Cambodia reports three H5N1 illnesses, two fatal

Jan 25, 2013 (CIDRAP News) – Cambodia's health ministry today announced three new H5N1 avian influenza cases, two of them fatal and all located in the southwestern part of the country with exposure to poultry, according to a joint statement from the ministry and the World Health Organization (WHO).

The cases are the world's first to surface in 2013 and push the number of H5N1 infections in Cambodia since 2005 to 24, which includes 21 deaths.

Rapid response teams are identifying and monitoring the patients' close contacts, exploring if there were any epidemiologic links between the three cases, and conducting educational campaigns about the virus in villages, according to the statement.

The first patient is an 8-month-old boy from the country's capital, Phnom Penh, who got sick on Jan 8 and whose illness was identified during sentinel surveillance after he was seen at a local hospital the day after he became ill. The facility forwarded his samples to the National Institute of Public Health for testing on Jan 11, and the Pasteur Institute confirmed H5N1 on Jan 22.

The boy has recovered, and an investigation into the source of his infection found that he had been exposed to poultry before he got sick.

In the second case, authorities confirmed an H5N1 infection in a 15-year-old girl from Takeo province on Jan 22, according to the health ministry. She came down with a fever and cough on Jan 11 and was first treated by a local private practitioner. When her condition worsened, she was transferred to Kantha Bopha Hospital in Phnom Penh on Jan 17, where she died on Jan 21 despite intensive treatment.

Public health investigators found that poultry deaths had recently occurred in her village and the girl had cooked a sick chicken before she got sick.

The third patient is a 35-year-old man from Kampong Speu province who started having symptoms on Jan 13 and initially sought care from local health providers. Kanpong Speu borders Takeo province, and both are near Phnom Penh.

After the man's condition worsened, he was admitted on Jan 21 to a hospital in Phnom Penh, which immediately obtained respiratory samples and provided intensive care. The man died shortly after the health team obtained the samples, and the Pasteur Institute confirmed H5N1 on Jan 23.

When health officials explored the source of the man's illness they found evidence of recent poultry deaths in his village and that he had cooked a sick chicken before he became ill.

Dr H. E. Mam Benheng, Cambodia's health minister, warned in the statement that the three new cases are a reminder that the H5N1 virus is still a threat to Cambodia. He added that children still seem to be most vulnerable to the disease. Of the country's 24 cases, 15 were kids younger than 14 years old. The statement also noted that 15 of Cambodia's 24 H5N1 cases were in girls and women.

"I urge parents and guardians to keep children away from sick or dead poultry, discourage them from playing in areas where poultry stay, and wash their hands often," he said. "If they have fast or difficulty breathing, they should be brought to medical attention at the nearest health facilities and attending physicians be made aware of any exposure to sick or dead poultry."

The three cases raise the global H5N1 total to 613 illnesses and 362 deaths, according to the statement.

See also:

Jan 25 Cambodia health ministry/WHO statement

Jan 16 WHO global H5N1 case count

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