Cambodia: Cholera cases

[Shiloh]

Source: http://www.phnompenhpost.com/index....fficial-fears-cholera-cases-in-prey-veng.html

Official fears cholera cases in Prey Veng
Thursday, 04 February 2010 15:04 Tep Nimol


SIX villagers in Prey Veng province have been stricken with an illness that one commune official said he believed to be cholera, although health officials have yet to hand down an official diagnosis.

The villagers from Reak Chey commune have suffered from intense diarrhoea and vomiting since Monday, commune chief Hong Sophal said.

?We have sent a man to Calmette Hospital [in Phnom Penh] because he is suffering, even though the doctors here have tried to help him,? he said.

The man?s daughter, Srun Vanthon, said her father?s condition has not improved since entering the hospital, and that doctors have not told her what is causing her father?s illness.

?He is still in bad condition,? she said. ?I am worried about his life.?

Health officials have not confirmed the presence of cholera in the area.

Sambath Narin, the director of the health centre in Reak Chey, said he has not met with anyone complaining of similar symptoms.

?I cannot say it is cholera because I have not met with the patients,? he said. ?Few people here have diarrhoea or are vomiting.?

Ly Sovann, deputy director of the Communicable Diseases Control Department at the Ministry of Health, said he also had not received reports of cholera outbreaks in Prey Veng.

The information comes after Vietnamese media reported that seven Cambodians infected with cholera were being treated in Vietnamese hospitals.

The report in Thanh Nien Daily said that the seven patients, all from Takeo and Kandal provinces, had been admitted to Vietnamese hospitals between January 19 and 28. A total of 45 people were first admitted with symptoms of ?acute diarrhoea?, but the report did not specify whether any of the other patients were Cambodian. The report said the patients were being treated in An Giang, which borders Cambodia and is also home to an ethnic Khmer minority population.

In early January, Cambodian health officials warned citizens against a potential cholera outbreak.

 

[Shiloh]

Re: Cambodia: Cholera cases

Source: http://www.phnompenhpost.com/index....alleged-outbreak-of-cholera-in-provinces.html

Health experts at odds over alleged outbreak of cholera in provinces
Wednesday, 10 February 2010 15:04 Tep Nimol And Brooke Lewis


HEALTH experts are at odds over the possibility of a cholera epidemic breaking out in the Kingdom, with Ministry of Health officials downplaying the threat and doctors from a Phnom Penh pediatric hospital saying cases could triple by March if the government does not intervene to stop the disease from spreading.

Dr Beat Richner, director of the Kantha Bopha Children?s Hospital in Phnom Penh, said Tuesday that the disease had been spreading for months, beginning with two confirmed cases in November 2009, followed by 10 in December, 53 in January, and 19 so far this month at his hospital alone.

He said his hospital had treated 120 suspected cholera patients in January, and that all cases had been reported to the Ministry of Health.

But Ly Sovann, deputy director of the Communicable Diseases Control Department at Ministry of Health, declined to say whether cholera cases had been confirmed, and argued that the distinction between diarrhoea and cholera was unimportant.

?Diarrhoea and cholera have the same treatment,? he said. ?We are not interested in whether it is diarrhoea or cholera. The important thing is that we treat them by instructing them to drink a lot of water when they get serious diarrhoea or by sending them to referral hospitals.?

Richner said health officials were guilty of spreading misinformation about cholera, which he said should be treated very differently from seasonal diarrhoea. Suspected cholera patients, he said, should be admitted to hospital and given antibiotics immediately.

He added that cholera can kill very quickly, and called for a state of emergency to be declared in areas where a high number of diarrhoea and suspected cholera cases had been reported, including Kandal, Prey Veng and Takeo provinces, as well as the capital.

?In the worst cases, a child can die within two hours of beginning to vomit or having diarrhoea,? he said.

Diarrhoea and a handful of suspected cholera cases have been reported widely in recent weeks, and the Ministry of Health launched a nationwide sanitation and hygiene awareness campaign last week. The campaign has involved placing officials on the ground in every province to treat cases of diarrhoea.

 

[Treyfish]

Re: Cambodia: Cholera cases

Bad water blamed for new deaths in KSpeu

Tuesday, 09 February 2010 15:03 Tep Nimol and Chhay Channyda




HEALTH officials have urged calm amid heightened fears of a diarrhoea outbreak after three villagers succumbed to the illness in Kampong Speu province, continuing a recent spate of cases that last week prompted the Ministry of Health to launch a nationwide sanitation and hygiene awareness campaign.

Ly Sovann, deputy director of the Communicable Diseases Control Department at the Ministry of Health, said samples from the three deceased Kampong Speu villagers had been sent to Calmette Hospital for analysis.

An official from the Kampong Speu Communicable Diseases Control Department who declined to be named because he was not authorised to speak to reporters said more than 50 people in the area had come down with serious diarrhoea.

<hr>

They got diarrhoea because they drank water from a pond that was unhygienic..."​

<hr>
Nov Doem, the chief of Voasar commune, where the deaths and reported outbreak occurred, said villagers had begun to panic and were erecting scarecrows outside their houses to protect them from infections.

But Ly Sovann stressed on Monday that the cause of the diarrhoea outbreak was the increasing number of villagers consuming contaminated water, adding that people who had boiled their water had avoided falling ill.

?They got diarrhoea because they drank water from a pond that was unhygienic because both animals and villagers drank the same water,? he said.

Pieter van Maaren, country representative for the World Health Organisation, said Monday that his office was monitoring the situation closely in partnership with the Ministry of Health, but added that he was not concerned about the possibility of an outbreak of cholera, a diarrhoeal disease caused by the Vibrio cholerae bacterium.

?The situation is such that, if you get large numbers of cases with watery diarrhoea, then that definitely warrants an investigation into a cholera outbreak,? he said.

?But so far, there have been very few cases that would warrant such an investigation.?

The campaign launched by the Health Ministry last week involves posting officials on the ground in every province to treat cases of diarrhoea.:tiphat:http://www.phnompenhpost.com/index....bad-water-blamed-for-new-deaths-in-kspeu.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Doctors declare ?epidemic?
Thursday, 11 February 2010 15:04 Brooke Lewis and Tep Nimol .
Hospitals confirm 14 cholera victims as officials dispute any confirmed cases


Photo by: Rick Valenzuela
Sok Reaka, a six-month-old suspected cholera patient from Kampong Speu province, watches a nurse tend to him at Kantha Bopha Children?s Hospital on Wednesday.
DOCTORS from two hospitals confirmed 14 new cases of cholera on Wednesday, but the Ministry of Health continued to question whether any patients had tested positive for the disease, a position that has drawn criticism from officials at a children?s hospital in Phnom Penh.

Dr Denis Laurent, head pathologist at Kantha Bopha Children?s Hospital, said six new cases had been confirmed there on Wednesday, bringing the total number of cases treated so far this month to 25. The hospital recorded 65 cases between November and January. ?This is an epidemic,? he said.

Or Vanda, deputy director of the technical office at Calmette Hospital, said staff there had confirmed eight cases of cholera on Wednesday. He added that families living nearby the eight people who tested positive for cholera had not been told of the diagnoses.

?In principal, it isn?t good for the public to be informed, because people become surprised and disturbed because cholera is regarded as a serious disease in their minds,? he said.

Despite the reports from the two hospitals, Ly Sovann, deputy director of the Communicable Diseases Control Department at the Ministry of Health, said he did not believe there had been any cholera cases in Cambodia. ?Doctors have a right to say their own opinions,? he added.

Nima Asgari, public health specialist at the World Health Organisation, said there was no doubt that cases of cholera had been confirmed, but that cholera is just one strain of watery diarrhoea, an affliction that is common during the dry season.

He said there was no need to distinguish between cholera and watery diarrhoea when warning people about the possibility of an outbreak.

?From the viewpoint of preventing transition and providing treatment [for cholera and other forms of watery diarrhoea], the initial steps are the same,? he said.

But Dr Visoth Mony, deputy director and head of the intensive care unit at Kantha Bopha Children?s Hospital, said seasonal diarrhoea is often caused by a virus, whereas cholera is caused by bacteria. He said cholera could very quickly lead to liver failure and death, and that the two diseases need to be treated differently, with suspected cholera patients given antibiotics immediately.

?The WHO completely disagrees with that statement,? Nima Asgari said. ?To routinely give out antibiotics is not the way the WHO recommends dealing with cholera. The first step should be rehydration with fluids and electrolytes.... Cholera kills because it dehydrates people.?



Photo by: Rick Valenzuela
Dr Khieu Kolrath holds up a petri dish showing a confirmed cholera specimen at Kantha Bopha Children?s Hospital on Wednesday.Nima Asgari said the majority of cholera cases could be treated simply by drinking plenty of fluids. ?The first line of treatment for cholera is oral hydration ? lots of water and supplements such as Royal D,? he said. ?Those who become sicker and are still dehydrated need to be admitted to hospital for intravenous treatment, and a small amount of these patients will also need antibiotics.?

Dr Beat Richner, director of Kantha Bopha Children?s Hospital, said it was imperative that people in affected areas be informed about the threat of cholera and told how to seek immediate help because, in the worst cases, the disease can kill within hours.

?We know about a 13-year-old girl who died because her family was not informed that their neighbour had cholera,? he said. ?This girl would not have died if they?d been informed.?

Visoth Mony said the Ministry of Health must know of the presence of cholera because the hospital was obliged to report all communicable diseases to the government.

?We have reported every case, and the Ministry of Health comes to the hospital to make reports, and they say that they will warn people in the villages. But when [patients] come to our hospital, they usually say nobody went to their village,? he said. ?Just 40 percent of patients have received information from the Ministry of Health, and 60 percent had heard nothing.?

Nima Asgari said he believed the Ministry of Health generally informed families living in areas stricken with many cases of watery diarrhoea about the potential threats.

Laurent said he did not know why the government might be reluctant to confirm the existence of cholera, but he speculated that it could be due to fear of a potentially negative impact on foreign investors and tourism. ?Our goal is not to create panic, but we have this problem now with cholera, and we have to react,? he said.
http://www.phnompenhpost.com/index.php/2010021131958/National-news/doctors-declare-epidemic.html

 

[Treyfish]

Re: Cambodia: Cholera cases

Ministry confirms cases of cholera

Monday, 15 February 2010 15:03 Brooke Lewis and khouth sophak Chakrya

Photo by: Rick Valenzuela ​

A doctor holds up a petri dish containing a confirmed cholera specimen at Kantha Bopha Children?s Hospital last week. The Health Ministry said Friday that 128 Cambodians had contracted cholera.


THE Ministry of Health has reported that more than 100 Cambodians have tested positive for cholera since November, reversing its initial refusal to confirm the presence of the disease and simultaneously defending its handling of the outbreak.

Speaking at a joint press conference held with the World Health Organisation (WHO) on Friday, Minister of Health Mam Bunheng said there had been 128 confirmed cholera cases and one death. About 65 percent of the cases involved children under the age of 15, and the single recorded fatality was an 82-year-old man from Takeo province :magnify:who died after contracting cholera in January, he said.

Dr Nima Asgari, a public health official at the WHO, on Sunday noted that the nation has only four hospitals, all in Phnom Penh, with the correct laboratory facilities required to test for cholera, adding that it would be ?almost impossible to estimate the actual number of cases of cholera? nationwide.

Prior to Friday, ministry officials had not released any information about cholera cases, drawing criticism from officials at Kantha Bopha Children?s Hospital in Phnom Penh, who said they had been forwarding information on cases of cholera to the government since mid-November.

Though doctors at the hospital last week accused the government of not doing enough to publicise the outbreak, Mam Bunheng said his ministry had tried to balance the need to be forthcoming and the need to avoid sowing ?panic?.

?We have not hidden any cases,? he said, pointing out that cholera cases had been reported in ?three or four? Khmer-language newspapers. He said the ministry had refrained from making more publicising information about the cases so as to avoid encouraging people to seek unnecessary treatment and potentially overwhelm medical facilities.

?We may cause panic among people, and they will rush to hospitals to get treated,? he said.

He said the ministry had taken immediate action after the first case was confirmed, visiting provinces in which potential cases had been reported to educate residents about the importance of frequent hand-washing, covering toilets and boiling drinking water. He also said the ministry had distributed oral rehydration salts, intravenous fluids and chlorine for disinfecting water.

Mam Bunheng said an uptick in diarrhoea cases was common during the dry season.

?An increase in diarrhoea is not unusual at this time of year in Cambodia, when water levels are low and people may be tempted to use unprotected water sources,? Mam Bunheng said.

?I hope the press will inform people about preventions rather than making them panic.?

Dr Sok Touch, director of the Health Ministry?s Communicable Diseases Control Department, echoed that sentiment, saying: ?This [press conference] is not to declare an emergency but to provide an update about cholera cases.?

Treatment
As they have throughout the past week, government and WHO officials argued that, when it comes to treatment, there is little difference between cholera and other forms of acute watery diarrhoea.

?We want to consider cholera as just another kind of diarrhoea,? Sok Touch said. He added that it was important for people to practice good hygiene to protect themselves from all forms of diarrhoea, not just cholera.

Asgari reiterated that most cholera cases can be treated with oral rehydration, and that only 10 to 20 percent of cases become severe enough to require hospitalisation.

He disputed the argument put forth by Kantha Bopha doctors last week that all suspected cases of cholera should be treated with antibiotics.
?Antibiotics should be used for only severe cases of acute watery diarrhea,? Asgari said, adding that indiscriminate use of antibiotics could eventually render them less effective.:tiphat:http://www.phnompenhpost.com/index....-news/ministry-confirms-cases-of-cholera.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

WHO sees rise in reported cholera cases
Tuesday, 02 March 2010 15:04 Brooke Lewis and Mom Kunthear .

THE number of reported cholera cases has increased by 95 in the last two weeks, a World Health Organisation representative said Monday, though a Health Ministry official described all cases reported since November as ?suspected?.

The 95 newly confirmed cholera cases bring the total number since the outbreak began in November to 223, said Dr Nima Asgari, public health specialist at the WHO. He added that the uptick in confirmed cases did not necessarily mean that the disease was spreading more quickly.

?It?s very difficult to say ? there has been an increase in reported numbers, but there has also been an increase in testing, so it?s hard to say if there has been a rise in the number of actual cholera cases,? he said.

The Health Ministry and the WHO announced at a joint press conference on February 12 that 128 cholera cases had been confirmed since November. That announcement followed criticism from doctors at a paediatric hospital in Phnom Penh who accused the government of downplaying the threat of cholera and failing to inform the public about the disease.

Prior to the press conference, Health Ministry representatives had declined to confirm the cholera outbreak, though doctors at Kantha Bopha Children?s Hospital insisted that the government must have been aware of it because hospitals are legally required to report all cases they record.
Ly Sovann, deputy director of the Communicable Diseases Control Department at the Ministry of Health, on Monday again declined to say that any cholera cases had been confirmed since November.

?There have been 223 suspected cases of cholera that have been reported. They have not been confirmed,? Ly Sovann said Monday, adding that the ministry would convene a meeting on Thursday to discuss the current state of the spread of acute watery diarrhoea cases along with diseases including A(H1N1) influenza, or bird flu, and A(H5N1), or swine flu.

Ly Sovann said the government was taking sufficient measures to prevent the spread of diarrhoea.

?The Ministry of Health keeps educating and broadcasting through the media to all people to protect themselves from having diarrhoea or cholera by boiling water and eating good food ? and especially that they have to go to a health centre or hospital when they have diarrhoea,? he said.

http://www.phnompenhpost.com/index..../who-sees-rise-in-reported-cholera-cases.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Poor hygiene tied to five deaths in Kratie
Monday, 29 March 2010 15:05 Mom Kunthear .

AUTHORITIES in Kratie province say they are boosting efforts to prevent the spread of preventable illnesses caused by poor hygiene after five villagers died and nearly 100 others fell ill in suspected cases of cholera before the weekend.
Four villagers from Kratie?s Chet Borey district died Thursday after experiencing severe diarrhoea and vomiting, said Chhneang Vutha, deputy director of the Kratie provincial hospital. The deaths came a week after one person with the same symptoms died.

Total diarrhoea illnesses in the area rose to 96 by Friday, said Chhneang Vutha, who blamed the outbreak on impure drinking water and poor hygiene practices.

?We are cooperating with the health centre in the district to set up more places in order to help [villagers] in time in case they get severe diarrhoea and vomiting,? he said.

Although some officials suspect the cases may be linked to cholera, Chhneang Vutha said, it is still too early to say exactly what caused the deaths.

?I have not confirmed yet whether these are cholera cases or not,? he said.

Choung Sean Heak, chief of Kratie?s provincial police, said nearly 60 people in the district had to be transported to the provincial hospital for
treatment, while the rest were treated in their villages in Thmey commune.


--------------------------------------------------------------------------------

THEY LIVE WITHOUT TAKING CARE OF THEIR HEALTH AND THEY DRINK BAD WATER.

--------------------------------------------------------------------------------

He also blamed the illnesses on poor hygiene.

?Those people were suspected of having cholera because they live without taking care of their health and they drink bad water,? he said.
No further deaths or illnesses have been reported since Friday, he said.

In the meantime, authorities have stepped up prevention efforts aimed at avoiding future illnesses.

?I and the other medical officers went down to their houses to educate them to clean their bodies, to boil their drinking water and to not allow their children to go out during the daytime because it is very hot,? Choung Sean Heak said.

?Most of them are not very well-educated and poor, so it is very difficult for them to follow.?

The outbreak of illness has alarmed some nearby villagers. Yos Sat, who lives just outside Thmey commune, said he has urged his family members to avoid the area.

?I used to go to sell fish before those villagers died,? he said. ?I will not go there for a period of time until there are no more cases.?

Up until last month, health officials had been reluctant to publicise cases of cholera, citing concerns about unnecessarily alarming the public.

In mid-February, authorities announced they had recorded 128 individual cases of cholera nationwide since last November.

Health experts see communicable diseases such as cholera as being directly linked to poor sanitation.

A 2008 study by the World Bank?s Water and Sanitation Programme estimated that almost 10,000 people a year in Cambodia die from sanitation
and hygiene-related diseases; two-thirds of the tally died from diarrhoea-related illnesses.

The Post was unable to reach officials with the Ministry of Health?s Communicable Diseases Control Department Sunday.
http://www.phnompenhpost.com/index....or-hygiene-tied-to-five-deaths-in-kratie.html

 

[alert]

Re: Cambodia: Cholera cases

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1040,81976

Archive Number 20100330.0992
Published Date 30-MAR-2010
Subject PRO/MBDS> Diarrheal illness - Cambodia: Kratie, cholera susp, RFI

DIARRHEAL ILLNESS - CAMBODIA: KRATIE, CHOLERA SUSPECTED, REQUEST FOR
INFORMATION
**********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 29 Mar 2010
Source: The Phnom Penh Post [edited]
<http://www.phnompenhpost.com/index.php/2010032934431/National-news/poor-hygiene-tied-to-five-deaths-in-kratie.html>


Authorities in Kratie province say they are boosting efforts to
prevent the spread of preventable illnesses caused by poor hygiene
after 5 villagers died and nearly 100 others fell ill in suspected
cases of cholera before the weekend [27-28 Mar 2010].

Four villagers from Kratie's Chet Borey district died Thursday [25
Mar 2010] after experiencing severe diarrhea and vomiting, said
Chhneang Vutha, deputy director of the Kratie provincial hospital.
The deaths came a week after one person with the same symptoms died.

Total diarrhea illnesses in the area rose to 96 by Friday [26 Mar
2010], said Chhneang Vutha, who blamed the outbreak on impure
drinking water and poor hygiene practices.

"We are cooperating with the health centre in the district to set up
more places in order to help [villagers] in time in case they get
severe diarrhea and vomiting," he said.

Although some officials suspect the cases may be linked to cholera,
Chhneang Vutha said it is still too early to say exactly what caused
the deaths. "I have not confirmed yet whether these are cholera cases
or not," he said.

Choung Sean Heak, chief of Kratie's provincial police, said nearly 60
people in the district had to be transported to the provincial
hospital for treatment, while the rest were treated in their villages
in Thmey commune.

[Byline: Mom Kunthear]

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[According to the above newswire, there were 5 deaths and 96 cases
with severe diarrhea and vomiting in Kratie province, Cambodia during
last week. The vehicle for transmission of this outbreak is stated as
impure drinking water and poor hygiene practices by provincial
hospital. From the clinical presentation and short incubation period
of the illness above, the differential etiologic agents of the
diarrheal outbreak include _Vibrio cholerae_, _Shigella spp._, and norovirus.

There have been potential cholera outbreaks going on in Cambodia. As
of 2 Mar 2010, the World Health Organization (WHO) stated that there
had been 223 confirmed cholera cases in Cambodia since November 2009
although these cases remain unconfirmed by the Ministry of Health
(see prior PRO/MBDS posting Cholera - Viet Nam ex Cambodia (03) 20100305.0720).

Information on the investigations and confirmed etiological agent
responsible for the above mentioned diarrheal outbreak would be
appreciated by PRO/MBDS.
For a map of Cambodia with provinces, see
<http://www.discoveryindochina.com/cam/map_provinces.html>. For the
interactive HealthMap/ProMED-mail map with links to other recent
PRO/MBDS and ProMED-mail postings on Cambodia and neighboring
countries, see <http://healthmap.org/r/01bO>. - Mod.SCM]

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Six more ill in Kratie as tests made for cholera
Tuesday, 30 March 2010 15:04 Mom Kunthear and Brooke Lewis .

KRATIE provincial hospital has admitted six new patients suffering from severe vomiting and diarrhoea, its deputy director said Monday, as officials continue to await test results to determine whether cholera was responsible for the deaths of five people late last week.

Chhneang Vutha said some 200 people had come down with severe diarrhoea and vomiting province-wide in the past five days. He said 69 had been treated by the hospital and the rest by health centres.
?I have not yet received the results from sample testing regarding whether it is a cholera case or not,? he said, adding that hospital workers would continue to educate patients about the role of hygiene in preventing the illness from spreading.

Pieter van Maaren, country representative for the World Health Organisation, said he had not yet received reports from the Health Ministry on the cholera test results, but that he had been informed that health officials in Kratie were ?in full control of the situation?.

?This is something that is being investigated,? he said. ?As with all cholera cases, I want to make it very clear that cholera can only be confirmed by laboratory investigation.?

Nevertheless, Toun Ngork, the governor of Kratie?s Chet Borei district, said Monday that he remained convinced that all five people who died in the district had been stricken with cholera.

?I confirmed from the health officials in the province that they died because of cholera,? he said. ?They got it because most people in this district drink [unboiled] water.?

Van Maaren said that beyond providing an official diagnosis, the test results would be helpful in devising measures to prevent the illness in Kratie from spreading. But he reiterated the position of the WHO and the government that the diagnosis was not a primary concern.

?In essence it doesn?t make any difference to us whether acute watery diarrhoea is caused by cholera or something else, because the treatment is the same,? he said.

?In all cases the primary treatment that has to be taken is plenty of fluids.?
http://www.phnompenhpost.com/index....-ill-in-kratie-as-tests-made-for-cholera.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Cholera caused Kratie deaths
Thursday, 01 April 2010 15:04 Mom Kunthear and Brooke Lewis .

LABORATORY tests have confirmed that five people who died of severe vomiting and diarrhoea in Kratie province last month had contracted cholera, according to a health official who declined to provide further information on the number of cholera cases reported nationwide for fear it would impact tourism.

Ly Sovann, deputy director of the Communicable Diseases Control Department at the Ministry of Health, said Wednesday that the five deaths were the result of “acute watery diarrhoea caused by Vibrio cholerae”, a reference to the bacterium that causes cholera.

Asked if there were other reported cases of cholera in Kratie or elsewhere, Ly Sovann said, “I cannot make the data of the cholera cases public because we are afraid the data will hit profits in our country.” He went on to say that he was particularly concerned about how news of cholera cases might affect the Kingdom’s tourism sector.
Ly Sovann’s comments provided further evidence of the Health Ministry’s reluctance to acknowledge the recent presence of cholera in Cambodia.
Development partners and some health experts have in recent weeks said that it makes little difference whether cholera is diagnosed, and that the disease can be treated much like any case of acute watery diarrhoea.


--------------------------------------------------------------------------------

We are doctors, not politicians or working in tourist offices.

--------------------------------------------------------------------------------

However, not everyone has agreed.

In early February, health officials at a Phnom Penh paediatric hospital criticised the government for failing to announce an outbreak that they said had been reported to the Health Ministry last November, and suggested that economic considerations – in particular, the well-being of the tourism industry – were exerting undue influence over a matter of public health.

“We are doctors, not politicians or working in tourist offices,” Dr Beat Richner, director of the Kantha Bopha Children’s Hospital, said at the time. “For us as doctors, it is most important that the people are informed.”

In a series of open letters published in local media that month, Richner argued that, contrary to statements made by World Health Organisation officials, cholera was a particularly acute form of watery diarrhoea that could kill within hours, and that it should be treated with antibiotics.

Dr Pieter van Maaren, the WHO’s country representative, on Wednesday reiterated the WHO’s position that cholera should be treated in the same way as other cases of acute watery diarrhoea, and said it was not necessary for cholera test results to be made public.

“People have a very poor association with the word cholera, and this is really affecting the work that the [Health Ministry] and its partners do.

People get scared when they hear the word cholera,” he said.

He added: “From a WHO perspective, we are very much following the health situation in the country; whether or not there is tourism doesn’t make any difference to us.”

However, Ou Virak, president of the Cambodian Centre of Human Rights, said the government should be transparent about the number of cholera cases, and that past attempts by governments to de-emphasise reports of confirmed cases had contributed to the spread of the disease.

“No doubt it will have some impact on tourism,” he said, “but in the long run Cambodia will be a more trusted destination if we are transparent about this.”
http://www.phnompenhpost.com/index.php/2010040136706/National-news/cholera-caused-kratie-deaths.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

No explicit mention of cholera here, but I'll post it pending further information.

Dirty water kills four in Ratanakkiri
Tuesday, 13 April 2010 15:01 Mom Kunthear and Tep Nimol .

FOUR ethnic Brov villagers from Ratanakkiri province?s Veun Sai district died on Saturday from acute diarrhoea after drinking unclean water during a forest excursion, and another 10 villagers were being treated at Koh Pong commune health centre.

Chum Ngel, district governor, said Monday that the four deceased Brov villagers, who were all from the same family, had gone into the forest to look for fruit to sell. ?They drank dirty water when they went into the forest,? he said.

He said that the mother Lam Ven, 39, daughter Puth Chanthou, 17, son Puth Chenda, 12, and brother-in-law Poy Romdos, 35, did not reach the health centre in time for treatment because they lived in a ?remote? village.

Chum Ngel said that on Sunday he had asked authorities in Veun Sai to educate villagers about proper hygiene and advise them to seek immediate treatment in the event of future cases.

?Indigenous villagers do not like to come to the health centre,? he said. ?They use traditional medicines, which we are concerned may spread the disease to other villagers.?

http://www.phnompenhpost.com/index....ws/dirty-water-kills-four-in-ratanakkiri.html

 

[alert]

Ratanakkiri, Cambodia: Four family members die of diarrheal illness after drinking contaminated water

Ratanakkiri, Cambodia: Four family members die of diarrheal illness after drinking contaminated water

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1040,82265

Archive Number 20100414.1218
Published Date 14-APR-2010
Subject PRO/MBDS> Diarrheal illness - Cambodia (04): fatality, Ratanakkiri, RFI

DIARRHEAL ILLNESS - CAMBODIA (04): FATALITY, RATANAKKIRI, REQUEST FOR
INFORMATION
*********************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 13 Apr 2010
Source: The Phnom Penh Post [edited]
<http://www.phnompenhpost.com/index.php/2010041337454/National-news/dirty-water-kills-four-in-ratanakkiri.html>


A total of 4 ethnic Brov villagers from Ratanakkiri province's Veun
Sai district died on Saturday [10 Apr 2010] from acute diarrhoea
after drinking unclean water during a forest excursion. Another 10
villagers were being treated at Koh Pong commune health center.

Chum Ngel, district governor, said Monday [12 Apr 2010] that the 4
deceased Brov villagers, who were all from the same family, had gone
into the forest to look for fruit to sell. "They drank dirty water
when they went into the forest," he said.

He said that the mother, 39, daughter, 17, son, 12, and
brother-in-law, 35, did not reach the health center in time for
treatment because they lived in a "remote" village.

Chum Ngel said that on Sunday [11 Apr 2010] he had asked authorities
in Veun Sai to educate villagers about proper hygiene and advise them
to seek immediate treatment in the event of future cases.

"Indigenous villagers do not like to come to the health center," he
said. "They use traditional medicines, which we are concerned may
spread the disease to other villagers."

[Byline: Mom Kunthear; Tep Nimol]

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[According to the above newswire, there are 4 deaths and another 10
cases with acute diarrhea in Ratanakkiri province, Cambodia, and all
of them are ethnic Brov villagers. The newswire mentioned that the
vehicle for transmission of this outbreak is stated as unclean
drinking water by district governor.

Although it is unclear about the clinical presentation and incubation
period of the illness, the acute diarrhea in this outbreak seemed to
be severe, leading to rapid dehydration and hypovolemic shock.

Information from reliable sources on the investigations and confirmed
etiological agent responsible for the above mentioned diarrheal
outbreak would be highly appreciated by PRO/MBDS.

 

[alert]

Re: Ratanakkiri, Cambodia: Diarrheal outbreaks - Cholera possible

Re: Ratanakkiri, Cambodia: Diarrheal outbreaks - Cholera possible

This is NOT the same outbreak as the above post (note the new title); it is a second similar outbreak in the same province. While the article states that this is not cholera, it very well might be. "Acute watery diarrhea" is often a keyword for suspect cholera.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1040,82369

Archive Number 20100422.1299
Published Date 22-APR-2010
Subject PRO/MBDS> Diarrheal illness - Cambodia (05): fatality, Ratanakkiri, RFI

DIARRHEAL ILLNESS - CAMBODIA (05): FATALITY, RATANAKKIRI, REQUEST FOR
INFORMATION
***************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 19 Apr 2010
Source: The Phnom Penh Post [edited]
<http://www.phnompenhpost.com/index.php/2010041937546/National-news/diarrhea-blamed-for-two-deaths-in-ratanakkiri.html>


A total of 2 ethnic Kreung men from Ratanakkiri province's O'Chum
district died last week [week of 12 Apr 2010] from acute watery
diarrhea, and another 55 were hospitalized after drinking from
tainted water sources near Tresh village, a provincial health official said.

In addition, a staffer for the rights group Adhoc said 2 Kreung girls
died on Saturday [17 Apr 2010] from acute watery diarrhea in the same
village, though officials could not confirm this Sunday [18 Apr 2010].

The reports come just over a week after 4 ethnic Brov villagers from
Ratanakkiri's Veun Sai district died and 10 required treatment at a
health centre after coming down with acute watery diarrhea, another
incident that was blamed on unclean drinking water.

Hoy Vannara, head of Ratanakkiri's Communicable Diseases Control
Department, said Sunday [18 Apr 2010] that the 2 deaths he could
confirm occurred on [10 Apr 2010] and [12 Apr 2010].

He said tests were being conducted on the victims' and hospitalized
patients' fecal matter, but that results were not yet available.
Still, he said that the villagers' general lack of hygiene and
unsanitary food and water were likely at fault. "It was not cholera," he said.

He said that no new cases had been reported since [12 Apr 2010], and
that all of the hospitalized patients in O'Chum district were recovering.

"We have sent patients who were in serious condition to the
provincial hospital, and we have sent heath officials to treat the
less serious ones in their villages," he said.

However, Chou Savath, who works for Adhoc in Ratanakkiri, said
residents of O'Chum district had told him that 2 girls died on
Saturday [17 Apr 2010] from acute watery diarrhea they contracted
after drinking water from a stream that had been polluted by the
rotting carcass of a dog. Hoy Vannara said that health officials
would be sent to investigate that report, but that he suspected it
was just a rumor.

He said there had been 8 deaths due to acute watery diarrhea in the
province [Ratanakkiri] so far this year [2010].

Dr Nima Asgari, public health specialist for the World Health
Organisation (WHO), said that nationwide there had been "generally a
much higher number of acute watery diarrhea cases when compared to
last year [2009]."

In the dry season, when the water supply is more concentrated, he
said, there is greater risk of diarrhea outbreaks than during the
rainy season, when people have access to fresh rainwater. "With so
many people taking water from the same limited number of sources, a
larger population can be infected," he said.

He added that ethnic minorities are at greater risk of dying from
acute watery diarrhea because they often live long distances from
health clinics.

To prevent the illness, he said, villagers should boil water or use
chlorine tablets, wash their hands regularly, defecate away from
water supplies, bury feces, and cover up food so flies cannot land in it.

A 2009 report released by STRIVER, a Norwegian-based organization
that studies water resource management, linked hydropower reservoirs
on the Sesan River in Viet Nam to high levels of toxic algae and
bacteria found downstream in Ratanakkiri and said that by WHO
standards the water was unfit for human consumption.

[Byline: Tep Nimol, Will Baxter]

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[The newswire above is the 2nd cluster of diarrheal illness outbreak
in Ratanakkiri province, Cambodia in April 2010. A total of 55 cases
were hospitalized and another 2 died from acute watery diarrhea. The
deaths occurred among ethnic Kreung men from O'Chum district.
Although the newswire mentioned another 2 deaths (Kreung girls from
the same village) over a week after the deaths of 2 ethnic Kreung
men, these 2 deaths (Kreung girls) have not been confirmed by
Ratanakkiri's Communicable Disease Control officer.

The recent 1st cluster of diarrheal illness outbreak in Cambodia also
occurred in Ratanakkiri province which was in Veun Sai district,
where 4 ethnic Brov villagers died and another 10 were treated at a
health center for acute watery diarrhea (see prior PRO/MBDS posting
Diarrheal illness - Cambodia (04): fatality, Ratanakkiri, RFI 20100414.1218).

According to the newswire above, a provincial health official states
that the vehicle for transmission of this outbreak was drinking
tainted water sources near Tresh village. Although the vehicle for
transmission of the diarrheal outbreak in Veun Sai district,
Ratanakkiri (1st outbreak) was also attributed to unclean drinking
water by the district governor, it remains unknown whether there is
any link between these 2 outbreaks.

There are potential outbreaks of cholera in Cambodia in 2010. As of 1
Mar 2010, WHO states that there have been 223 confirmed cholera cases
in Cambodia since November 2009 although the Ministry of Health has
not confirmed these cases. In addition, as of 1 Apr 2010, cholera has
been confirmed as the cause of 5 deaths of severe diarrhea and
vomiting in Kratie province, Cambodia (see prior PRO/MBDS posting
Diarrheal illness - Cambodia (03): Kratie, cholera conf. RFI 20100401.1044).

PRO/MBDS would highly appreciate more information from reliable
sources on the result of investigations and confirmed etiological
agent responsible for the above mentioned acute watery diarrhea outbreak.

STRIVER -- Strategy and methodology for improved IWRM (Integrated
Water Resources Management Organization): an integrated
interdisciplinary assessment in 4 twinning river basins is a 3 year
(2006-2009) European Commission (EC) funded project (see
<http://www.semide.net/initiatives/fol060732/strategy-and-methodology-improved-iwrm->).
A 2009 report released by STRIVER is available at
<http://ec.europa.eu/research/sd/conference/2009/papers/9/per_stalnacke_-_striver.pdf>.

For a map of Cambodia with provinces, see
<http://www.discoveryindochina.com/cam/map_provinces.html>. For the
interactive HealthMap/ProMED-mail map with links to other recent
PRO/MBDS and ProMED-mail postings on Cambodia and neighboring
countries, see <http://healthmap.org/r/01dw>. - Mod.SCM]

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Diarrhoea kills another two victims
Monday, 26 April 2010 15:02 Tep Nimol .

AN 18-year-old woman in Ratanakkiri province has died from acute diarrhoea contracted after she consumed contaminated water, marking the seventh such death in the province in the last two weeks, a health official said.

Huy Vannara, head of the provincial Communicable Diseases Control Department, said on Sunday that he did not recall the name of the latest victim, but noted that, in addition to the seven deaths, about 100 people suffering from diarrhoea have been rushed to hospitals or health centres since April 10.

?The ministry has promised to send some medical experts to find out the cause of the epidemic and the source of the disease so that effective measures to prevent the spread of the disease can be taken,? he said.

Meanwhile, a villager in Svay Rieng province died on Thursday and 10 others were rushed to hospital after contracting acute diarrhoea that health officials blamed on the consumption of unhygienic food.
http://www.phnompenhpost.com/index....news/diarrhoea-kills-another-two-victims.html

 

[alert]

Re: Cambodia: Cholera cases

Thank you to the mod who moved/renamed/merged this thread.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1040,82438

Archive Number 20100427.1351
Published Date 27-APR-2010
Subject PRO/MBDS> Diarrheal illness - Cambodia (06): fatality, RFI

DIARRHEAL ILLNESS - CAMBODIA (06): FATALITY, REQUEST FOR INFORMATION
*****************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 26 Apr 2010
Source: The Phnom Penh Post [edited]
<http://www.phnompenhpost.com/index.php/2010042638059/National-news/diarrhoea-kills-another-two-victims.html>


An 18-year-old woman in Ratanakkiri province has died from acute
diarrhea contracted after she consumed contaminated water, marking
the 7th such death in the province in the last 2 weeks, a health official said.

Huy Vannara, head of the provincial Communicable Diseases Control
Department, said on Sunday [25 Apr 2010] that he did not recall the
name of the latest victim but noted that, in addition to the 7
deaths, about 100 people suffering from diarrhea have been rushed to
hospitals or health centers since [10 Apr 2010].

"The ministry has promised to send some medical experts to find out
the cause of the epidemic and the source of the disease so that
effective measures to prevent the spread of the disease can be taken," he said.

Meanwhile, a villager in Svay Rieng province died on Thursday [22 Apr
2010], and 10 others were rushed to hospital after contracting acute
diarrhea that health officials blamed on the consumption of unhygienic food.

[Byline: Tep Nimol]

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[According to the above newswire, the outbreak of acute diarrhea has
been reported in 2 provinces of Cambodia. One outbreak is in
Ratanakkiri province with one more fatality reported, and this
fatality brings the total number of deaths attributable to acute
diarrhea in Ratanakkiri province to 7 deaths since 10 Apr 2010.

Another outbreak reported is in Svay Rieng province with one fatality
reported, and 10 others were seeking treatment in hospital. Although
health officials state the vehicle for transmission of the outbreak
in Syay Rieng to be consumption of unhygienic food, the location of
cases and links between them were not specified in the newswire.

The earlier 6 fatalities in Ratanakkiri were reported in 2 districts.
Two deaths were reported in ethnic Kreung men in O'Chum district and
another 4 deaths were reported in ethnic Brov villagers. The links of
sources of the outbreaks remain unclear (see prior PRO/MBDS postings
Diarrheal illness - Cambodia (05): fatality, Ratanakkiri, RFI 20100422.1299).

During March 2010, more than 200 cases of severe diarrhea were
reported from Kratie province (see prior PRO/MBDS posting Diarrheal
illness - Cambodia (02): Kratie, cholera susp, RFI 20100331.1024), of
which 5 deaths of cholera cases were confirmed (see prior PRO/MBDS
posting Diarrheal illness - Cambodia (03): Kratie, cholera conf. RFI
20100401.1044)

PRO/MBDS would highly appreciate more information from reliable
sources on the investigation and confirmed etiological agents
responsible for the above mentioned acute diarrhea outbreaks.

For a map of Cambodia with provinces, see
<http://www.discoveryindochina.com/cam/map_provinces.html>. For the
interactive HealthMap/ProMED-mail map with links to other recent
PRO/MBDS and ProMED-mail postings on Cambodia and neighboring
countries, see <http://healthmap.org/r/01eh>. - Mod.SCM]

 

[Shiloh]

Re: Cambodia: Cholera cases

Source: http://www.phnompenhpost.com/index.php/2010042838264/National-news/more-diarrhoea-deaths.html

More diarrhoea deaths
Wednesday, 28 April 2010 15:02 Mom Kunthear


TWO residents of Peam Khes village in Stung Treng province died from severe vomiting and diarrhoea late last week, and a further 20 were admitted to the district health centre with similar symptoms, health officials said Tuesday.

Chhoun Samneang, director of Siem Pang district health centre, said the 20 people who had been treated were all in recovery, and that the two who died had not sought treatment at the health centre.

?Two people died in their village, a 55-year-old man and a 24-year-old woman, after they had severe diarrhoea,? he said.

Chhoun Samneang said patient samples had been sent for testing, and that emergency health workers have been put on standby in the village so that any further cases can be treated as quickly as possible.

Bou Vutha, deputy director of the Stung Treng provincial health department, said Tuesday that there had been a similar outbreak in the same district earlier this month after a group of about 12 villagers returned from a trip to the forest.

?We don?t know what kind of water they drank when they stayed in the forest, but when they arrived home they had diarrhoea and vomiting,? she said. She added that they had ignored advice given to them by health officials.

?I went down to their villages and explained to them to bring boiled water with them when they go into the forest. I don?t know why they didn?t follow this advice,? she said.

 

[alert]

Re: Cambodia: Cholera cases

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1040,82473

Archive Number 20100429.1381
Published Date 29-APR-2010
Subject PRO/MBDS> Diarrheal illness - Cambodia (07): fatality, Stung Treng, RFI

DIARRHEAL ILLNESS - CAMBODIA (07): FATALITY, STUNG TRENG, REQUEST FOR
INFORMATION
***************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 28 Apr 2010
Source: The Phnom Penh Post [edited]
<http://www.phnompenhpost.com/index.php/2010042838264/National-news/more-diarrhoea-deaths.html>


Health officials said Tuesday [27 Apr 2010] that 2 residents of Peam
Khes village in Stung Treng province died from severe vomiting and
diarrhea late last week [week of 19 Apr 2010], and a further 20 were
admitted to the district health centre with similar symptoms.

Chhoun Samneang, director of Siem Pang district health centre, said
the 20 people who had been treated were all in recovery and that the
2 who died had not sought treatment at the health centre.

He said, "2 people died in their village [Peam Khes], a 55-year-old
man and a 24-year-old woman, after they had severe diarrhea."

Chhoun Samneang said patient samples had been sent for testing and
that emergency health workers have been put on standby in the village
so that any further cases can be treated as quickly as possible.

Bou Vutha, deputy director of the Stung Treng provincial health
department, said Tuesday [27 Apr 2010] that there had been a similar
outbreak in the same district earlier this month [April 2010] after a
group of about 12 villagers returned from a trip to the forest.

"We don't know what kind of water they drank when they stayed in the
forest, but when they arrived home they had diarrhea and vomiting,"
she said. She added that they had ignored advice given to them by
health officials. "I went down to their villages and explained to
them to bring boiled water with them when they go into the forest. I
don't know why they didn't follow this advice," she said.

[Byline: Mom Kunthear]

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[According to the newswire above, 2 fatalities with severe vomiting
and diarrhea were reported in Peam Khes village, Siem Pang district,
Stung Treng province. In addition, there were 20 cases hospitalized
with similar symptoms in the district health centre late last week
(week of 19 Apr 2010). The fatal cases mentioned in the newswire have
brought the total number of deaths in Cambodia to 10 since 10 Apr 2010.

During April 2010, more than 130 cases and 8 fatalities of acute
diarrhea have been reported from several acute diarrheal outbreaks in
2 provinces in Cambodia: 7 fatalities from Ratanakkiri province and
another fatality from Svay Rieng (see prior PRO/MBDS postings
Diarrheal illness - Cambodia (06): fatality, RFI 20100427.1351).

The newswire above mentions a similar outbreak in the same district
earlier in April 2010; a group of 12 villagers had symptoms after
returning from a trip to the forest. It is unclear whether these 2
fatalities and the 20 cases that occurred late last week had a common
source such as the same source of water in the forest. However,
similar to previous acute diarrheal outbreaks in Ratanakkiri and Svay
Rieng provinces, health officials considered that unclean drinking
water was the vehicle of transmission in the outbreaks. So far, the
etiological agents of the outbreaks in these 3 provinces (including
Stung Treng) have not been confirmed.

PRO/MBDS would greatly appreciate more information from knowledgeable
sources on the investigations and confirmed etiological agents
responsible for the mentioned acute diarrheal outbreaks in Cambodia.

For a map of Cambodia with provinces, see
<http://www.discoveryindochina.com/cam/map_provinces.html>. For the
interactive HealthMap/ProMED-mail map with links to other recent
PRO/MBDS and ProMED-mail postings on Cambodia and neighboring
countries, see <http://healthmap.org/r/01eR>. - Mod.SCM]

[see also:
Diarrheal illness - Cambodia (06): fatality, RFI 20100427.1351
Diarrheal illness - Cambodia (05): fatality, Ratanakkiri, RFI 20100422.1299
Diarrheal illness - Cambodia (04): fatality, Ratanakkiri, RFI 20100414.1218
Diarrheal illness - Cambodia (03): Kratie, cholera conf. RFI 20100401.1044
Diarrheal illness - Cambodia (02): Kratie, cholera susp, RFI 20100331.1024
Diarrheal illness - Cambodia: Kratie, cholera susp, RFI 20100330.0992
Cholera - Cambodia (06): RFI 20100303.0696
Cholera - Cambodia (05): RFI 20100227.0661
Cholera - Cambodia (04): Phnom Penh, RFI 20100216.0549
Cholera - Cambodia (03): Phnom Penh, RFI 20100212.0493
Cholera - Cambodia (02) 20100211.0475
Cholera - Cambodia: (Phnom Penh), RFI 20100112.0139
Cholera - Viet Nam ex Cambodia (03) 20100305.0720
Cholera - Viet Nam ex Cambodia (02) 20100209.0434
Cholera - Viet Nam ex Cambodia: RFI 20100131.0338
2009
----
Cholera - Cambodia: Kandal, prison, RFI 20091225.4342]
...................................scm/msp/scm/mj/yma

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Impure water sickens 21 in Kratie district
Friday, 07 May 2010 15:02 Mom Kunthear .

HEALTH officials treating 21 people for severe diarrhoea and vomiting in Kratie province?s Chet Borey district ? where five people died of cholera in March ? said Thursday that they thought unclean water was responsible for the new outbreak of illness.

District Governor Toun Ngork said the illness began spreading through the district on Wednesday, and that an investigation by local officials had proved that bad water was the cause.

?They went to their rice fields after the rain and they drank the water in the lake and puddle nearby without boiling it, and they didn?t think about their health,? he said, referring to the sick villagers. ?Health officials and myself often educate them to be careful with hygiene and to drink boiled water, but they don?t listen to us. That?s why they still get diarrhoea.?

Chhneang Vutha, deputy director of the provincial hospital, concurred with this assessment.

?They have diarrhoea and vomiting because they don?t pay enough attention to hygiene; they drank uncooked water and bad food,? he said. ?They are not cholera cases.?

He added, though, that tests would be run on samples from the sick patients, some of whom are being treated at the hospital, to confirm the cause of illness.

Laboratory tests revealed that cholera caused five deaths in the same district in March. Around 200 people, 70 of whom were admitted to hospital, displayed symptoms of cholera during the week the tests results came back.

Initially, health officials blamed bad hygiene for the outbreak, and they were reluctant to comment on the presence of cholera in the district even after it had been confirmed, citing concerns that press coverage of the disease might negatively affect tourism.

Dr Nima Asgari, public health specialist at the World Health Organisation, said Thursday that tests should be conducted on the new group of sick villagers, noting that cholera ?can be transferred by food or water?.
http://www.phnompenhpost.com/index....pure-water-sickens-21-in-kratie-district.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Ratanakkiri villagers return after fleeing outbreak
Monday, 10 May 2010 15:01 Mom Kunthear .

VILLAGERS from Ratanakkiri province?s O?Chum district have returned to their homes after fleeing into the jungle after a diarrhoea outbreak killed two villagers last week, officials said.

Tha Bunthak, deputy director of the Ratanakkiri provincial Health Department, said Sunday that after the death of a 17-year-old girl and 52-year-old woman last week, most of those living in Kham village left their homes Thursday, fearing they would come down with the ailment.

?Many villagers ran into the jungle to escape getting the same disease, but I and local authorities announced for them to return to the village in order to prevent them from getting the same disease,? he said. He added that a total of 53 villagers have reported symptoms to local officials.

He said that authorities are now educating the villagers about how to protect themselves from diarrhoea.

?We explained to them not to go into the jungle, because it can make them get ill ... because they drink bad water and eat bad food, so it is easy for them to get diarrhoea,? he said.

Tha Bunthak said the prevalence of diarrhoea had increased in Ratanakkiri so far this year, and that lack of awareness of the illness was partly to blame.

A total of 14 people have died from diarrhoea this year.

?Diarrhoea cases in Ratanakkiri province are worse than last year because the weather is not so good and the villagers don?t follow our advice,? he said.

?We told them to drink boiled water and eat food which is hygienic, but they don?t do it. They still drink unboiled water.?

Sak Sun, the governor of O?Chum district, said officials had succeeded in calming villagers since last week?s outbreak. ?The health officials helped them in time at their village after the two people died,? he said.
http://www.phnompenhpost.com/index....-villagers-return-after-fleeing-outbreak.html

 

[Ronan Kelly]

Re: Cambodia: Cholera cases

Villagers aim to scare off diarrhoea
Wednesday, 12 May 2010 15:02 Mom Kunthear .

VILLAGERS in Kampot province?s Banteay Meas district are starting to place scarecrows in front of their homes in the hope of warding off sickness, following the death of one woman from severe diarrhoea, officials said.

Torn Phorn, the chief of Daeum Chamriek village, said villagers became afraid after a woman fell sick and died in April. They have taken to erecting scarecrows and burning fires at night, hoping the presence of both will chase ghosts and disease from their villages.

But authorities and health officials say it is poor hygiene practices, not ghosts, that are actually making the villagers sick.

?They drink the water from the well and rainwater without cooking. That?s why it made them sick,? Torn Phorn said.

Eng Eav, the chief of Sdach Kong Khang Lech commune, said officials have tried to convince villagers to abandon their superstitions.

?They are sick because of bad water. It does not have anything to do with ghosts coming into their villages,? he said.

Khek Daravuth, the director of a district referral hospital, said he believes that between 20 and 30 percent of famlies in Banteay Meas district have placed scarecrows in front of their homes, but that health officials had emphasised the importance of following good hygiene practices.

?Health officials went to their villages and told them to use boiled water and provided them with medicine,? he said
http://www.phnompenhpost.com/index....ews/villagers-aim-to-scare-off-diarrhoea.html