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Map of Cambodia highlighting Tboung Khmum
/https://en.wikipedia.org/wiki/Tboung_Khmum_province
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Translation Google
After The Bird Flu Outbreak, Professional Officers Sprayed Pesticides On Farms In Tbong Khmum Province
Posted on February 14, 2024
Tbong Khmum Province: Veterinarians instructed the people and sprayed bird flu on the chicken farms of the villagers in Ou Raing Ov and Tbong Khmum districts in Tbong Khmum province on the morning of 12 and 13 February. : 2024. On February 13th, he led the staff of pesticides in Preah Theat commune in 4 villages bordering Koh Sotin district, Kampong Cham province, including: first, Tuol Khleang village, second, Boeung Kang village, third, Tuol Pnov village and fourth Trapeang Kong village. He added that in those villages, the authorities sprayed the backs of 11 houses where he raised chickens and ducks, and distributed pesticides to bird flu in two villages to 15 families. Please be informed that in relation to the recurrence of H5N1 bird flu (H5N1), the Ministry of Health has also reminded people to be constantly vigilant. If you have a fever, cough, runny nose or shortness of breath and have a history of contact with sick or dead chickens during the 14 days before the onset of symptoms, citizens should not go to gatherings or crowded towns. Seek consultation and treatment at the nearest health center as soon as possible. It should be reminded that on the afternoon of February 9, 2024, the Ministry of Health announced that a 9-year-old boy in Kratie province. Died of bird flu after the boy ate dead chickens and ducks. On February 12, the Ministry of Health issued a press release regarding the discovery of bird flu. 5 in 1 (H5N1) on another 16-year-old boy living in Kapo 1 village, Or Russey commune, Kratie city, Kratie province, after receiving certification from the National Institute of Public Health. Edited by Teang Bonry
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Cambodia MOH Reports 5th H5N1 Case of 2024
#17,919
Nine days after reporting their 4th H5N1 case of 2024 - a mild case in the 16-y.o. brother of the fatal 3rd case (a 9-y.o. boy, both from Kratie province), we learn of a 5th case; this time in a 17-y.o. girl who appears to be in stable improving condition from Kampot province.
Over the past 4 weeks we've seen 5 new human H5N1 infections reported out of Cambodia (see also here, and here) - which when added to 6 cases reported in 2023 - make 11 cases in the past 12 months after an absence of reports during the previous years.
All of these cases have been due to the older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4, which began spreading in earnest in early 2014 in South Korean poultry. Exactly what is behind its resurgence after nearly a decade isn't clear.
The Cambodian statement and translation on today's case follows, after which I'll have a bit more.
Translation:
Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
OnPress Release on Avian Influenza in 17-Year-Old Girl
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 17-year-old girl and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute. Public health on February 20, 2024, residing in Damnak Trop Khang Tbong village, Kraing Svay commune, Chhuk district, Kampot province.
The girl had a fever, cough, tiredness, and difficulty breathing. At present, the patient's condition has improved and he is receiving intensive care by doctors. According to the survey, about 5 days before the onset of illness at home, the patient had seven dead chickens.
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 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: The H5N1 bird flu virus 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 birds.Who is sick or dead. 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.Wednesday, May 12, 2021, Phnom Penh
Prior to the emergence of (the now ubiquitous) clade 2.3.4.4 in 2014, clade 2.3.2.1c managed to successfully wing its way 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 spread to nations outside of Cambodia.
The good news is, 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.
https://afludiary.blogspot.com/2024/...1-case-of.htmlAll medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.Comment
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Cambodia H5N1 Case Map & Timeline (2023-2024)
#17,920
Today's report of a 5th H5N1 case in Cambodia in less than a month demonstrates that even after going early a decade without a human case, older disease threats can still stage a comeback. A reminder that old scourges like SARS-CoV, MERS-CoV, and even avian H7N9 could someday regroup and threaten public health.
I've put together a map showing the locations and the timeline of Cambodian cases over the past 12 months, one which shows that infections have been spread across 5 provinces, with most of the cases reported from 3 southern provinces (Kampot, Prey Veng, and Svay Rieng).
Even more striking, the first two cases were reported in February of 2023, which were followed by nearly 10 months without a case. In October 2 more cases were reported, followed by another two in November.
While December was quiet, we've seen 5 cases reported since the 4th week of January.
This acceleration in cases isn't totally unexpected, as avian flu transmission tends to increase during the winter months. Of course, winter is a relative thing, and in Cambodia January daytime temperatures still often reach the 90s.
Last October we looked at a Preprint: A Timely Survey of Knowledge, Attitudes, and Practices Related to Avian Influenza (H5N1) in Rural, Cambodia, which was published just before the 3rd and 4th cases were announced in 2023, which examined some of the common practices in this part of the world which can increase the risks of H5N1 infection.
More than 200 (n=208) participants from Prey Veng province were invited to be interviewed face-to-face on their knowledge, attitudes, and practices related to avian influenza.
Although this study was limited both in number of participants, and geographic scope, it is probably fairly representative of the practices of tens, or even hundreds, of millions of people living in this part of the world.
We've seen many of the practices described before, including the consumption or improper disposal of dead poultry, often in connection with H5N1 spillovers.
Convincing people that something they have been doing for generations - like raising chickens in their backyard, or buying live poultry at bird markets - could suddenly be dangerous can be a hard `sell'.
We've seen similar (and often bitter) resistance to the notion that beloved camels in Saudi Arabia could carry a new, deadly coronavirus (seeSaudi Camel Owners Threaten Over MERS `Slander’).
Over the past few years, fur farms around the the world are suddenly viewed as potential `flu factories' (see PNAS: Mink Farming Poses Risks for Future Viral Pandemics), while some pet owners have had consider the possibility that their companion animals may be at risk from avian flu in the outdoor environment.
As the level of H5N1 (and other zoonotic viruses) continue to increase around the world, we find ourselves living in a `new normal', where old practices and traditions may need to be reconsidered and modified if we hope to reduce the risk of future outbreaks.
https://afludiary.blogspot.com/2024/...line-2023.htmlAll medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.Comment
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Cambodia Reports 6th H5N1 Case of 2024
#18,167
While news has been quiet out of Cambodia since the flurry of 5 H5N1 cases reported last January and February, today their Ministry of Health has announced a 6th case for 2024. This makes the same number of cases over the first 6 months of this year equal to last year's total (n=6).
All of these recent Cambodian cases have been due to the older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b which is currently plaguing American cattle and birds and mammals around the world. Exactly what is behind its resurgence after nearly a decade isn't clear.
The (translated) statement from the Cambodian MOH follows, after which I'll return with a bit more.
Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release on Avian Influenza Cases in 3-Year-Old Boy
The Ministry of Health would like to inform the public that there is one case of bird flu in a 3-year-old boy and was confirmed positive for the H5N1 bird flu virus from the National Institutes of Public Health and the Institut Pasteur. On July 5, 2024, living in Po village, Prasat Choan Chum commune, Kirivong district, Takeo province. The boy had a fever, a cough, tiredness, and difficulty breathing. At present, the patient's condition has improved and he is receiving intensive care by doctors. According to the interrogation, about 10 days ago, there was a dead chicken in the village, and at home, the patient brought food to eat, the boy touched and held the dead chicken.
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 local consultation and treatment. 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.
Prevention: 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 animals. 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.
For more information, please contact the Ministry of Health Hotline 115 toll-free.
Saturday, 1st of Asat month, year of Rong Chhasak, BE 2561, Phnom Penh, July 6, 2024
Royal Government + Ministry of HealthGovernment + Ministry of Health
Cambodia
While Cambodia is doing an admirable job of reporting these hospitalized cases, it is entirely possible that some milder infections are going unreported. Of the 12 cases reported over the past 18 months, 5 have died, 4 were classified as `severe', 2 were `mild', and one was `asymptomatic'.
Credit CDC June Technical Report
Severe or critical cases are far more likely to be hospitalized, tested, and confirmed as H5N1 positive. All of which makes it difficult to know how many people are really being infected, and what the fatality rate truly is.
Last year, 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.
While H5N1 clade 2.3.4.4b has most of the world's attention - 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.
All have the potential to reassort with other viruses (including human seasonal flu), and new clades, subclades, genotypes, and subtypes are likely to emerge over time.
Which is why, as important as it is that we take the H5N1 in cattle threat seriously, it isn't the only pandemic threat simmering out there. Any pandemic plans we make must be nimble enough to deal with the unexpected, from left field.
All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.Comment
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Takéo province
/https://en.wikipedia.org/wiki/Tak%C3%A9o_province
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3-year-old boy in Cambodia contracts H5N1 bird flu
Source: Xinhua
Editor: huaxia 2024-07-06 13:20:15
PHNOM PENH, July 6 (Xinhua) -- A three-year-old boy from southern Cambodia's Takeo province has been confirmed for H5N1 human avian influenza, raising the number of the cases to six so far this year, the Ministry of Health said in a statement on Saturday.
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The patient, who lives in Kiri Vong district's Pou village, has the symptoms of fever, cough, fatigue and breathing difficulty, and is currently recovering after receiving intensive care from a team of doctors, the ministry added.
"According to queries, about 10 days before the boy fell ill, chicken and ducks in the village had died, and he touched and held dead chickens," the ministry said, adding that the patient's family had also cooked the dead poultry for food.
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Among the six human cases of H5N1 bird flu this year were five children, one of whom had died, and an adult. All patients reportedly had a history of recent exposure to sick or dead poultry prior to their illness.
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From 2003 to date, there were 68 cases of human infection with H5N1 influenza, including 42 deaths in the Southeast Asian country, according to the ministry. ■
https://english.news.cn/20240706/a0b...heir%20illness.Comment
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5-year-old girl in Cambodia contracts H5N1 bird flu, 7 cases confirmed so far
2024-07-08 17:44:15
PHNOM PENH, July 8 (Xinhua) -- Another human case of H5N1 bird flu has been confirmed on a 5-year-old girl from southern Cambodia's Takeo province, bringing the number of the cases to seven since the start of 2024, the Ministry of Health said in a statement on Monday.
"The patient has a fever and is the cousin of a 3-year-old boy, who tested positive for the virus on July 5," the statement said, adding that the two victims live in the same house in Kiri Vong district's Pou village.
"About 10 days before the girl fell ill, chickens and ducks in the village had died and the patient's family cooked them for food, and the patient had direct contact with the dead chickens," the statement said.
Among the seven human cases of H5N1 bird flu so far this year were six children, one of whom died, and an adult. All patients reportedly had a history of recent exposure to sick or dead poultry prior to their illness.
...https://english.news.cn/20240708/baa...%20on%20Monday.Comment
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July 8, 2024
Two Takeo boys confirmed infected by H5N1 bird flu
The Takeo Health Department said two boys, ages three and five, have been confirmed to be infected with the H5N1 bird flu, while 29 others are still waiting for test results from the National Institute of Public Health (NIPH) and the Pasteur Institute (PI) of Cambodia.
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Takeo Health Director Nhea Sithan said yesterday that two children have been diagnosed with the H5N1 bird flu virus, while 29 people were waiting on results of blood tests from the NIPH and PI.
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Ministry of Health announces the detection of H5N1 bird flu in a 5-year-old girl in Takeo Province
2 mins ago
The Ministry of Health issued a press release on July 8, 2024, on the case of bird flu (H5N1) in another 5-year-old girl living in Kirivong district, Takeo province. This is the second case and has happened recently after being silent for a while.
According to the announcement, the girl had a fever, was the cousin of a positive 3-year-old boy on July 5, and lived in the same house. At present, the patient’s condition is mild, and she is receiving intensive care by doctors.
According to the investigation, about 10 days ago, there were dead chickens and ducks in the village, and at the patient’s home, they brought dead chicken to cook, and the girl touched the dead chicken.
The Ministry stated that emergency response teams from the Ministry of Health, officials with the Ministry of Agriculture and local authorities are investigating the outbreak of bird flu and continue to search for sources of transmission in both animals and humans.
The team is conducting searches for other suspected cases of the flu to prevent transmission in the community, as well as to distribute Tamiflu vaccine and conduct a health education campaign for people living in the area.
The Ministry of Health warns people to be careful about bird flu because H5N1 bird flu continues to pose a health threat, including fever, cough, runny nose, or shortness of breath and have a history of contact with sick or dead chickens or birds within 14 days before the onset of symptoms, not go to crowded places or towns, and seek medical advice and treatment at the nearest medical centre as soon as possible.
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Cambodia Reports 7th H5N1 Case of 2024
#18,171
Cambodia's MOH reports their 7th human H5N1 infection for 2024 - and the 2nd one in past two days - with the discovery that a 5 y.o. girl living in the same household as Saturday's case(who is reportedly mildly symptomatic) has tested positive for the virus.
While we don't have word on the exact clade of these two most recent H5N1 cases, they are very likely the older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b and has been identified in 10 of the last 11 cases in Cambodia.
The (translated) statement from the MOH follows, after which I'll have a bit more.
(translation)Kingdom of Cambodia
Nation Religion King
That way
Ministry of Health
Press Release
Cases of bird flu in 5-year-old girls
The Ministry of Health would like to inform the public that there is another case of bird flu in 5-year-old girls and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute of Public Health on July 7, 2024, living in Po village, Preah Bat Choan Chum commune, Kirivong district, Takeo province. The girl had a fever and was the cousin of a positive 3-year-old boy on July 5, 2024 and lived in the same house. At present, the patient's condition is mild and he is receiving intensive care by doctors. According to the interrogation, about 10 days ago, there was a dead chicken in the village and at home, the patient brought food to eat, the girl touched the dead chicken.
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. According to technical methods and protocols, continue to search for sources of transmission in both animals and humans, and continue to search for suspected cases and exposure to prevent transmission to others in the community, and distribute Tamu 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 advice. Get medical check-ups at your nearest health facility on time.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 home. 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 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.
For more information, please contact the Ministry of Health Hotline 115 for free.
While Cambodia has an excellent reputation for reporting and investigating cases or clusters, it takes a bit of luck for these cases to be detected. Mild or moderate cases are more likely to go unrecognized, since the best chance for detection comes when a patient is hospitalized.
Of the 13 H5N1 cases reported by Cambodia over the past 18 months, only 3 have been in adults and all of them survived. Among the 10 children infected - while several had mild symptoms -half (n=5) died.
Younger people (< 40) seem to be more susceptible to H5 infections while the opposite appears true for H7N9 (see H7N9: The Riddle Of The Ages). This affinity for the H5N1 virus to infect younger patients has evoked a number of theories, but has never been adequately explained.
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).
Up until relatively recently, we thought of influenza viruses as being grouped primarily by HA subtype; H1, H3, H5, H7, etc.
But, as the chart below illustrates, the 18 known subtypes are divided into two basic groups; Group 1 and Group 2.
Some studies suggest that the first HA group you are exposed to may affect your ability to fight infection by viruses from the other group. A few past blogs include:
PLoS Path.: Childhood Immune Imprinting to Influenza A
Nature Comms: Middle-Aged Individuals May Be in a Perpetual State of H3N2 Flu Virus Susceptibility
This childhood imprinting may help to explain why (HA Group 2) H7N9 cases in China skewed heavily to those > 50, while (HA Group 1) H5N1 cases generally affected those under the age of 40 (see chart below).
Regardless of the actual reasons behind it, this track record of H5N1 hitting children particularly hard has long been a concern. Past performance may not predict future results, of course, since different clades or genotypes of H5Nx might produce vastly different results.
While HPAI H5 clade 2.3.4.4b remains our primary concern, HPAI H5 viruses continue to diversify and evolve around the globe.
In addition to Cambodia's clade 2.3.2.1c, sporadic H5N6 spillovers continue inChina, India recently exported a case to Australia (clade 2.3.2.1a), and last month we saw the first human H5N2 infection reported by Mexico.
None of which suggests that HPAI H5 threat is likely to recede anytime soon.
All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.Comment
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Cambodia detects another H5N1 bird flu case in human
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July 8, 2024 at 06:45:15
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The Cambodian Ministry of Health on July 8 announced that another human case of H5N1 bird flu has been confirmed on a 5-year-old girl in Takeo province, bringing the number of the infections to seven since the start of 2024.
According to the ministry, the patient has a fever and is the cousin of a 3-year-old boy, who tested positive for the virus on July 5. The two children live in the same house in Kiri Vong district's Pou village.
...
Among the seven human cases of H5N1 bird flu so far this year were six children, one of whom died, and an adult. All patients reportedly had a history of recent exposure to sick or dead poultry prior to their illness.
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From 2003 to date, there were 69 cases of human infection with H5N1 influenza, including 42 deaths in the Southeast Asian country, according to the ministry./.
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Hat tip to Lance
GO TO POST
Cambodia - High pathogenicity avian influenza viruses (poultry) (Inf. with) - Immediate notification
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NEW OUTBREAKS
OB_136448 - POR VILLAGE, PREAH BAT CHOAN CHUM COMMUNE, KIRI VONG DISTRICT, TAKEO PROVINCE
OUTBREAK REFERENCE
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START DATE
2024/07/05
END DATE
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DETAILED CHARACTERISATION
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FIRST ADMINISTRATIVE DIVISION
Takêv
SECOND ADMINISTRATIVE DIVISION
Kiri Vong
THIRD ADMINISTRATIVE DIVISION
Preah Bat Choan Chum
EPIDEMIOLOGICAL UNIT
Village
LOCATION
Por village, Preah Bat Choan Chum commune, Kiri Vong district, Takeo province
Latitude, Longitude
10.655617 , 104.83847
(Approximate location)
OUTBREAKS IN CLUSTER
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MEASURING UNIT
Animal
AFFECTED POPULATION DESCRIPTION
The H5N1 virus was detected in a poultry backyard farm in the village from poultry was suspected of an avian influenza outbreak.
SpeciesSusceptibleCasesDeathsKilled and Disposed ofSlaughtered/ Killed for commercial useVaccinated
Birds (DOMESTIC)
Poultry
NEW 1168 474 474 694 - -
TOTAL 1168 474 474 694 - -
...Comment
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