19th and 20th new human cases of avian influenza H5N1 in Cambodia in 2013

Joint news release between the Ministry of Health of the Kingdom of Cambodia and the World Health Organization

WHO Cambodia
Improper transport of poultry risks the spread of the H5N1 virus.

The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that two new human cases of avian influenza have been confirmed for the H5N1 virus. These are the 19th and 20th cases this year and the 40th and 41st persons to become infected with the H5N1 virus in Cambodia. The 20th case died on 17th September. Of the 41 confirmed cases, 30 were children under 14, and 24 of the 41 were female. In addition, only 9 cases out of the 20 cases this year survived.

The 19th case, a 5-year-old girl from Prey Slek village, Prey Slek commune, Traing district in Takeo province confirmed positive for human H5N1 avian influenza on 14th September by Institut Pasteur du Cambodge. The girl developed fever on 7th September and her family initially sought treatment for her in a private clinic. Her condition later worsened and the girl was admitted to Kantha Bopha Hospital on 12th September with fever, dyspnea, cyanosis, somnolence, cough and chest pain. Laboratory samples were taken and Tamiflu administered on 13th September. The girl recovers and is discharged from the hospital today.

Investigations by the 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.

The 20th case, a 2-year-old girl from Trapaing Chrab village, Thmey commune, Thek Chhou district in Kampot province confirmed positive for human H5N1 avian influenza on 16th September by Institut Pasteur du Cambodge. The child developed fever on 11th September. On 12th September, her parents sought treatment for her in a local village clinic. The child’s condition worsened and on 14thSeptember her parents sought treatment in a clinic in Kampot town. On 15thSeptember, the child was admitted to Kantha Bopha Hospital with fever, dyspnea, somnolence, diarrhea, cough and a distended abdomen. Laboratory samples were taken and Tamiflu administered on 16th September 2013. The child died on 17th September.

The child went to her neighbor’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.

The Ministry of Health’s RRTs and the Ministry of Agriculture, Forestry and Fishery’s Animal Health Task Force are working together closely in Prey Slek village in Takeo and Trapaing Chrab village in Kampot to investigate and implement control measures. The RRTs are trying to identify the cases’ close contacts, any epidemiological linkage among the 20 cases and initiate preventive treatment as required.The Animal Health Task Force is investigating cases of poultry deaths in the villages.

"Avian influenza H5N1 remains a serious threat to the health of all Cambodians and more so for children, who seem to be most vulnerable and are at high risk. There have been 20 cases of H5N1 infection in humans this year. As we approach the Pchum Ben festival season, when chicken and ducks are prepared for offerings and meals, I urge parents and guardians to take special care to make sure their children are not playing with poultry, or in any areas that may be contaminated with poultry faeces, or feathers or liquid wastes. Parents and guardians must also make sure children thoroughly wash their hands with soap and water before eating and after any contact with poultry. Hands may carry the virus that cannot be seen by the naked eye. Soap kills the virus on hands. If children have fast or difficult breathing, their parents should seek medical attention at the nearest health facility and attending physicians must be made aware of any exposure to sick or dead poultry,” said H.E. Dr. Mam Bunheng, Minister of Health.

A nationwide public health education campaign using radio has been launched before the Pchum Ben festival in early October. Also, public health education campaigns are being conducted in Prey Slek village, Takeo and Trapaing Chrab village in Kampot using information, education and communications materials to inform families on how to protect themselves from contracting avian influenza. The government's message is - wash hands often with soap and water, before eating and after coming into contact with poultry; keep children away from poultry; keep poultry away from living areas; do not eat dead or sick poultry; and all poultry eaten should be well cooked.

H5N1 influenza is a flu that normally spreads between sick poultry, but it can sometimes spread from poultry to humans. Human H5N1 avian influenza is a very serious disease that requires hospitalization. Although the virus currently does not easily spread among humans, if the virus changes it could easily be spread like seasonal influenza. Hence, early recognition of cases is important.

The Ministry of Health will continue to keep the public informed of developments via the MoH website www.cdcmoh.gov.kh where relevant health education materials can also be downloaded.

For more information on human influenza please call the MoH Influenza Hotline numbers: 115 (free call); 012 488 981 or 089 669 567

Ministry of Health
Dr Sok Touch:+855 12 856 848
Dr Ly Sovann: +855 12 825 424

World Health Organization
Dr Pieter JM van Maaren: +855 23 216 610
Dr Reiko Tsuyuoka: +855 23 216 610