What to know about H5N1 bird flu in humans as a girl dies in Cambodia and her father tests positive
Catherine Schuster-Bruce
Feb 24, 2023, 6:20 PM
A girl has died in Cambodia from bird flu, health officials said.
The girl's dad is infected, but we don't know if he caught it from her.
Experts have said the risk of the virus spreading among people is low.

An 11-year-old girl has died in Cambodia from bird flu, health authorities in the country said.

The girl initially fell ill with a high fever and cough on February 16 and later died in the National Children's Hospital in Phnom Penh, Cambodia's capital city, on Wednesday, the authorities said, per Reuters.

The case comes amid an outbreak of bird flu that has lead to the deaths of more than 200 million birds worldwide since early 2022, either from disease or mass culls, the World Organisation for Animal Health told Reuters.

The bird flu strain "H5 Highly Pathogenic Avian Influenza A" or "H5N1" has infected 868 people since it was first detected in humans in 1997, and 457 of those confirmed cases died, according to the World Health Organization. Officials in Cambodia said that the girl was the first human case in a Southeast Asian country since 2014, per Reuters.

Officials believe that the young girl caught the virus from dead wild birds or animals near her home in the Prey Veng province in south Cambodia, close to the border with Vietnam — 22 chickens and three ducks were found dead nearby, per The Telegraph.

Officials have taken samples from those birds as well as at least 12 people who came into contact with the girl, according to Reuters. As of Friday, the girl's father had tested positive for the virus, but we don't know how he caught it.

Jonathan Ball, a professor of molecular virology at the University of Nottingham, UK, told the Science Media Centre on Friday that human infections are rare, and the likelihood of onward human to human transmission was "very low."
In full: https://www.nbcnews.com/science/science ... -rcna72163

Viruses in Cambodian bird flu cases identified as circulating for many years
27 Feb 2023 07:30AM (Updated: 27 Feb 2023 07:30AM)

The viruses that infected two people in Cambodia with H5N1 avian influenza have been identified as an endemic clade of bird flu circulating in the country, the US Centers for Disease Control and Prevention (CDC) said.

The cases reported last week had raised concerns they were caused by a new strain of H5N1, clade 2.3.4.4b, which emerged in 2020 and has caused record numbers of deaths among wild birds and domestic poultry in recent months.

But work so far suggests this is not the case.

Preliminary genetic sequencing carried out in Cambodia led its health ministry to identify the viruses as H5 clade 2.3.2.1c, which has circulated in Cambodia among birds and poultry for many years and has sporadically caused infections in people, the CDC said in a statement on Saturday (Feb 25).

"Yes, this is an older clade of avian influenza that had been circulating around the region for a number of years and while it has caused human infections in the past, it has not been seen to cause human-to-human transmission. However, that doesn't mean that the threat is any less," said Erik Karlsson, director of the National Influenza Center of Cambodia and acting head of virology at the Institut Pasteur du Cambodge, which sequenced the virus.

He added that the response needed to be coordinated and swift to prevent any further spread and to limit exposure to any common source.

An investigation into the source and to detect any additional cases is ongoing, the CDC said, adding that so far there had been no indication of person-to-person spread.
https://www.channelnewsasia.com/asia/ca ... ed-3306841

Health Senior Official: Situation of H5N1 in Roleang Village under Control
AKP Phnom Penh, February 27, 2023 --

The situation of avian influenza (H5N1) in Roleang village, Romleach commune, Sithor Kandal district, Prey Veng province, is now under control, affirmed on Monday H.E. Dr. Or Vandine, Secretary of State and Spokesperson of the Ministry of Health and Chairperson of Ad-hoc Committee for Rolling Out COVID-19 Vaccination Throughout the Country (ACC-19).

Only two cases of H5N1 have been detected and confirmed by the lab, she wrote, adding that a girl (11 years old and 6 months) passed away and her father confirmed positive for H5N1 is under the medical care and treatment in district hospital.

“After treating him, his additional sample was tested and got negative result as I received the information this morning of Feb. 27, 2023, but he is still in hospital to complete his treatment course according to the drug usage's protocol,” she continued.

A total of 29 samples – 16 closed contacts and 13 illness like influenza (ILI) – collected by the investigation team have been tested by the laboratory with all negative results, she pointed out.
-AKP

Bird flu spillover 'concerning', doctor warns - as virus in girl who died had mutations making it better adapted to humans
Dr Erik Karlsson, who led the team at the Pasteur Institute of Cambodia that decoded the genetic sequence of the girl's virus, says the discovery "needs to be treated with the utmost concern".
Thomas Moore
Science correspondent @SkyNewsThomas
Wednesday 1 March 2023 15:36, UK

The bird flu virus isolated from a girl who died from the disease had mutations that made it better adapted to human cells, Sky News has learned.

The 11-year-old is believed to have been infected by poultry kept by her family in Prey Veng province, in the south of Cambodia.

Her father also tested positive for the H5N1 virus, but did not develop symptoms.

Dr Erik Karlsson, who led the team at the Pasteur Institute of Cambodia that decoded the genetic sequence of the girl's virus, said it differed from samples taken from birds.

"There are some indications that this virus has gone through a human," he revealed in an exclusive interview.

"Any time these viruses get into a new host they'll have certain changes that allow them to replicate a little bit better or potentially bind to the cells in our respiratory tract a little bit better."
Full article: https://news.sky.com/story/bird-flu-vic ... s-12822936

Vietnam to monitor foreign entrants amid bird flu risks
By Le Nga March 1, 2023 | 03:27 pm PT
The Health Ministry on Wednesday requested localities to closely monitor foreign entrants amid the risk of H5N1 avian flu outbreaks entering Vietnam.

The ministry said that as Vietnam and other countries’ commercial activities expand, the risk of avian flu entering the country and infecting people is high.

Current weather conditions are optimal for avian flu viruses to thrive, and the fact that several festivals are being held after the Lunar New Year in late January means the transportation and sales of poultry may increase, leading to more infection risks, the ministry added.

As such, the ministry has requested localities to closely monitor entrants to detect suspected infections, with extra caution for those who butcher and trade poultry, as well as those coming from areas with outbreaks. Cases of suspected infections would have their samples taken for testing.

The WHO on Feb. 24 called for all countries to be vigilant amid rising number of avian flu cases in humans. Cambodia, which borders Vietnam, has already confirmed two cases of H5N1 infections, of whom one has died.

Vietnam recorded its first human case of A/H5N1 avian flu in eight years in October 2022, a five-year-old girl in the northern Phu Tho Province who had consumed meat from sick chickens and ducks a week before falling sick. She recovered after treatment.
https://e.vnexpress.net/news/news/healt ... 76336.html

Avian Flu in Cambodia
Human cases of avian influenza in Cambodia exemplify the importance of global surveillance and collaboration
by Rick A. Bright March 13, 2023

In late February 2023, Cambodia reported that two people had contracted bird flu, sparking concern that the avian influenza virus might become transmissible between humans and spark another pandemic. The influenza A (H5N1) virus, which has been killing millions of birds worldwide and perennially crosses to other species, has long been viewed as a likely source of the next major human outbreak, having the potential to spread globally even faster than the SARS-CoV-2 virus, causing even more sickness and death.

H5N1 influenza viruses, which are endemic in wild waterfowl, have a specificity for binding to cellular receptors in birds and do not replicate well or transmit efficiently in humans. Most human infections terminate with the primary case and do not transmit to close contacts.

As human and bird interactions increase, however, the likelihood of zoonotic transmission grows. The first confirmed bird-to-human transmission of these viruses occurred in Hong Kong in 1997, though seroprevalence studies in the same region suggest a substantial number of mild or asymptomatic infections among people who work closely with poultry.

In Cambodia, where highly pathogenic H5N1 influenza viruses have been detected in wild birds since 2003, fifty-eight cases of human infection and thirty-eight deaths have been documented, a fatality rate of 66 percent. The February cases are the first since 2014.
Full article: https://www.thinkglobalhealth.org/artic ... u-cambodia

Bird Flu’s Young Victims
Over the past decade, nearly four out of five H5N1 victims in Cambodia have been children.
By Sribala Subramanian
March 17, 2023
The death of an 11-year-old in Cambodia last month reopened a Pandora’s box of questions about the mysterious H5N1 virus.

The case initially set off alarm bells among pandemic watchers. The girl from Prey Veng province appeared to be part of a family cluster; her 49-year-old father also tested positive for the virus. Post-COVID-19, the phrase “family cluster” has an ominous ring. Could the infection have involved human-to-human transmission? Much to the relief of scientists, Cambodian health officials ruled out that possibility.

The girl’s death, however, highlighted another vexing problem. In the past decade, children accounted for nearly 80 percent of bird flu fatalities in Cambodia. In 2014, 100 percent of recorded cases were in the under-14 age group; nine contracted the virus, and four died. Data gathered by the Institut Pasteur du Cambodge shows that the median age of a bird flu patient is six years.

A 2013 review of cases by the London School of Hygiene & Tropical Medicine found that most bird flu patients were young (under 18), had not received antivirals in the early stages of infection, and were taken to the hospital only when they were in critical condition. Data from confirmed H5N1 cases showed that “no patients received their first dose of oseltamivir within the recommended 48 hours from the onset of symptoms.”
Article in full: https://thediplomat.com/2023/03/bird-fl ... g-victims/

Chile detects first case of bird flu in a human
30 March 2023
SANTIAGO, March 29 (Reuters) - Chile detected the first case of bird flue in a human, the country's health ministry reported on Wednesday (Mar 29).

The case was detected in a 53-year-old man who presented severe influenza symptoms, according to a statement issued by the ministry, but they noted the patient was in stable condition.

The government is also investigating the source of contagion as well as others who were in contact with the patient.

Chile has reported cases of the H5N1 bird flu since late last year in wild animals.
- FRESH NEWS

CAMBODIA
A Dead Case of Avian Influenza Reported

AKP Phnom Penh, October 08, 2023 -- A 50-year-old man living in Tras commune, Romeas Hek district, Svay Rieng province, has died of H5N1 avian influenza, announced the Ministry of Health in a press release this evening.

According to the source, the man was confirmed positive for H5N1 on Oct. 7 by the National Institute of Public Health.

This is the 2nd case of H5N1 this year, and the 58th person to be infected with the virus in Cambodia since 2005, it pointed out.

The Ministry of Health’s Rapid Response Teams (RRTs) at the national and sub-national levels have been working to investigate the causes of transmission on both animals and humans and implement control measures.

H5N1 is a type of influenza virus that causes a highly infectious, severe respiratory disease in birds called avian influenza (or “bird flu”). Human cases of H5N1 avian influenza occur occasionally, but it is difficult to transmit the infection from person to person.
By C. Nika
AKP