Flu Scan for Feb 04, 2014

H5N1 case in Cambodia
Flu and pregnancy warning

Cambodia reports H5N1 in 5-year-old boy

Cambodia—which had by far the most H5N1 avian flu cases in 2013—has confirmed its first case of 2014, in a 5-year-old boy, the country's Ministry of Health (MOH) reported today.

The boy, from Chongda village in Kampong Thom province in the center of the country, developed a fever and headache on Jan 24, and his parents brought him to a local clinic on Jan 27. After his condition worsened, he was transported on Jan 30 to a hospital in the city of Siem Reap, which is in the neighboring province of Siem Reap.

He was given oseltamivir (Tamiflu) on Jan 31 and is currently listed in stable condition, the MOH said. Public health and agriculture officials discovered that about 200 area chickens died suddenly in mid-January, and the boy's parents prepared the poultry for food near the boy.

Of the 47 H5N1 Cambodian cases confirmed by the World Health Organization (WHO) since 2005 (which do not include this case), 33 have been fatal, for a case-fatality rate (CFR) of 70%. But the CFR has actually dropped markedly in the past year. Before last year, 16 of 19 Cambodian case-patients had died, for a CFR of 84%.

Last year Cambodia had 26 confirmed H5N1 cases, 14 of which were fatal. The countries with the next-highest level of cases in 2013 were Egypt, with 4, and Indonesia, with 3. Vietnam has already confirmed 2 cases this year.
Feb 4 Cambodia MOH statement
Jan 24 WHO global H5N1 case count


Provider letter urges flu vaccine, prompt treatment for pregnant women

Federal health officials yesterday sent a letter to health providers urging them to take steps to protect pregnant women because of ongoing high activity of 2009 H1N1 flu, which is known to be hard on pregnant women. The US Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) said they have received reports of flu hospitalizations and deaths in pregnant women.

The officials urged health providers to offer the seasonal flu vaccine to pregnant women, because influenza is more likely to cause severe illness in that group than in women who aren't pregnant. Officials also note that the flu infection can increase the risk of premature labor and that vaccination during pregnancy can protect the mother and her baby from flu-related illness and hospitalization.

Health officials also reminded providers that antiviral drugs are recommended for pregnant women who have the flu, and during the 2009 H1N1 pandemic, prompt treatment of pregnant women with antivirals was shown to prevent respiratory failure and death.
Feb 3 HHS/CDC letter to providers

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