Post Reply - Cambodia 9th case human H5N1

   https://afludiary.blogspot.com/2024/08/cambodia-reports-9th-h5n1-case-of-2024.html or https://afludiary.blogspot.com/2024/08/cambodia-reports-9th-h5n1-case-of-2024.html ;
For the second time in less than a week Cambodia's MOH has announced an H5N1 infection; this time in a 16 y.o. girl who is reportedly in serious condition.  This case, as was the last, lives in Svay Rieng Province, albeit in a different village. 

While we don't have word on the exact clade of these two most recent H5N1 cases, they are very likely the older 2.3.2.1c clade of H5N1, which predates the emergence of clade 2.3.4.4b and has been identified in all of the other cases reported from Cambodia.
Today's case is the 15th in just 18 months, all of which have come after Cambodia going nearly a decade without a case.
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The girl had a fever, cough, sore throat, fatigue, and difficulty breathing. 

Currently, the patient's condition is serious and is receiving intensive care by doctors. According to the interrogation, about four days before the onset of the illness at the neighbor's house and the patient's house, there were nine dead chickens and used to cook, the girl touched and held the dead chickens.
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Although Cambodia is doing 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.

All of which makes it difficult to know how many people are really being infected, and what the fatality rate truly is.

Last year, in UK Novel Flu Surveillance: Quantifying TTD, the HKHSA described some of the challenges in detecting or confirming community spread of H5N1 - even in the UK - until after dozens, or even hundreds, of cases had occurred.

While H5N1 clade 2.3.4.4b has most of the world's attention - 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...no info on CoViD co-infections...