23rd new human case 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

The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that one new human case of avian influenza has been confirmed for the H5N1 virus. This is the 23rd case this year and the 44th person to become infected with the H5N1 virus in Cambodia. The 23rd case died on 26th October 2013. Of the 44 confirmed cases, 33 were children under 14, and 27 of the 44 were female. In addition, only 11 cases out of the 23 cases this year survived.

The 23rd case, a 2-year-old girl from Svay Chrum village, Borng Bort Kandal commune, Bakane district, Pursat province was confirmed positive for H5N1 human avian influenza on 30th October 2013 by Institut Pasteur du Cambodge. The girl developed fever on 17th October 2013. On 19th October 2013, her parents sought treatment for her at a local private practitioner. Her condition worsened and she was admitted to Jayavarman VII Hospital in Siem Reap on 25th October 2013 with fever, running nose, lethargy, dyspnea, cough and breathing difficulties. Laboratory samples were taken the same day, but no Tamifu was administered. The girl died on the 26th October 2013.

Investigations in Svay Chrum village by the Ministry of Health’s Rapid Response Teams (RRT) and the Ministry of Agriculture, Forestry and Fishery’s Animal Health Task Force revealed that two months before the girl’s illness, poultry had suddenly died at her grandparent’s house. The child often stayed with her grandparent in this house. Human and animal investigations are underway to determine if the girl had direct exposure or handled the dead chickens.

The Ministry of Health’s RRTs and the Ministry of Agriculture, Forestry and Fishery’s Animal Health Task Force are working together closely in Svay Chrum village in Pursat to investigate and implement control measures. The RRTs are trying to identify the case’s close contacts, any epidemiological linkage among the 23 cases and initiate preventive treatment as required. The Animal Health Task Force is investigating cases of poultry deaths in the village.

"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 23 cases of H5N1 infection in humans this year. Children often care for domestic poultry by feeding them, cleaning pens and gathering eggs. Children may also have closer contact with poultry as they often treat them as pets and also seem to be most vulnerable and are at high risk because they like to play where poultry are found. I urge parents and guardians to keep children away from sick or dead poultry and prevent them from playing with chickens and ducks. 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 washes away 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 in early October. Also, public health education campaigns are being conducted in Svay Chrum village in Pursat 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