Bird Flu Death Toll Rises to Eight

A 35-year-old man from Kompong Cham province has become the eighth person to die from avian influenza since January 21, in the worst single outbreak of the virus the country has ever seen and the worst outbreak globally so far this year.

Thoeun Doeun died on Mon­day at Phnom Penh’s Calmette Hospital after fighting the disease for almost two weeks, according to the Ministry of Health.

“He died [Monday] night at about 10:45 as a result of respiratory complications,” caused by the H5N1 virus, the director of the ministry’s department for communicable disease control, Sok Touch, said on Tuesday.

Sonny Krishnan, communications officer for the World Health Organization (WHO), confirmed that Thoeun Doeun had died from rapid fluid build-up in his lungs, a reaction to the virus.

Thoeun Doeun was admitted to Kompong Cham Referral Hospital on February 13, where doctors immediately started to treat him with Tamiflu, currently the only medicine to treat bird flu in humans, and his condition initially improved.

On Friday, however, his condition worsened again, and he was transferred to Calmette Hospital in Phnom Penh.

“He was making progress and he was fighting when he got to Calmette Hospital,” Mr. Krishnan said, adding that generally, chances of surviving the virus are good if the right treatment is ad­ministered within the first 48 hours of infection, which was the case with Thoeun Doeun.

“This is a very interesting case, and I think several epidemiologists are chasing this and looking at it closely as well as clinicians,” he said.

Out of nine cases recorded in just over a month in Cambodia, only one person has survived. All previously confirmed cases have occurred in areas within about 50 km of each other in the southern provinces of Kampot, Kompong Speu and Takeo.

Thoeun Doeun, from Stung Trang district, is the first victim to contract the disease in Kompong Cham province, which suggests that the virus has infected poultry in a wide area of the country.

“The virus doesn’t know borders and there have been poultry deaths in [Mr. Doeun’s] area,” Mr. Krishnan said.

Experts say one of the major problems in containing the spread in chickens and ducks is a dearth of reporting of sick poultry because of a lack of government compensation for farmers whose chickens are culled to stop the spread of the disease.

So far, the Ministry of Agriculture has neither introduced a highly effective vaccine for poultry, which is being used in Vietnam and Thailand, nor initiated mass culling such as in Mexico, where more than 2 million chickens were killed this month before any hu­mans fell sick.

Hong Kong has temporarily banned the import of Cambodian eggs, and Chinese media reported on Monday that authorities have started to measure the body temperature of people traveling to China from Cambodia in order to prevent the disease from spreading across borders.

In joint statements, the WHO and the Ministry of Health have warned of a possible mutation of the virus, allowing it to spread from human to human—much like seasonal influenza.

So far this year, aside from Cambodia, only Egypt and China have had human avian influenza cases. One person died of the vi­rus in Egypt this month and two people also died in the south-central Chinese city of Guiyang—resulting in 110 people exposed to the victims being quarantined.

The WHO’s Mr. Krishnan said that Chinese screening of travelers from Cambodia was an over-reaction, adding that it was highly unlikely that the disease would spread across borders, as controls have been increased.

“I think it’s an overreaction… you shouldn’t check people but should be checking poultry,” he said.

Sorn San, director of the national veterinary research institute at the Ministry of Agriculture, declined to comment on measures being taken to prevent the spread of the disease in poultry.

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