Young woman is Cambodia’s fourth Avian Influenza A (H5N1) death in 2023

Young woman is Cambodia’s fourth Avian Influenza A (H5N1) death in 2023
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Cambodia has reported its fourth fatal case of Avian Influenza A (H5N1), commonly known as bird flu, this year. This latest death brings the total number of people killed by the virus in Cambodia since 2003 to 41, with 62 cases of Avian Influenza A infection in humans reported there over the same period.

A Cambodia CDC official conducts an Avian Influenza A(H5N1) education campaign for residents in Preah Kampong Thom commune, Kampot
A Cambodia CDC official conducts an Avian Influenza A (H5N1) education campaign for residents in Preah Kampong Thom commune, Kampot Cambodia CDC

The most recent victim is a woman aged between 20 and 25, from Preah Kampong Thom commune in Kampot’s Tek Chhou district, who first developed a fever, cough, and shortness of breath on November 19, and was treated at home for several days. On November 23, she sought treatment at the provincial referral hospital.

Samples collected at the hospital were transported to the National Institute of Public Health for testing where they were subsequently confirmed as influenza A (H5N1) by RT-qPCR assays at the National Laboratory at the National Institute of Public Health (NIPH) and reconfirmed by Institute Pasteur du Cambodge.

The woman’s condition rapidly deteriorated, and she was transferred to the intensive care ward of the National Pediatric Hospital in Phnom Penh, where she succumbed to the virus on November 26.

Child is Cambodia’s sixth Avian Influenza A (H5N1) case for 2023

Cambodia's CDC team reacted quickly to reports of an Avian Influenza A(H5N1) outbreak in Kampot dispatching a large team to conduct active surveillance and education
Cambodia’s CDC team reacted quickly to reports of an Avian Influenza A (H5N1) outbreak in Kampot dispatching a large team to conduct active surveillance and education Cambodia CDC

As a result of active surveillance in response to the first reported case, a female child aged less than five was detected exhibiting a fever, cough and a rash.

The child was transported to hospital on November 25 for testing, with samples returning positive for influenza A (H5N1) by RT-qPCR assay in a process identical to the first case.

The young girl is currently receiving treatment in an isolation room in the respiratory ward of the hospital.

An epidemiological investigation found both cases had exposure to backyard birds which were reported to be sick and/ or dead, over the past month. No epidemiological linkage of these cases has yet been confirmed, other than that they both lived in the same village.

The Cambodia Ministry of Health (MOH) has launched an investigation into the source of the infection, tracing potential contacts, and is conducting laboratory tests of poultry samples from the surrounding area.

As a result of active surveillance in response to the first reported case of Avian Influenza A(H5N1), a female child aged less than five was detected exhibiting a fever, cough and a rash
As a result of active surveillance in response to the first reported case of Avian Influenza A (H5N1), a female child aged less than five was detected exhibiting a fever, cough and a rash Cambodia CDC

The ministry has also reiterated the importance of preventive measures, such as avoiding contact with sick or dead poultry, practicing good hand hygiene, and cooking poultry thoroughly.

Laboratory investigation shows the viruses, as indicated by phylogenetic analysis, fall within the H5 clade 2.3.2.1c with close similarity to the viruses that have been circulating in Cambodia and Southeast Asia since 2013-2014. The sequences cluster most closely with the viruses from the two human cases reported in October 2023.

The recent death underscores the persistent threat posed by influenza A (H5N1), a highly contagious virus that can jump from animals to humans. While the virus does not easily transmit from person to person, close contact with infected birds or their contaminated environments remains the primary mode of human transmission.

More than have of Influenza A (H5N1) cases result in death

According to the World Health Organization (WHO), there were 882 human cases of Avian Influenza A (H5N1) reported globally between 2003 and November 27, 2023 with 461 deaths, or a case fatality rate (CFR) of  52.26 per cent. Cambodia’s official figures reveal a CFR of 57 per cent.

Depending on the original host, influenza A viruses can be classified as avian influenza (H5N1), swine influenza (H1N1), or other types of animal influenza viruses.

A public education poster and advertisement warning people of the dangers of Avian Influenza A(H5N1) and advising them not to handle poultry
A public education poster and advertisement warning people of the dangers of Avian Influenza A (H5N1) and advising them not to handle poultry Cambodia CDC

Avian, swine, and other animal influenza virus infections in humans may cause disease ranging from mild upper respiratory tract infection to more severe diseases and can be fatal. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have also been reported.

There has also been several detections of Avian Influenza A (H5N1) virus in asymptomatic persons, but who had exposure to infected birds in the days before a sample was collected.

In Cambodia, poultry farming is widespread, particularly in rural areas, making it challenging to eliminate the virus reservoir.

The Ministry of Agriculture, Forestry, and Fisheries is working to strengthen surveillance and control measures in poultry populations to reduce the risk of human exposure.

Cambodia CDC staff take a pathology sample for testing for Avian Influenza A (H5N1) from a resident of Preah Kampong Thom commune, Kampot
Cambodia CDC staff take a pathology sample for testing for Avian Influenza A (H5N1) from a resident of Preah Kampong Thom commune, Kampot Cambodia CDC

Meanwhile people with concerns over their own health, that of others, or wishing to report sick or dead birds can use the country’s 115 hotline to contact the MOH directly.

Launched in 2016 as a collaboration between InSTEDD iLab Southeast Asia, Cambodia MOH’s Communicable Disease Control Department (CDC), and Skoll Global Threats Fund, the 115 hotline allows the public and healthcare workers in Cambodia to access information and submit disease reports for free by dialing 1-1-5 from any phone.

In early 2017, the 115 hotline received around 35,000 total calls from the public, allowing Cambodian CDC to rapidly respond to, contain, and eradicate an outbreak of a deadly strain of Avian Influenza A (H5N1) in Svay Rieng province.

 

 

Feature photo Cambodia CDC

 

 

Related:

  • Avian Influenza A (H5N1) – Cambodia (WHO)
  • Cambodia reports bird flu outbreak near Vietnamese border (Reuters)
  • As Chinese virus runs wild a 115 hotline puts help at the end of the phone for Cambodians (video) (Asean News Today)
  • Zoonotic crossover fear sees Vietnam ban (almost) all wildlife trade (video) (Asean News Today)

 

 

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