Bird flu in Cambodia

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Avian Influenza A (H5N1), Cambodia
11 year old girl died of H5N1
Father tested positive for H5N1
Human-to-human transmission of H5N1, incredibly rare
Not impossible
Cambodia, 2003 to 2014
56 human cases of H5N1,
37 of them were fatal
From 2003 to 25 February 2023
873 human cases of infection with influenza A (H5N1)
458 deaths have been reported
From 21 countries.
Reported 23 February 2023
www.who.int/em...
Cambodia International Health Regulations (IHR) National Focal Point (NFP)
Confirmed human infection with avian influenza A (H5N1)
A second case, family contact, reported 24 February 2023
First two cases of avian influenza A (H5N1) reported from Cambodia since 2014
December 2003 to 2014
All human cases due to poultry-to-human transmission
Description of the cases
Referred, 21 February 2023
Admitted to the National Pediatric Hospital with severe pneumonia
Tested positive for avian influenza A (H5N1) virus,
by reverse transcriptase-polymerase chain reaction (RT-PCR)
Institute Pasteur Cambodia, confirmed the finding
Died on 22 February 2023
Cambodia shared the genetic sequence data
Twelve close contacts tested
Father, asymptomatic, in isolation at the referral hospital
The eleven other samples tested negative for A (H5N1) and SARS-CoV-2.
Further human cases can be expected
WHO advice
PPE for infected poultry workers
Registered and monitored closely for seven days
Currently, no vaccine widely available to protect against avian influenza in humans.
WHO, poultry or birds workers, seasonal influenza vaccination, reduce risk of reassortment.
Cambodian CDC
outbreaknewstod...
Bird flu virus H5N1, cause of death, Rolang village, Khlach commune
There has not been any clear evidence of transmitting H5N1 bird flu from person to person.
Clade identified is 2.3.2.1c. (H5N1)
Circulating in poultry in southeast Asia since 2014
Vietnam
Lao
Clade 2.3.4.4b viruses (H5N1)
Detected in birds, many countries in Africa, Asia, Europe, North America, Central and South America
The high levels of infection in birds, increased geographic distribution = genetic diversification
Spread
Droplet, bird saliva, nasal secretions
Flapping wings etc
Droppings
Fomites and surfaces
Direct contact
Meat (virus killed by heat)
Into eyes, nose mouth
Avoid any contact with wild birds
H5N1 influenza A, history
First detected, chickens, Scotland, 1959
China and Hong Kong, 1996
First was detected in humans, 1997
Hong Kong, 1997, 18 H5N1 cases in Hong Kong,
some were acquired human-to-human
This outbreak
Infected 15 million domesticated birds
Countless wild birds and animals
Detected in foxes, otters, seals, mink
Therefore more opportunities to mutate
In the UK
All farmed chickens now required indoors
The UKHSA
www.gov.uk/gov...
Very high levels of transmission in wild birds
Constant risk
US
10 billion animals killed for meat in the US in 2022
Imported 200 million live animals
Human infection possible at any stage in the meat supply chain
58 million birds culled
One US human case in 2022, recovered