Reap
/https://en.wikipedia.org/wiki/Siem_Reap_province
-----------------------------------------------------

Cambodia records 2nd human case of bird flu so far this year

Source: Xinhua| 2024-01-28 17:59:32|Editor: huaxia

PHNOM PENH, Jan. 28 (Xinhua) -- A 69-year-old man from northwest Cambodia's Siem Reap province has been confirmed for H5N1 human avian influenza, becoming the second case of this year, the country's Ministry of Health said in a statement on Sunday.

"The man was confirmed positive for H5N1 bird flu virus by the National Institute of Public Health on Saturday," the ministry said. "Currently, the patient is receiving intensive care from a team of doctors."

"According to queries, the man had raised 50-60 chicken and the chicken had subsequently died about two weeks ago," the ministry said.
...
It was the second case of 2024 after a 3-year-old boy from southeast Prey Veng province was confirmed positive for the virus on Thursday.
...

http://english.news.cn/asiapacific/20240128/a9a33436615c4fa2823e3532249d4e8e/c.html

[sharon sanders]

Please see:

FluTrackers 2016+ Global H5N1 Human Cases List

[Shiloh]

Source: https://www.khmertimeskh.com/5014304...d-in-cambodia/

January 29, 2024
Two more bird flu cases found in Cambodia
Torn Vibol / Khmer Times

Two more persons have been diagnosed with H5N1 avian flu, a 69-year-old man residing in Prey Chrouk commune, Puok district, Siem Reap province, and a three-year-old boy in Prek Poun commune, Kampong Trabek district, Prey Veng province.

The Ministry of Health announced yesterday that they are being treated in the referral hospitals.

The Ministry said that both patients had numerous fowls at their homes, each of which perished one after the other.

The national and sub-national emergency response teams of the Ministry of Health are now investigating instances of H5N1 bird flu and searching for human and animal routes of transmission in addition to searching for suspected cases or those linked to the victims to stop the sickness from spreading throughout the community.

The Ministry of Health has also provided Tamiflu to victims and conducted health education campaigns for H5N1 bird flu...

...According to a press release issued by the Prey Veng Provincial Department of Agriculture, experts have intervened in the outbreak of bird flu in Ta Proy village, Prey Poun commune, Kampong Trabek district. They found a total of 3,764 sick and dead birds, took the birds for testing, and sprayed the backyard with disinfectants...

[Shiloh]

Source: https://www.who.int/emergencies/dise...em/2024-DON501


Disease Outbreak News

Avian Influenza A (H5N1) - Cambodia

8 February 2024


Situation at a Glance

Between 26 and 28 January 2024, the Cambodia National Focal Point (NFP) for the International Health Regulations (IHR) notified the World Health Organization (WHO) of two confirmed cases of human infection with avian influenza A(H5N1) virus. These cases were reported from Kampong Trabek district, Prey Veng province, and Puok district, Siem Reap province, Cambodia. These are the first two cases of human infection with influenza A(H5N1) reported in Cambodia in 2024. One case was detected through severe acute respiratory infection (SARI) sentinel surveillance and one by a physician at a non-SARI sentinel site. Both patients had contact with sick poultry. There is no evidence of an epidemiological link between the two cases. In December 2003, Cambodia reported an outbreak of highly pathogenic avian influenza (HPAI) H5N1 for the first time, affecting wild birds. Following this, human cases due to poultry-to-human transmission were reported sporadically until 2014, after which there was a gap until the next cases reported in 2023: two cases each were reported in February, October, and November of 2023. H5N1 infection in humans can cause severe disease, has a high mortality rate, and is notifiable under IHR (2005).
Description of the Situation

Between 26 and 28 January 2024, the Cambodia IHR NFP notified WHO of two confirmed cases of human infection with avian influenza A (H5N1) virus. These cases were reported from Kampong Trabek district, Prey Veng province, and Puok district, Siem Reap province, Cambodia.
The first case, a 3-year-old, was reported on 26 January 2024, from Kampong Trabek district, Prey Veng province. The patient developed symptoms on 13 January 2024 and was admitted to hospital on 16 January 2024 with high fever, cough and runny nose. Samples were collected at the hospital and were transported to the National Institute of Public Health for testing. There, the samples tested positive for H5N1 through quantitative reverse transcription polymerase chain reaction (RT-qPCR) on 25 January 2024 and were confirmed by the Institut Pasteur du Cambodge (IPC) on 25 January 2024. The patient had a history of exposure to backyard chickens that were found dead around the residence. A total of 14 close contacts of the case were identified and samples were collected and tested, of which none were positive for influenza.
The second case, a 69-year-old, was reported on 28 January 2024, from Puok district, Siem Reap province, Cambodia. The patient had pre-existing hypertension and had onset of symptoms on 21 January 2024, including a fever exceeding 38°C, cough, and difficulty breathing. The patient was admitted to the hospital on 23 January 2024 and tested positive for H5N1 through RT-PCR at the National Institute for Public Health on 27 January 2024. The sample was confirmed positive by additional testing at IPC on 28 January 2024. Based on the initial investigation, the patient raised domestic poultry and fighting roosters. Three chickens tested were found to be positive for influenza A(H5N1). No sampling and testing of the environment was done. Four close contacts and 39 additional contacts were identified and tested, of which one was found positive for an unrelated influenza B/Victoria lineage.
The two confirmed cases of human infection with avian influenza A (H5N1) virus have since recovered. Genome sequencing and phylogenetic analysis revealed that the HA genes of A/H5 isolates in both confirmed cases belong to clade 2.3.2.1c.
In 2023, six human cases, including four deaths, were reported from Kampot Province (n=2), Prey Veng Province (n=3) and Svay Rieng (n=1). From 2003 through 28 January 2024, a total of 64 cases of human infection with influenza A(H5N1), including 41 deaths, have been reported from Cambodia.

Epidemiology

Animal influenza viruses normally circulate in animals but can also infect humans. Infections in humans have primarily been acquired through direct contact with infected animals or contaminated environments. Depending on the original host, animal influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses.
Avian, swine, and other animal influenza virus infections in humans may cause disease ranging from mild upper respiratory tract infection to more severe disease and death. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have been reported. There have also been several detections of influenza A(H5N1) virus in asymptomatic persons. These detections were made because the individuals had exposure to infected birds as they were involved in poultry farms depopulation/decontamination procedures following reported poultry outbreaks.
Laboratory tests are required to diagnose human infection with influenza. WHO periodically updates technical guidance protocols for the detection of zoonotic influenza using molecular methods, e.g. reverse transcription polymerase chain reaction (RT-PCR). Evidence suggests that some antiviral drugs, notably neuraminidase inhibitors (oseltamivir, zanamivir), can reduce the duration of viral replication and improve prospects of survival in some cases.

Public Health Response

The Cambodia Ministry of Health's national and sub-national rapid response teams, with support from the Ministry of Agriculture, Forestry and Fisheries, and the Ministry of Environment, have been actively investigating the avian influenza outbreak in the Prey Veng and Siem Reap Provinces.
Ongoing efforts involve investigations to find sources and modes of transmission in both animals and humans. Additionally, there is a continuing search for suspected cases and contacts to prevent any possibility of onward transmission. Poultry samples have been collected and testing is ongoing.

WHO Risk Assessment

From 2003 to 28 January 2024, 884 human cases of influenza A (H5N1) infection, including 461 deaths, have been reported globally from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) were sporadic infections and have been linked to close contact with infected live or dead birds, or influenza A(H5N1) contaminated environments. These animal influenza viruses do not easily infect humans, and human-to-human transmission appears to be unusual. However, severe disease with high mortality rates can occur as a result of human infection. Given that the virus continues to circulate in poultry, particularly in rural areas in Cambodia and other countries where the virus is endemic in poultry, the potential for further sporadic human cases can be expected.
Available epidemiological and virological evidence suggests that A(H5N1) viruses have not acquired the ability to sustain transmission among humans. Therefore, the likelihood of human-to-human spread is considered low. Based on available information, WHO assesses the risk to the general population posed by this virus to be low. The risk assessment will be reviewed as needed if additional information becomes available.
Close analysis of the epidemiological situation, further characterization of the most recent influenza A(H5N1) viruses in both human and poultry populations, and serological investigations, are critical to assess associated risks to public health and promptly adjust risk management measures.
There are no specific vaccines for influenza A(H5N1) in humans. However, candidate vaccines to prevent influenza A(H5) infection in humans have been developed for pandemic preparedness in some countries. WHO continues to update the list of zoonotic influenza candidate vaccine viruses (CVV) twice a year at the WHO consultation on influenza virus vaccine composition. The list of such CVVs is available on WHO website. In addition, the genetic and antigenic characterizations of contemporary zoonotic influenza viruses are published on Global Influenza Programme (who.int).

WHO Advice

This event does not change the current WHO recommendations on public health measures and influenza surveillance.
Given reports of sporadic influenza A (H5N1) cases in humans, outbreaks in mammals, the widespread circulation in birds and the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global surveillance to detect and monitor virological, epidemiological, and clinical changes associated with emerging or circulating influenza viruses that may affect human (or animal) health, and timely virus sharing for risk assessment.
The public should avoid high-risk environments, such as live animal markets/farms, and avoid contract with live poultry or surfaces that might be contaminated by birds or poultry droppings. Additionally, it is recommended to maintain good hand hygiene with frequent washing or use of alcohol- based hand sanitizer.
The general public and at-risk individuals should immediately report instances of sick animals or unexpected deaths in animals to veterinary authorities. Consumption of poultry that are sick or have died unexpectedly should be avoided.
In countries where avian influenza is known to cause outbreaks in poultry, people who handle live poultry for consumption should wear respiratory protection/barriers during slaughtering or when handling slaughtered poultry and should seek health care immediately if they feel unwell soon after such exposure.
Any person who has had exposure to potentially infected birds or contaminated environments and feels unwell should seek health care promptly and inform their healthcare provider of their exposure.
WHO advises against implementing any travel or trade restrictions based on the current information available on this event. WHO does not advise special traveler screening at points of entry or other restrictions due to the current situation of influenza viruses at the human-animal interface.
States Parties to the International Health Regulations (2005) are required to immediately notify WHO of any laboratory-confirmed case of a recent human infection caused by a new subtype of influenza virus. Evidence of illness is not required for this notification.

[Michael Coston]

Cambodia: MOH Announces 3rd H5N1 Case of 2024




#17,901

Twelve days after reporting their second case of 2024, Cambodia's MOH has posted a statement (see below) regarding death of a 9-y.o. boy from the H5N1 virus. This time, this case was identified in Kratié Province, in the Northeastern part of the nation.





The translated statement reads:

Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release
On

9-year-old boy dies of bird flu

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 9-year-old boy and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute. Public Health on February 8, 2024, living in Kapo 1 Village, Or Russey Commune, Kratie City, Kratie Province. Despite the care and rescue of doctors, due to the serious condition of the child, including fever, shortness of breath, cough and fainting, the child died on February 8, 2024. According to the interrogation, at the patient's house, 5 chickens and 3 ducks died and the chickens and ducks were eaten.
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. Respond to methods and technical protocols, continue to search for sources of transmission on both animals and humans, and continue to search for suspected cases and affected people to prevent transmission to others in the community, and distribute Tamiflu to affected people. Close to the people in the village where the incident occurred. And health education campaign
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 before the onset of symptoms, do not visit crowded places or seek consultation and examination. Get treatment at the nearest health facility 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: 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.

Friday, February 15, 2024, Phnom Penh, February 20, 2024

This becomes the 9th case (and 5th fatality) reported by Cambodia from HPAI H5N1 in less than a year, which is the biggest 12 month total for any nation since 2015. As with the previous 8 cases, this infection is likely to be from the older 2.3.2.1c clade of the virus.

All this comes after 9 years of quiescence in Cambodia from the H5N1 virus.

Prior to the emergence of (the now ubiquitous) clade 2.3.4.4 in 2014, clade 2.3.2.1c had successfully winged its was 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 pose a threat to nations outside of Cambodia.

So far, 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.

I posted the WHO's most recent update and risk assessment on this blog yesterday.

https://afludiary.blogspot.com/2024/02/cambodia-moh-announces-3rd-h5n1-case-of.html

[sharon sanders]

Please see:

FluTrackers 2016+ Global H5N1 Human Cases List

[sharon sanders]

bump this

[Pathfinder]

Note: the MOH report posted by Michael Coston above states that the boy was 9 years old, not 10.

Translation Google

A 10-year-old boy in Kratie's Or Russey 3 commune has died of bird flu after eating a sick chicken.

09-February-2024 04:40 PM 202

Kratie Province: The H5N1 virus has claimed the life of a 10-year-old boy living in Kapo 1 Village, Sangkat Or Russey 3, Kratie City, Kratie Province, after a child brought a sick chicken to cook or eat.

Dr. Ngy Bunlen, Director of Kratie Provincial Health Department, said that this case occurred and was found to be infected with bird flu (H5N1) on a 10-year-old boy named Roeun Virun after being admitted to hospital. Kratie Provincial Referral Hospital on February 5, 2024 at 1:00 am with symptoms of fever, cough, runny nose and fatigue, and the team of doctors treated very carefully until the morning of February 8, 2024 at 7:00 am Due to the condition of the disease did not improve, the team of doctors, the emergency response team of the Department of Health researched and sent the analysis to the National Institute of Public Health: Phnom Penh and sent the patient for further treatment. At Kantha Bopha Department, Phnom Penh.

He said that the emergency response team of the Department of Health visited the patient's house for further investigation, but did not see any other suspicious cases until 20:45 pm, the Provincial Health Department received the results. The patient was positive for bird flu (H5N1) and was pronounced dead at 7:30 p.m.

On the morning of February 9, 2024, the team of Kratie Provincial Health Department, in cooperation with the Department of Agriculture, Forestry and Fisheries, with professional officers from the veterinary office, continued to investigate bird flu and sprayed in the area around the house. There is also the participation of Orussey Sangkat authorities and relevant authorities.

The Director of Kratie Provincial Health Department also requested and advised the people in the area and the public if chickens - ducks are sick or dead to be buried, please do not eat to avoid the spread of - to be cooked well and if there is a case of chickens Illness or death should be reported to the local authorities, and if people have symptoms: fever, cough, runny nose and fatigue, should be sent to the nearest health center or hospital and live clean hygiene practices.
By: Sarineth

https://www.cnc.com.kh/detail/news/49880

[Michael Coston]

Cambodia: MOH Announces 4rd H5N1 Case of 2024 (Brother of Last Case)




#17,905

Three days after reporting their 3rd H5N1 case of 2024 - a fatal infection in a 9-y.o. boy from Kratié Province - Cambodia's MOH has posted a statement (see below) regarding the apparent mild infection of his 16-y.o. brother.

Details are scant, but it seems likely this case was detected via routine testing of close contacts. The patient was described as having `no respiratory symptoms', but it isn't clear whether any other clinical signs (e.g. fever, diarrhea, etc.) were present.

H5N1 infection severity runs the gamut from severe or fatal to mild/asymptomatic. It's infamous 50% fatality rate is probably overstated, since mild or moderate cases are less likely to seek medical care, making it unlikely they will be tested, or reported.

Over the past 12 months Cambodia has reported 10 cases, of which 5 were fatal, 2 were moderately severe, and 3 were described as `mild'.

First, the original post and translation, after which I'll have a bit more.

Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release
On

Cases of bird flu in 16-year-old boy

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 16-year-old boy and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute. Public Health on February 11, 2024, living in Kapo 1 Village, Sangkat Or Russey, Kratie City, Kratie Province. The boy had no respiratory symptoms and was the brother of the boy who died on February 8, 2024.

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 before the onset of symptoms, do not visit crowded places or seek consultation and examination. Get treatment at the nearest health facility 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: Government education 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 for free.
Monday, March 3, 2067, Phnom Penh, February 12, 2024

Whenever a `cluster' of cases appears in a family, or a neighborhood, the question always arises whether it is a sign of human-to-human transmission.

When it comes to proving human-to-human (H-2-H) transmission of an emerging virus, the bar is intentionally set pretty high. When there are other, equally plausible explanations (e.g. shared environmental exposures), then H-2-H cannot be assumed.

Ten months ago, in UK Novel Flu Surveillance: Quantifying TTD, the HKHSA described some of the challenges in detecting or confirming community spread of H5N1 - even in the UK - until after dozens, or even hundreds, of cases had occurred.

In 2006, we saw several clusters of H5N1 infection in both Indonesia and Turkey, and yet, it never managed to gain enough momentum to spark a wider epidemic (see 2006 Karo Cluster Involved H2H Transmission).

A family cluster in Pakistan in 2007 raised similar concerns, but once again failed to catch fire (see EID Journal: Unraveling Pakistan’s H5N1 Outbreak).

Should we begin to see evidence of efficient and sustained H-2-H transmission (ie. 3rd, 4th, 5th generation transmission) - then things start to get considerably more concerning.


For now, that hasn't happened, and perhaps it never will. But as long as the virus is in circulation, and spilling over into humans, we can't rule out the possibility.

https://afludiary.blogspot.com/2024/02/cambodia-moh-announces-4rd-h5n1-case-of.html

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Translation Google

The Ministry of Health announces a case of bird flu infection in a 16-year-old boy in Kratie City and informs the people about preventive measures (Video inside)

2024-02-12 12:50pm


(Phnom Penh): The Ministry of Health on February 12, 2024 issued a press release on the case of bird flu (H5N1) on a 16-year-old boy living in Kapo 1 village, Orussey commune, Kratie city, Kratie province. The ministry confirmed that the boy had no respiratory symptoms and was the brother of another child who died on February 8, 2024 recently.

The Ministry of Health also advised residents to take precautionary measures to prevent the spread of bird flu, such as washing their hands frequently with soap and water before eating and after contact with birds, keeping children away from animals. Birds and keep birds away from living, do not eat the meat of sick or dead birds, all birds made for eating must be cooked well.

...

https://freshnewsasia.com/index.php/en/localnews/328321-2024-02-12-05-50-24.html

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Map of Cambodia highlighting Kampong Cham
/https://en.wikipedia.org/wiki/Kampong_Cham_province

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Translation Google

NATIONAL NEWS

Kampong Cham Veterinarians Spray Antiseptics While Suspected of Avian Influenza in Koh Sotin Commune Emerged

9 minutes ago At Monday, 12 February 2024
By And Malis

Veterinary officials of Kampong Cham province on February 10, 2024, sprayed and sprayed pesticides in village 9, Koh Sotin commune, Koh Sotin district after a suspected bird flu outbreak in this area.

After receiving the news that a family chicken farmer living in Village 9, Koh Sotin Commune, Koh Sotin District, was suffering from suffocation and fever, the Director of Production and Veterinary Office of Kampong Cham Provincial Department of Agriculture, Forestry and Fisheries, Mr. Nong Meng Heang, led the officer Experts cooperate with local authorities to spray pesticides and disseminate preventive measures in areas where there is a fear of bird flu due to the subsequent deaths of chickens and ducks. Mr. Nong Meng Heang said that the visit to the area to spray pesticides is to prevent various diseases in birds suspected of being infected with bird flu.

Residents of Village 9, Koh Sotin Commune, Koh Sotin District, expressed their happiness and warmth when they saw veterinary officers come down to spray pesticides on the back of their houses, which used to kill chickens and ducks.

In spraying pesticides to prevent bird flu in the area, veterinary officials also advertised and called on all people who raise animals, including slaughterhouses, to monitor the health of animals and clean the environment. If there is any suspicion or death of birds, they must cooperate and report to the village medical officer immediately to take joint measures to prevent this disease from spreading further.

Text and photos: Lek Chanpech

https://www.kampucheathmey.com/local-news/657060