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

[Michael Coston]

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.


https://afludiary.blogspot.com/2024/07/cambodia-reports-6th-h5n1-case-of-2024.html
​

 

[sharon sanders]

Please see:

FluTrackers 2016+ Global H5N1 Human Cases List​

 

[Pathfinder]

​
Takéo province
/https://en.wikipedia.org/wiki/Tak%C3%A9o_province
---------------------------------------

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.
...
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.
...
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.
...
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/a0...ix human cases,poultry prior to their illness.

 

[Commonground]

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/ba...PENH, July 8 (Xinhua,in a statement on Monday.

 

[Commonground]

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.
-snip-
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.
...
https://www.khmertimeskh.com/501519079/two-takeo-boys-confirmed-infected-by-h5n1-bird-flu/

 

[Commonground]

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.
​
https://www.khmertimeskh.com/501519...d-flu-in-a-5-year-old-girl-in-takeo-province/

 

[Michael Coston]

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:

Science: Protection Against Novel Flu Subtypes Via Childhood HA Imprinting​

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.


https://afludiary.blogspot.com/2024/07/cambodia-reports-7th-h5n1-case-of-2024.html
​

 

[sharon sanders]

Case list updated link

 

[Pathfinder]

Cambodia detects another H5N1 bird flu case in human
...
July 8, 2024 at 06:45:15
...
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.
...
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./.

https://en.vietnamplus.vn/cambodia-detects-another-h5n1-bird-flu-case-in-human-post289832.vnp

 

[Pathfinder]

Hat tip to Lance

GO TO POST​

Cambodia - High pathogenicity avian influenza viruses (poultry) (Inf. with) - Immediate notification
...
NEW OUTBREAKS

OB_136448 - POR VILLAGE, PREAH BAT CHOAN CHUM COMMUNE, KIRI VONG DISTRICT, TAKEO PROVINCE

OUTBREAK REFERENCE
-

START DATE
2024/07/05

END DATE
-

DETAILED CHARACTERISATION
-

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
-

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 - -
...​

 

[Michael Coston]

Cambodia Reports 8th H5N1 Case of 2024

#18,219


For the third time in the month of July, and the 14th case over the past 18 months, Cambodia's Ministry of Health is reporting a new H5N1 case, this time in a 4 y.o. boy from Svay Rieng Province.

All of the cases reported in Cambodia to date have been from an older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b which has spread across much of the rest of the world.​

The following announcement was posted on the MOH's facebook page earlier today (translation follows).

Kingdom of Cambodia, Nation, Religion, King *
Ministry of Health
Press Release on Avian Influenza Cases in 4-Year-Old Boys


The Ministry of Health would like to inform the public that there was one case of bird flu in a 4-year-old boy and that it was confirmed as H5N1 bird flu virus from the National Institutes of Public Health and the Institut Pasteur. On July 30, 2024, living in Chrung Popel village, Meam commune, Romeas Hek district, Svay Rieng province. The boy had a fever, a cough, tiredness, difficulty breathing and drowsiness. At present, the patient's condition has improved and he is receiving intensive care by doctors.

According to the interrogation, about 12 days before the onset of illness in the village and at home, the patient had a large number of dead chickens and flowed and brought food to eat, the boy touched and held the dead chickens and liked to play With chicken and duck.

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 consultation and treatment at the local level. 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.

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 living. 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 the problem.​

Public health 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.​

Of the 14 H5N1 cases reported by Cambodia over the past 18 months, only 3 have been in adults and all of them survived. Among the 11 children infected - while several had mild symptoms - nearly half (n=5) have died.

We've seen this affinity of H5N1 to preferentially infect younger people often over the years, although the reasons behind it are poorly understood.​

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).

H5 is an HA Group type 1 while H7 viruses fall in group 2.

• Those born prior to the mid-1960s were almost certainly first exposed to Group 1 flu viruses (H1N1 or H2N2)
• Those born after 1968 and before 1977 would have been exposed to Group 2 (H3N2)
• After 1977, both Group 1 and 2 viruses co-circulated, meaning the first exposure could have been to either one.

This suggests that those born before 1968 may carry some degree of limited protection against H5 infection.

That said, any advantage of being born in the 1950s or early 1960s is probably being gradually offset by advancing age and comorbidities, and may not be as pronounced today as it was 20 years ago.​

Today's report is a reminder that while we are heavily focused on clade 2.3.4.4b of H5N1, there are a number of other novel flu viruses with zoonotic potential that have pandemic potential, and deserve our attention.
​

https://afludiary.blogspot.com/2024/08/cambodia-reports-8th-h5n1-case-of-2024.html

 

[sharon sanders]

Please see updated:

FluTrackers 2016+ Global H5N1 Human Cases List​

 

[sharon sanders]

WOAH report on H5N1 chickens in same village as male child in post 11 (8th case). link

 

[Michael Coston]

Cambodia Reports 9th H5N1 Case of 2024

#18,224

For the second time in less than a week Cambodia's MOH has announced an H5N1 infection; this time in a 16 y.o. girl who is reportedly in serious condition. This case, as was the last, lives in Svay Rieng Province, albeit in a different village.

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 all of the other cases reported from Cambodia.​

Today's case is the 15th in just 18 months, all of which have come after Cambodia going nearly a decade without a case. The announcement, posted on the Cambodian MOH Facebook page - and the translation - follow:

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

Cases of bird flu in 16-year-old girl


The Ministry of Health would like to inform the public that there is another case of bird flu in a 16-year-old girl and has been confirmed as H5N1 bird flu virus (H5N1) from the National Institute of Public Health and the Institute. Pasteur on August 3, 2024, residing in Chamkar Leav village, Prey Koki commune, Chantrea district, Svay Rieng province. The girl had a fever, cough, sore throat, fatigue, and difficulty breathing.

Currently, the patient's condition is serious and is receiving intensive care by doctors. According to the interrogation, about four days before the onset of the illness at the neighbor's house and the patient's house, there were nine dead chickens and used to cook, the girl touched and held the 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. 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, as well as distribute Tamillu 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 treatment at the local level. 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.


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 toll-free.​

Although Cambodia is doing an admirable job of reporting these hospitalized cases, it is entirely possible that some milder infections are going unreported. 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.​



https://afludiary.blogspot.com/2024/08/cambodia-reports-9th-h5n1-case-of-2024.html

 

[sharon sanders]

Updated:

FluTrackers 2016+ Global H5N1 Human Cases List
​