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Interim Human Avian influenza A(H5N1) by Cambodian Provinces and Outcome (n=44) 31 deaths (CFR=70.45%)
Throughout 2013 regional distribution appears now to be slowing engulfing the provincial villages around the Tonle Sap Biosphere Reserve ! We are seeing a farther reaching grip from the Northern and Southern provinces to new sporadic human cases for the first time in Battambang, Kampong Thom, and now Pursat.
Provincial distribution of Human Avian Influenza A(H5N1) in Cambodia (n=44)
12 provinces, 29 districts [cases (deaths)]
1. Banteay Meanchey [n=4 (4)] *
2. Battambang [n=2 (1)]
3. Kampong Cham [n=5 (4)]
4. Kampong Chhnang [n=1 (1)]
5. Kampong Speu [n=5 (4)]
6. Kampong Thom [n=1(0)]
7. Kampot [n=10 (9)]
8. Kandal [n=3 (0)]
9. Phnom Penh [n=4 (1)]
10. Pursat [n=1 (1)]
11. Prey Veng [n=5 (4)]
12. Takéo [n=3 (2)]
Total [n=44 (31)] CFR 70.45%
*Note: 2 fatal cases from Banteay Meanchey province acquired infection in Prash Sdach, Prey Veng respectively!
From January to April during the preparation of the Khmer New Year festival celebrations in Cambodia! The increase of interprovincial transportation of poultry in Cambodia and also from adjacent countries like Vietnam, Thailand increases! Notably that 78% of confirmed cases and 74% of confirmed deaths occurred during this period from 2005-2012 however now after the unprecedented surge in sporadic H5N1 cases in Cambodia 2013 these percentages are starting to change.
Seasonal distribution of Human H5n1 Confirmed Cases in Cambodia
Month: Total cases Survivors (n=13); Deaths (n=31)
January: 11 cases, 3 (8)
February: 5 cases, 0 (5)
March: 7 cases, 1 (6)
April: 4: cases, 0 (4)
May: 2 cases, 0 (2)
n=29 (25)....29/44 (65.90% of cases) and 25/31 fatal (80.65%)
June: 1 case, 0 (1)
July: 4 cases 2 (2)
August: 3 cases 2 (1)
September: 2 cases 1 (1)
October: 3 cases 2 (1)
November: 1 case (0)
December: 1 case (0)
n=15 (6) ....15/44 34.09% of cases and 6/31 fatal (19.35%)
Notably from 2005-2013 that 65.90% (29/43) of confirmed cases and 80.65% (25/31) of confirmed deaths occurred from Jan to April during the preparations of the Khmer (Lunar) New Year festival celebrations in April which is possibly r/t the increase of interprovincial transportation of poultry in Cambodia and importation of poultry from adjacent countries like Vietnam, Thailand, Laos and China respectively which has been described by many authors before the writer
Cambodia Avian Influenza H5N1 Confirmed Cases and Deaths by Sex, Age and Outcome (n=44) 2005-2013
Age Groups
0-9 [n=29 (19)] ; Male 9 (4); Female 20 (15)
10-19 [n=7 (6)] ; Male 2 (1); Female 5 (5)
20-29 [n=4 (4)] ; Male 2 (2); Female 2 (2)
30-39 [n=2 (2)] ; Male 2 (2); Female 0 (0)
40-49 [n=0)] ; N/A
50-59 [n=2 (0)] ; Male 2 (0); Female N/A
60-69 (n=0) ; N/A
>70 (n=0) ; N/A
Total : n= 44 (31) 70.45%
Male: n=17 (9) CFR 51.94%
Female: n=27 (22) CFR 81.48%
Comparison of CFR’s in Cambodia from 2005-2012 and 2013
2005-2012
Cambodia Avian Influenza H5N1 Confirmed Cases and Deaths by Sex, Age and Outcome From 2005-2012 (n=21)
Total= Male n=7 (5) 71%; Female n=14 (14) 100%
Cumulative total = 21 (19) 90%
2013
Interim Cambodia Avian Influenza H5N1 Confirmed Cases and Deaths by Sex , Age and Outcome (n=23) 2013
Total= Male n=10 (4) 40%; Female n=13 (8) decrease to 61.53%
Cumulative total = 23 (13) 56.52%%
CFR in 2013 age group 0-9 [n=19 (9)] CFR 47.37%
Two Clusters
1. Suspect cluster 2005 Brother/Sister in Kampot Trach, Kampong Chhnang
Case # Age Sex Province District Onset Admission Antiviral Outcome Exposure
Suspect Index 14a Male Kampot Kampot Trach Mid Jan No data No data Fatal 24-Jan Father’s chickens died (died before testing)
1 25 Female Kampot Kampot Trach 21-Jan-05 28-Jan-05 No data Fatal 30-Jan-05 Father’s chickens died ; slaughtered fowls for meal 2 weeks before onset
2. Confirmed Cluster 2011 Mother/Son in Malay, Banteay Meanchey
Case # Age Sex Province District Onset Admission Antiviral Outcome Exposure
12 19 Female From Banteay Meanchey [Prey Veng] Malay 5-Feb-11 12-Feb-11 No data Fatal 12-Feb-11 Mother was exposed to eating and preparing sick poultry while visiting relatives in Prash Sdach district, Prey Veng a few days before onset
13 0.11 Male From Banteay Meanchey [Prey Veng] Malay 5-Feb-11 15-Feb-11 No data Fatal 17-Feb-11 Son had multiple exposures to sick and dead poultry in the same time frame while visiting relatives in Prash Sdach district, Prey Veng a few days before onset
Days between onset and hospitalisation Survivors (n=13) Deaths (n=31)
0 0 0
1 0 (1)
2 1 (1)
3 1 (2)
4 2 (5)
5 4 (4)
6 0 (7)
7 0 (3)
8 1 (4)
9 0 (1)
10 1 (1)
11 0 (0)
12 0 (1)
13
out pt 3 (0)
Unknown (1)
As you can see day 4-8 23/31 [74%] fatal cases occurred.
Time to antiviral average (med) was 8 days for all cases, 7.5 for fatal and recovered cases known publically!
As usual antiviral should be given ideally within 24-36hrs after onset but as you can see rural Cambodia has it’s challenges. The most recent case didn’t receive an antiviral and the outcome was fatal.. Very sad! Especially in a day and age of pandemic preparedness, again poverty has it’s challenges.
All information is from my H5N1 spreadsheet where references can be provided on request!
It’s too bad I can’t just post the power point on FluTrackers... So you can see the graph, tables and much more!
This platform doesn’t give it justice!
Cambodian Spreadsheet Highlights:
Case # Age Sex Province (sub list) District (sub list) Onset Admission Antiviral Outcome Exposure
Suspect Index, 14 Male Kampot (0) Kampot Trach Mid Jan No data No data Fatal 24-Jan-05 Father’s chickens died (Bother of case 1, not sampled)
1, 25* Female (1) Kampot (1) Kampot Trach (1) 21-Jan-05 28-Jan-05 No data Fatal 30-Jan-05 Father’s chickens died ; slaughtered fowls for meal 2 weeks before onset
2, 28 Male (1) Kampot (2) Bantey Meas (1) 17-Mar-05 21-Mar-05 No data Fatal 22-Mar-05 Direct contact with dead chickens 1 week before onset , defeathering and consumed
3, 8 Female (2) Kampot (3) Bantey Meas (2) 29-Mar-05 7-Apr-05 No data Fatal 7-Apr-05 Had contact with died poultry but not within 2 weeks of onset
4, 20 Female (3) Kampot (4) Kampot Trach (2) No data 19-Apr-05 No data Fatal 19-Apr-05 Part time poultry vendor at school
5, 3 Female (4) Kampong Speu (1) Kong Pisey (1) 14-Mar-06 20-Mar-06 No Data Fatal 21-Mar-06 known to play with sick and dead poultry 1 week prior to onset
6, 12 Male (2) Prey Veng (1) Mesang (1) 29-Mar-06 4-Apr-06 No data Fatal 5-Apr-06
Known to have collected sick and dead chickens around house
7, 13 Female (5) Kampong Cham (1) Ponhea Kreak (1) 2-Apr-07 3-Apr-07 No Data Fatal 5-Apr-07 consumed sick chicken prior to onset (backyard poultry (chickens and ducks) in one village (5 households)
8, 19 Male (3) Kandal (1) Kandal Steung (1) 28-Nov-08 2-Dec-08* (WPRO) or 3- Dec-13 (NCDM) No Data Recovered consumed sick chicken prior to onset (backyard poultry (chickens and ducks) in one village (5 households)1; 16-Nov-08 reported to have received a dead chicken from a military camp in Kandal Strung district returned to Kampong Speu and developed symptoms on 28-Nov-08 and returned to Tunsay Keuch village, sample taken at NAMRU-2 FSS; private clinic in , Admitted to TB centre 3-Dec-10, referred to Calmette 11-Dec-08 (NCDM Mar-09)
9, 57 Male (4) Kampong Cham (2) Ponhea Kreak (2) 11-Dec-09 16-Dec-09 No Data Recovered Backyard poultry including chickens and ducks (1,012 chickens and 204 ducks). 875 birds corresponding to 751 chickens and 124 ducks were culled. La-ak, Ponhea Kraek
10, 27 Male (5) Prey Veng (2) Kampong Leav (1) 13-Apr-10 16-Apr-10 No Data Fatal 17-Apr-10 prepared and consumed sick poultry in the 7 days before onset of symptoms.
11, 5 Female (6) Phnom Penh (1) Reussey Keo (1) 30-Jan-11 3-Feb-11 4-Feb-11 Fatal 4-Feb-11 contact with sick poultry during the 7 days before onset of symptoms
12, 19 Female (7) From Banteay Meanchey (1) [Prey Veng^] Malay (1) 5-Feb-11 12-Feb-11 No data Fatal 12-Feb-11 Mother was exposed to eating and preparing sick poultry while visiting relatives in Prash Sdach district, Prey Veng a few days before onset^
13, 0.11 Male (6) From Banteay Meanchey (2) [Prey Veng^] Malay (2) 5-Feb-11 15-Feb-11 No data Fatal 17-Feb-11
Son had multiple exposures to sick and dead poultry in the same time frame while visiting relatives in Prash Sdach district, Prey Veng a few days before onset^
14, 11 Female (8) Kampong Cham (3) Stueng Trang (1) 22-Mar-11 29-Mar-11 No data Fatal 31-Mar-11 Were reports of poultry die off in her village
15, 5 Female (9) Prey Veng (3) Pea Reang (1) 11-Apr-11 13-Apr-11 No data Fatal 16-Apr-11 Were reports of poultry die off in her village (Isolate is closely related to environment sample)
16, 7 Female (10) Prey Veng (4) Kampong Trabek (1) 24-May-11 31-May-11 No data Fatal 7-Jun-11 Were reports of poultry die off in her village and exposed to sick poultry, almost 1/3 cases exposed in Prey Veng (including case 12 and 13)
17, 4 Female (11) Banteay Meanchey (3) Mongkul Borei (1) 10-Jul-11 18-Jul-11 No data Fatal 20-Jul-11 Evidence of poultry die off in the village and the case had consumed dead chicken prior to becoming sick (OIE-Follow-up report No.: 3 Report reference: 321-322-323/2011, OIE Ref: 11313, Report Date: 21/11/2011, Country: Cambodia-Birds – 580 – 100 – 100 – 480 – 0
18, 6 Female (12) Kampong Cham (4) Cheung Prey Operational District (1) 7-Aug-11 12-Aug-11 13-Aug-11 Fatal 14-Aug-11 Evidence of recent deaths among poultry in the village and the patient had contact with sick or dead poultry and their waste prior to becoming sick
19, 2 Male (7) Banteay Meanchey (4) Pro Neth Preah (1) 3-Jan-12 9-Jan-12 Yes Fatal 18-Jan-12 Evidence of recent deaths among poultry in the village and the patient had contact with sick or dead poultry [backyard poultry] prior to becoming sick.
20, 6 Female (13) Kampong Chhnang (1) Kampong Trolach (1) 22-Mar-12 28-Mar-12 No data Fatal 30-Mar-12 Reported that the patient had contact with sick or dead poultry prior to onset of illness
21, 10 Female (14) Kampong Speu (2) Bosedth District (1) 20-May-12 25-May-12 No data Fatal 27-May-12 Pring village ,Toul Sala positive chicken and Duck 30-05-12 EMPRES-I; Report reference: 577/12 NaVRI, OIE Ref: 12032, Report Date: 11/06/2012, Country: Cambodia
22, 0.8 Male (8) Phnom Penh (2) Khan Por Sen Chey 8-Jan-13 Mild symptoms ,Out pt- IlI Sentinel Surveillance No data Recovered History of coming into contact with poultry prior to becoming sick
23, 15 Female (15) Takéo (1) Prey Kabbas (1) 11-Jan-13 17-Jan-13 No data Fatal 21-Jan-13 Evidence of recent deaths among poultry in the village and the patient prepared sick chicken for food prior to becoming sick; Report reference: 38/13 NaVRI REF OIE 12931, Report Date: 27/01/2013, Country : Cambodia . Backyard poultry started being sick and dying in the village from 9 January 2013.
24, 35 Male (9) Kampong Speu (3) Kong Pisey (2) 13-Jan-13 21-Jan-13 No data Fatal 21-Jan-13 Evidence of recent deaths among poultry in the village and the patient prepared sick chicken for food prior to becoming sick
25, 1.5 Female (16) Kampong Speu (4) Kong Pisey (3) 13-Jan-13 17-Jan-13 No data Fatal 28-Jan-13 Evidence of recent deaths among poultry in the village and the girl had history of coming into contact with poultry prior to becoming sick. (different village)
26, 9 Female (17) Kampot (5) Toeuk Chhou (1) (formally Kompot district) 19-Jan-13 27-Jan-13 No data Fatal 28-Jan-13 Evidence of recent deaths among poultry in the village ( Non official- contact exposure to backyard poultry)
27, 5 Female (18) Takéo (2) Prey Kabass (2) 25-Jan-13 31-Jan-13 No data Fatal 7-Feb-13 Evidence of recent deaths among poultry in the village and the girl had a history of coming into contact with poultry prior to becoming sick.
28, 3 Female (19) Kampot (6) Angkor Chey (1) 3-Feb-13 6-Feb-13 No data Fatal 13-Feb-13 Evidence of recent deaths among poultry in the village and the girl had history of coming into contact with poultry prior to becoming sick
29, 1.8 Male (10) Kampot (7) Angkor Chey (2) 6-Feb-13 18-Feb-13 No data Fatal 19-Feb-13 Evidence of recent deaths among poultry in the village. (different village)
30, 35 Male (11) Kampong Cham (5) Stueng Trang (2) 8-Feb-13 13-Feb-13 13-Feb-13 Fatal 25-Feb-13
Evidence of recent deaths among poultry in the village and the man had history of coming into contact with sick poultry prior to becoming sick, [Non official slaughtered, prepared and consumed 2 infected ducks]; Report reference: 38/13 NaVRI, Reference OIE : 12947, Report Date : 30/01/2013, Country : Cambodia
31, 5 Male (12) Kampot (8) Kampong Bay (1) 27-Mar-13 31-Mar-13 1-Apr-13 Recovering in severe condition? Exposure under investigations, not known whether the boy had direct contact with poultry; Wild birds were seen in area
32~, 5 Female (20) Kampong Speu (5) Thpong (1) 28-Jan-13 Out pt- Enrolled in fever surveillance study of the US Naval Medical Research Unit; No data recovered Unknown, exposure to poultry is/was being investigated; co-infection with Influenza A(H1N1) 30-Jan-13 Influenza and 2-May-13 H5N1 ; [retrospectively confirmed ~] ....First Female Survivor reported since 2005!
33~, 58 Male (13) Phnom Penh (3) Roeusey Keo (2) 4-Jan-13 6-Jan-13 Yes recovered Exposure not reported; co-infection with influenza (influenza strain not reported) 9-Jan-13 influenza and 21-Jun-13 H5N1 [retrospectively confirmed ~]
34, 6 Female (21) Kampot (9) Bantey Meas (3) 24-Jun-13 28-Jun-13 28-Jun-13 Fatal 28-Jun-13 Recent poultry deaths in the village and the girl was likely to be exposed to sick and dead poultry before she became sick
35, 3 Male (14) Prey Veng (5) Kampong Trabek (2) 3-Jul-13 8-Jul-13 9-Jul-13 recovered Were recent deaths among poultry in the village and the boy was likely to be exposed to sick and dead poultry before he became sick
36, 9 Male (15) Battambang (1) Sang Ke (1) 26-Jul-13 2-Aug-13 9-Aug-13 Fatal 18-Aug-13 Were recent deaths among chickens and ducks in the village, He carried dead and sick ducks and chickens from a cage for food preparation by his sister prior to onset ; Report reference: 646/13 NaVRI REF OIE 13939, Report Date: 19/08/2013, Country : Cambodia- Damnak Dangkor Village, Raing Kesey commune, Sang Ke
37, 5 Female (22) Kandal (2) Saang (1) 1-Aug-13 9-Aug-13 10-Aug-13 Critical condition-recovered Were recent deaths among poultry in the village.
38~, 6 Male (16) Kandal (3) Kandal Stung (1) 21-July-13 Outpt with ILI surveillance via FSS study in Kendal No data Recovered Came into contact with sick poultry
39, 1.3 Male (17) Phnom Penh (4) Russey Keo (3) 16-Aug-13 26-Aug-13 27-Aug-13 Recovering in stable condition Exposure to poultry, Ministry of Health’s Rapid Response Teams (RRT) in the village to determine whether the child came into contact with sick or dead poultry.
40, 5 Female (23) Takéo (3) Traing (1) 7-Sep-13 12-Sep-13 13-Sep-13 Recovered and discharged 20-Sep-13 Ministry of Health’s Rapid Response Teams (RRT) in Prey Slek village revealed that the girl came into direct contact with sick and dead chickens in her village
41, 2 Female (24) Kampot (10) Thek (Teuk) Chhou (2) 11-Sep-13 15-Sep-13 16-Sep-13 Fatal 17-Sep-13 Child went to her neighbour's house, with her mother, to ‘watch’ villagers prepare a meal from chickens that had died earlier. The villagers also shared the meal with the girl’s family. Pending further investigations by Ministry of Health’s Rapid Response Teams (RRT)
42, 8 Female (25) Kampong Thom (1) Baray (1) 8-Oct-13 11-Oct-13 14-Oct-13 Currently in stable condition Ministry of Health’s Rapid Response Teams (RRT) in O-Raing village revealed that the girl had come into direct contact with dead poultry when she helped prepare a meal from a chicken that had died earlier
43, 6 Female (26) Battambang (2) Phnom Preuk district (1) 14-Oct-13 19-Oct-13 24-Oct-13 Currently in stable condition Ministry of Health’s Rapid Response Teams (RRT) in ROI-S&DP-chickens and ducks at neighbours' house and nearby villages, pending investigations for direct contact/handling of sick and dead poultry and ducks
44, 2 Female (27) Pursat (1) Bakane district (1) 17-Oct-13 25-Oct-13 26-Oct-13 Fatal- 26-Oct-13 Ministry of Health’s Rapid Response Teams (RRT) pending further investigation , [query environmental or other exposure] as chickens died 2 month before onset at grandfathers house where the child often stayed
----
This line list is not warranted by writer, all information is my personal research and is as accurate as the information in the public domain!
Throughout 2013 regional distribution appears now to be slowing engulfing the provincial villages around the Tonle Sap Biosphere Reserve ! We are seeing a farther reaching grip from the Northern and Southern provinces to new sporadic human cases for the first time in Battambang, Kampong Thom, and now Pursat.
Provincial distribution of Human Avian Influenza A(H5N1) in Cambodia (n=44)
12 provinces, 29 districts [cases (deaths)]
1. Banteay Meanchey [n=4 (4)] *
2. Battambang [n=2 (1)]
3. Kampong Cham [n=5 (4)]
4. Kampong Chhnang [n=1 (1)]
5. Kampong Speu [n=5 (4)]
6. Kampong Thom [n=1(0)]
7. Kampot [n=10 (9)]
8. Kandal [n=3 (0)]
9. Phnom Penh [n=4 (1)]
10. Pursat [n=1 (1)]
11. Prey Veng [n=5 (4)]
12. Takéo [n=3 (2)]
Total [n=44 (31)] CFR 70.45%
*Note: 2 fatal cases from Banteay Meanchey province acquired infection in Prash Sdach, Prey Veng respectively!
From January to April during the preparation of the Khmer New Year festival celebrations in Cambodia! The increase of interprovincial transportation of poultry in Cambodia and also from adjacent countries like Vietnam, Thailand increases! Notably that 78% of confirmed cases and 74% of confirmed deaths occurred during this period from 2005-2012 however now after the unprecedented surge in sporadic H5N1 cases in Cambodia 2013 these percentages are starting to change.
Seasonal distribution of Human H5n1 Confirmed Cases in Cambodia
Month: Total cases Survivors (n=13); Deaths (n=31)
January: 11 cases, 3 (8)
February: 5 cases, 0 (5)
March: 7 cases, 1 (6)
April: 4: cases, 0 (4)
May: 2 cases, 0 (2)
n=29 (25)....29/44 (65.90% of cases) and 25/31 fatal (80.65%)
June: 1 case, 0 (1)
July: 4 cases 2 (2)
August: 3 cases 2 (1)
September: 2 cases 1 (1)
October: 3 cases 2 (1)
November: 1 case (0)
December: 1 case (0)
n=15 (6) ....15/44 34.09% of cases and 6/31 fatal (19.35%)
Notably from 2005-2013 that 65.90% (29/43) of confirmed cases and 80.65% (25/31) of confirmed deaths occurred from Jan to April during the preparations of the Khmer (Lunar) New Year festival celebrations in April which is possibly r/t the increase of interprovincial transportation of poultry in Cambodia and importation of poultry from adjacent countries like Vietnam, Thailand, Laos and China respectively which has been described by many authors before the writer
Cambodia Avian Influenza H5N1 Confirmed Cases and Deaths by Sex, Age and Outcome (n=44) 2005-2013
Age Groups
0-9 [n=29 (19)] ; Male 9 (4); Female 20 (15)
10-19 [n=7 (6)] ; Male 2 (1); Female 5 (5)
20-29 [n=4 (4)] ; Male 2 (2); Female 2 (2)
30-39 [n=2 (2)] ; Male 2 (2); Female 0 (0)
40-49 [n=0)] ; N/A
50-59 [n=2 (0)] ; Male 2 (0); Female N/A
60-69 (n=0) ; N/A
>70 (n=0) ; N/A
Total : n= 44 (31) 70.45%
Male: n=17 (9) CFR 51.94%
Female: n=27 (22) CFR 81.48%
Comparison of CFR’s in Cambodia from 2005-2012 and 2013
2005-2012
Cambodia Avian Influenza H5N1 Confirmed Cases and Deaths by Sex, Age and Outcome From 2005-2012 (n=21)
Total= Male n=7 (5) 71%; Female n=14 (14) 100%
Cumulative total = 21 (19) 90%
2013
Interim Cambodia Avian Influenza H5N1 Confirmed Cases and Deaths by Sex , Age and Outcome (n=23) 2013
Total= Male n=10 (4) 40%; Female n=13 (8) decrease to 61.53%
Cumulative total = 23 (13) 56.52%%
CFR in 2013 age group 0-9 [n=19 (9)] CFR 47.37%
Two Clusters
1. Suspect cluster 2005 Brother/Sister in Kampot Trach, Kampong Chhnang
Case # Age Sex Province District Onset Admission Antiviral Outcome Exposure
Suspect Index 14a Male Kampot Kampot Trach Mid Jan No data No data Fatal 24-Jan Father’s chickens died (died before testing)
1 25 Female Kampot Kampot Trach 21-Jan-05 28-Jan-05 No data Fatal 30-Jan-05 Father’s chickens died ; slaughtered fowls for meal 2 weeks before onset
2. Confirmed Cluster 2011 Mother/Son in Malay, Banteay Meanchey
Case # Age Sex Province District Onset Admission Antiviral Outcome Exposure
12 19 Female From Banteay Meanchey [Prey Veng] Malay 5-Feb-11 12-Feb-11 No data Fatal 12-Feb-11 Mother was exposed to eating and preparing sick poultry while visiting relatives in Prash Sdach district, Prey Veng a few days before onset
13 0.11 Male From Banteay Meanchey [Prey Veng] Malay 5-Feb-11 15-Feb-11 No data Fatal 17-Feb-11 Son had multiple exposures to sick and dead poultry in the same time frame while visiting relatives in Prash Sdach district, Prey Veng a few days before onset
Days between onset and hospitalisation Survivors (n=13) Deaths (n=31)
0 0 0
1 0 (1)
2 1 (1)
3 1 (2)
4 2 (5)
5 4 (4)
6 0 (7)
7 0 (3)
8 1 (4)
9 0 (1)
10 1 (1)
11 0 (0)
12 0 (1)
13
out pt 3 (0)
Unknown (1)
As you can see day 4-8 23/31 [74%] fatal cases occurred.
Time to antiviral average (med) was 8 days for all cases, 7.5 for fatal and recovered cases known publically!
As usual antiviral should be given ideally within 24-36hrs after onset but as you can see rural Cambodia has it’s challenges. The most recent case didn’t receive an antiviral and the outcome was fatal.. Very sad! Especially in a day and age of pandemic preparedness, again poverty has it’s challenges.
All information is from my H5N1 spreadsheet where references can be provided on request!
It’s too bad I can’t just post the power point on FluTrackers... So you can see the graph, tables and much more!
This platform doesn’t give it justice!
Cambodian Spreadsheet Highlights:
Case # Age Sex Province (sub list) District (sub list) Onset Admission Antiviral Outcome Exposure
Suspect Index, 14 Male Kampot (0) Kampot Trach Mid Jan No data No data Fatal 24-Jan-05 Father’s chickens died (Bother of case 1, not sampled)
1, 25* Female (1) Kampot (1) Kampot Trach (1) 21-Jan-05 28-Jan-05 No data Fatal 30-Jan-05 Father’s chickens died ; slaughtered fowls for meal 2 weeks before onset
2, 28 Male (1) Kampot (2) Bantey Meas (1) 17-Mar-05 21-Mar-05 No data Fatal 22-Mar-05 Direct contact with dead chickens 1 week before onset , defeathering and consumed
3, 8 Female (2) Kampot (3) Bantey Meas (2) 29-Mar-05 7-Apr-05 No data Fatal 7-Apr-05 Had contact with died poultry but not within 2 weeks of onset
4, 20 Female (3) Kampot (4) Kampot Trach (2) No data 19-Apr-05 No data Fatal 19-Apr-05 Part time poultry vendor at school
5, 3 Female (4) Kampong Speu (1) Kong Pisey (1) 14-Mar-06 20-Mar-06 No Data Fatal 21-Mar-06 known to play with sick and dead poultry 1 week prior to onset
6, 12 Male (2) Prey Veng (1) Mesang (1) 29-Mar-06 4-Apr-06 No data Fatal 5-Apr-06
Known to have collected sick and dead chickens around house
7, 13 Female (5) Kampong Cham (1) Ponhea Kreak (1) 2-Apr-07 3-Apr-07 No Data Fatal 5-Apr-07 consumed sick chicken prior to onset (backyard poultry (chickens and ducks) in one village (5 households)
8, 19 Male (3) Kandal (1) Kandal Steung (1) 28-Nov-08 2-Dec-08* (WPRO) or 3- Dec-13 (NCDM) No Data Recovered consumed sick chicken prior to onset (backyard poultry (chickens and ducks) in one village (5 households)1; 16-Nov-08 reported to have received a dead chicken from a military camp in Kandal Strung district returned to Kampong Speu and developed symptoms on 28-Nov-08 and returned to Tunsay Keuch village, sample taken at NAMRU-2 FSS; private clinic in , Admitted to TB centre 3-Dec-10, referred to Calmette 11-Dec-08 (NCDM Mar-09)
9, 57 Male (4) Kampong Cham (2) Ponhea Kreak (2) 11-Dec-09 16-Dec-09 No Data Recovered Backyard poultry including chickens and ducks (1,012 chickens and 204 ducks). 875 birds corresponding to 751 chickens and 124 ducks were culled. La-ak, Ponhea Kraek
10, 27 Male (5) Prey Veng (2) Kampong Leav (1) 13-Apr-10 16-Apr-10 No Data Fatal 17-Apr-10 prepared and consumed sick poultry in the 7 days before onset of symptoms.
11, 5 Female (6) Phnom Penh (1) Reussey Keo (1) 30-Jan-11 3-Feb-11 4-Feb-11 Fatal 4-Feb-11 contact with sick poultry during the 7 days before onset of symptoms
12, 19 Female (7) From Banteay Meanchey (1) [Prey Veng^] Malay (1) 5-Feb-11 12-Feb-11 No data Fatal 12-Feb-11 Mother was exposed to eating and preparing sick poultry while visiting relatives in Prash Sdach district, Prey Veng a few days before onset^
13, 0.11 Male (6) From Banteay Meanchey (2) [Prey Veng^] Malay (2) 5-Feb-11 15-Feb-11 No data Fatal 17-Feb-11
Son had multiple exposures to sick and dead poultry in the same time frame while visiting relatives in Prash Sdach district, Prey Veng a few days before onset^
14, 11 Female (8) Kampong Cham (3) Stueng Trang (1) 22-Mar-11 29-Mar-11 No data Fatal 31-Mar-11 Were reports of poultry die off in her village
15, 5 Female (9) Prey Veng (3) Pea Reang (1) 11-Apr-11 13-Apr-11 No data Fatal 16-Apr-11 Were reports of poultry die off in her village (Isolate is closely related to environment sample)
16, 7 Female (10) Prey Veng (4) Kampong Trabek (1) 24-May-11 31-May-11 No data Fatal 7-Jun-11 Were reports of poultry die off in her village and exposed to sick poultry, almost 1/3 cases exposed in Prey Veng (including case 12 and 13)
17, 4 Female (11) Banteay Meanchey (3) Mongkul Borei (1) 10-Jul-11 18-Jul-11 No data Fatal 20-Jul-11 Evidence of poultry die off in the village and the case had consumed dead chicken prior to becoming sick (OIE-Follow-up report No.: 3 Report reference: 321-322-323/2011, OIE Ref: 11313, Report Date: 21/11/2011, Country: Cambodia-Birds – 580 – 100 – 100 – 480 – 0
18, 6 Female (12) Kampong Cham (4) Cheung Prey Operational District (1) 7-Aug-11 12-Aug-11 13-Aug-11 Fatal 14-Aug-11 Evidence of recent deaths among poultry in the village and the patient had contact with sick or dead poultry and their waste prior to becoming sick
19, 2 Male (7) Banteay Meanchey (4) Pro Neth Preah (1) 3-Jan-12 9-Jan-12 Yes Fatal 18-Jan-12 Evidence of recent deaths among poultry in the village and the patient had contact with sick or dead poultry [backyard poultry] prior to becoming sick.
20, 6 Female (13) Kampong Chhnang (1) Kampong Trolach (1) 22-Mar-12 28-Mar-12 No data Fatal 30-Mar-12 Reported that the patient had contact with sick or dead poultry prior to onset of illness
21, 10 Female (14) Kampong Speu (2) Bosedth District (1) 20-May-12 25-May-12 No data Fatal 27-May-12 Pring village ,Toul Sala positive chicken and Duck 30-05-12 EMPRES-I; Report reference: 577/12 NaVRI, OIE Ref: 12032, Report Date: 11/06/2012, Country: Cambodia
22, 0.8 Male (8) Phnom Penh (2) Khan Por Sen Chey 8-Jan-13 Mild symptoms ,Out pt- IlI Sentinel Surveillance No data Recovered History of coming into contact with poultry prior to becoming sick
23, 15 Female (15) Takéo (1) Prey Kabbas (1) 11-Jan-13 17-Jan-13 No data Fatal 21-Jan-13 Evidence of recent deaths among poultry in the village and the patient prepared sick chicken for food prior to becoming sick; Report reference: 38/13 NaVRI REF OIE 12931, Report Date: 27/01/2013, Country : Cambodia . Backyard poultry started being sick and dying in the village from 9 January 2013.
24, 35 Male (9) Kampong Speu (3) Kong Pisey (2) 13-Jan-13 21-Jan-13 No data Fatal 21-Jan-13 Evidence of recent deaths among poultry in the village and the patient prepared sick chicken for food prior to becoming sick
25, 1.5 Female (16) Kampong Speu (4) Kong Pisey (3) 13-Jan-13 17-Jan-13 No data Fatal 28-Jan-13 Evidence of recent deaths among poultry in the village and the girl had history of coming into contact with poultry prior to becoming sick. (different village)
26, 9 Female (17) Kampot (5) Toeuk Chhou (1) (formally Kompot district) 19-Jan-13 27-Jan-13 No data Fatal 28-Jan-13 Evidence of recent deaths among poultry in the village ( Non official- contact exposure to backyard poultry)
27, 5 Female (18) Takéo (2) Prey Kabass (2) 25-Jan-13 31-Jan-13 No data Fatal 7-Feb-13 Evidence of recent deaths among poultry in the village and the girl had a history of coming into contact with poultry prior to becoming sick.
28, 3 Female (19) Kampot (6) Angkor Chey (1) 3-Feb-13 6-Feb-13 No data Fatal 13-Feb-13 Evidence of recent deaths among poultry in the village and the girl had history of coming into contact with poultry prior to becoming sick
29, 1.8 Male (10) Kampot (7) Angkor Chey (2) 6-Feb-13 18-Feb-13 No data Fatal 19-Feb-13 Evidence of recent deaths among poultry in the village. (different village)
30, 35 Male (11) Kampong Cham (5) Stueng Trang (2) 8-Feb-13 13-Feb-13 13-Feb-13 Fatal 25-Feb-13
Evidence of recent deaths among poultry in the village and the man had history of coming into contact with sick poultry prior to becoming sick, [Non official slaughtered, prepared and consumed 2 infected ducks]; Report reference: 38/13 NaVRI, Reference OIE : 12947, Report Date : 30/01/2013, Country : Cambodia
31, 5 Male (12) Kampot (8) Kampong Bay (1) 27-Mar-13 31-Mar-13 1-Apr-13 Recovering in severe condition? Exposure under investigations, not known whether the boy had direct contact with poultry; Wild birds were seen in area
32~, 5 Female (20) Kampong Speu (5) Thpong (1) 28-Jan-13 Out pt- Enrolled in fever surveillance study of the US Naval Medical Research Unit; No data recovered Unknown, exposure to poultry is/was being investigated; co-infection with Influenza A(H1N1) 30-Jan-13 Influenza and 2-May-13 H5N1 ; [retrospectively confirmed ~] ....First Female Survivor reported since 2005!
33~, 58 Male (13) Phnom Penh (3) Roeusey Keo (2) 4-Jan-13 6-Jan-13 Yes recovered Exposure not reported; co-infection with influenza (influenza strain not reported) 9-Jan-13 influenza and 21-Jun-13 H5N1 [retrospectively confirmed ~]
34, 6 Female (21) Kampot (9) Bantey Meas (3) 24-Jun-13 28-Jun-13 28-Jun-13 Fatal 28-Jun-13 Recent poultry deaths in the village and the girl was likely to be exposed to sick and dead poultry before she became sick
35, 3 Male (14) Prey Veng (5) Kampong Trabek (2) 3-Jul-13 8-Jul-13 9-Jul-13 recovered Were recent deaths among poultry in the village and the boy was likely to be exposed to sick and dead poultry before he became sick
36, 9 Male (15) Battambang (1) Sang Ke (1) 26-Jul-13 2-Aug-13 9-Aug-13 Fatal 18-Aug-13 Were recent deaths among chickens and ducks in the village, He carried dead and sick ducks and chickens from a cage for food preparation by his sister prior to onset ; Report reference: 646/13 NaVRI REF OIE 13939, Report Date: 19/08/2013, Country : Cambodia- Damnak Dangkor Village, Raing Kesey commune, Sang Ke
37, 5 Female (22) Kandal (2) Saang (1) 1-Aug-13 9-Aug-13 10-Aug-13 Critical condition-recovered Were recent deaths among poultry in the village.
38~, 6 Male (16) Kandal (3) Kandal Stung (1) 21-July-13 Outpt with ILI surveillance via FSS study in Kendal No data Recovered Came into contact with sick poultry
39, 1.3 Male (17) Phnom Penh (4) Russey Keo (3) 16-Aug-13 26-Aug-13 27-Aug-13 Recovering in stable condition Exposure to poultry, Ministry of Health’s Rapid Response Teams (RRT) in the village to determine whether the child came into contact with sick or dead poultry.
40, 5 Female (23) Takéo (3) Traing (1) 7-Sep-13 12-Sep-13 13-Sep-13 Recovered and discharged 20-Sep-13 Ministry of Health’s Rapid Response Teams (RRT) in Prey Slek village revealed that the girl came into direct contact with sick and dead chickens in her village
41, 2 Female (24) Kampot (10) Thek (Teuk) Chhou (2) 11-Sep-13 15-Sep-13 16-Sep-13 Fatal 17-Sep-13 Child went to her neighbour's house, with her mother, to ‘watch’ villagers prepare a meal from chickens that had died earlier. The villagers also shared the meal with the girl’s family. Pending further investigations by Ministry of Health’s Rapid Response Teams (RRT)
42, 8 Female (25) Kampong Thom (1) Baray (1) 8-Oct-13 11-Oct-13 14-Oct-13 Currently in stable condition Ministry of Health’s Rapid Response Teams (RRT) in O-Raing village revealed that the girl had come into direct contact with dead poultry when she helped prepare a meal from a chicken that had died earlier
43, 6 Female (26) Battambang (2) Phnom Preuk district (1) 14-Oct-13 19-Oct-13 24-Oct-13 Currently in stable condition Ministry of Health’s Rapid Response Teams (RRT) in ROI-S&DP-chickens and ducks at neighbours' house and nearby villages, pending investigations for direct contact/handling of sick and dead poultry and ducks
44, 2 Female (27) Pursat (1) Bakane district (1) 17-Oct-13 25-Oct-13 26-Oct-13 Fatal- 26-Oct-13 Ministry of Health’s Rapid Response Teams (RRT) pending further investigation , [query environmental or other exposure] as chickens died 2 month before onset at grandfathers house where the child often stayed
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This line list is not warranted by writer, all information is my personal research and is as accurate as the information in the public domain!
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