10th Cambodia H5N1 case

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   https://afludiary.blogspot.com/2024/08/cambodia-reports-10th-h5n1-case-of-2024.html or https://afludiary.blogspot.com/2024/08/cambodia-reports-10th-h5n1-case-of-2024.html ;
For the third time in the last 3 weeks Cambodia's MOH has announced another H5N1 case - the 10th of 2024 and the 18th since new cases began to be reported in early 2023 - this time in a 15 y.o. girl from Prey Veng Province, who reportedly died today after severe illness. 

It isn't clear from this report exactly when she fell ill, and while the press release refers to `onset of illness in the village', one should never rely too heavily on the exact syntax of these translated reports.

The epidemiological investigation continues, and we'll simply have to wait to see if new cases are announced.  As is customary,  Tamiflu is being dispersed to those who may have been exposed.
All of the cases reported in Cambodia to date have been from an older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b which has spread across much of the rest of the world.  Until early last year, Cambodia had gone nearly a decade without reporting a human infection. 
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Despite the care and assistance of the medical team, due to the serious condition of the patient, including fever, cough, sore throat, shortness of breath and fainting. The girl passed away on August 20, 2024. According to the interrogation, about 5 days before the onset of illness in the village, there were many dead chickens and the relatives of the dead chickens were distributed to the patients' families to cook, and the girl touched and held the dead chickens to make Food.
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While the reasons behind this sudden resurgence after 9 years remain a mystery, a 2023 study (see Preprint: A Timely Survey of Knowledge, Attitudes, and Practices Related to Avian Influenza (H5N1) in Rural, Cambodia) found very lax attitudes regarding avian flu among the rural population. 
The sharing, and cooking, of sick or dying poultry is something we've seen reported previously with these outbreaks, and was a major risk cited by that study.  The authors noted:
Cambodia's higher-risk behaviors or vulnerability groups need priority intervention to reduce infectious and zoonotic diseases.
Furthermore, we noticed that 23% of participants cooked sick or dead poultries for their families. 
This study found that 49% reported poultry illness and deaths to local authorities.
Although Cambodia continues to do an admirable job of reporting these hospitalized cases, it is entirely possible that some milder infections are going unreported. Severe or critical cases are far more likely to be hospitalized, tested, and confirmed as H5N1 positive.
While we are understandably focused on H5N1 clade 2.3.4.4b - clade 2.3.2.1c in Cambodia, the recently imported (ex India) clade 2.3.2.1a case in Australia, and > 90 H5N6 cases in China - remind us that HPAI H5 continues to evolve along multiple concurrent pathways.

DJ, There must be more H5N1 cases -in humans- in the US...just "kept out of the news" or maybe even not tested...

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Dutch Josh Members Profile Send Private Message Find Members Posts Add to Buddy List Admin Group Joined: 23 Jun 2024 Status: Offline Points: 554	Post Options Post Reply Quote Dutch Josh Report Post Thanks(0) Quote Reply Topic: 10th Cambodia H5N1 case Posted: 20 Aug 2024 at 9:10pm
	https://afludiary.blogspot.com/2024/08/cambodia-reports-10th-h5n1-case-of-2024.html or https://afludiary.blogspot.com/2024/08/cambodia-reports-10th-h5n1-case-of-2024.html ; For the third time in the last 3 weeks Cambodia's MOH has announced another H5N1 case - the 10th of 2024 and the 18th since new cases began to be reported in early 2023 - this time in a 15 y.o. girl from Prey Veng Province, who reportedly died today after severe illness. It isn't clear from this report exactly when she fell ill, and while the press release refers to `onset of illness in the village', one should never rely too heavily on the exact syntax of these translated reports. The epidemiological investigation continues, and we'll simply have to wait to see if new cases are announced. As is customary, Tamiflu is being dispersed to those who may have been exposed. All of the cases reported in Cambodia to date have been from an older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b which has spread across much of the rest of the world. Until early last year, Cambodia had gone nearly a decade without reporting a human infection. - Despite the care and assistance of the medical team, due to the serious condition of the patient, including fever, cough, sore throat, shortness of breath and fainting. The girl passed away on August 20, 2024. According to the interrogation, about 5 days before the onset of illness in the village, there were many dead chickens and the relatives of the dead chickens were distributed to the patients' families to cook, and the girl touched and held the dead chickens to make Food. - While the reasons behind this sudden resurgence after 9 years remain a mystery, a 2023 study (see Preprint: A Timely Survey of Knowledge, Attitudes, and Practices Related to Avian Influenza (H5N1) in Rural, Cambodia) found very lax attitudes regarding avian flu among the rural population. The sharing, and cooking, of sick or dying poultry is something we've seen reported previously with these outbreaks, and was a major risk cited by that study. The authors noted: Cambodia's higher-risk behaviors or vulnerability groups need priority intervention to reduce infectious and zoonotic diseases. Furthermore, we noticed that 23% of participants cooked sick or dead poultries for their families. This study found that 49% reported poultry illness and deaths to local authorities. Although Cambodia continues to do an admirable job of reporting these hospitalized cases, it is entirely possible that some milder infections are going unreported. Severe or critical cases are far more likely to be hospitalized, tested, and confirmed as H5N1 positive. While we are understandably focused on H5N1 clade 2.3.4.4b - clade 2.3.2.1c in Cambodia, the recently imported (ex India) clade 2.3.2.1a case in Australia, and > 90 H5N6 cases in China - remind us that HPAI H5 continues to evolve along multiple concurrent pathways. DJ, There must be more H5N1 cases -in humans- in the US...just "kept out of the news" or maybe even not tested...