Kompong Trach district, Kampot province – Tests conducted on a 24-year-old Cambodian woman who died in a Vietnamese hospital on Sunday indicate that she died of avian influenza, the country’s first human death from the disease, health officials said. “Based on communication between Pasteur Institute in Ho Chi Minh City and Pasteur Institute in Phnom Penh, a rapid test has indicated that she had the H5 virus,” Ly Sovann, chief of the Ministry of Health’s Disease Surveillance Bureau, said Tuesday during a visit to the deceased woman’s home in Kampot province.
“We are still treating this as a suspect case and are waiting for further tests by the WHO for confirmation. Based on this information we believe it more likely she had the disease,” he added.
Ly Sovann said that a World Health Organization Collaboration Center, possibly outside of Vietnam, would conduct in-depth tests of Tit Sakhan’s blood before final confirmation that she had bird flu.
“We are continuing our surveillance of this area, we have given medicines to the two family members who have flu symptoms,” Ly Sovann said. The health ministry team would also attempt to locate Tit Sakhan’s brother-in-law, whom family members said has gone to another village about 10 km away after coming down with chest pains and fever.
Tit Sakhan’s 14-year-old brother, Tit Chiang, also died of bird flu-like symptoms at the family’s Kampot home on Jan 21.
National health, provincial health and Agriculture Ministry investigators descended on the sleepy village of Koh Chamkar in Boeung Khang Thbong commune on Tuesday in what Suon Sothoeun, deputy director of the Department of Animal Health, branded a “stamping out effort.”
After interviewing the deceased woman’s husband, Sanh Rann, and father, Ngoy Uy, Suon Sothoeun ordered their home doused with the disinfecting chemical TH4 and the culling of one duck, one hen and her chicks. The hen was the only remaining bird of about 50 that Ngoy Uy said died late last year from a sudden illness.
Village Chief Mei Sun, 63, said that about 500 chickens died in the last few months in the village, up from an average of a few a week. To his knowledge, Mei Sun said that no poultry had been imported from Vietnam to the 3,400 person village, but until Jan 26 chickens were being sold across the border to Vietnam. On that day he said, the local border crossing was completely closed for 3 days.
“Since then, the Vietnamese stopped eating Cambodian chickens,” Mei Sun said.
Suon Sothoeun said that it was important to carefully analyze the statements of local farmers before concluding that hundreds of chickens had died of bird flu in the village.
“The symptoms of bird flu are very similar to that of Newcastle Disease which does not affect humans,” he said, adding that in both cases there is a great amount of mucus discharge from the birds and a swelling of the face.
“The difference in avian influenza is that the faces first turn white and then a yellowish-green,” he added.
Chau Khim, the UN Food and Agriculture Organization’s adviser on bird flu, said that there may have been an additional factor. A pond located near the family’s home, which Tit Chiang frequented to fish, has a population of migratory cranes.
“When the cranes defecate, the droppings can be infected,” he said.
Dr Ou Sary, who treated Tit Sakhan but did not treat her brother, said at his clinic in Kompong Trach town on Tuesday that he had never suspected bird flu because pneumonia is common in the area.
He said that he did not stock Tamiflu, a medicine thought to be effective against the virus. “I studied about [the drug], but we have only masks here to protect against it,” he said, adding that government officials have not yet interviewed him about the case.
Outside the clinic, three villagers told reporters that they have seen strange deaths among their domesticated fowl.
Chap Sok, 28, said that he had 70 chickens die suddenly this month; So Pon said that 30 of her chickens died in one night.
Standing before a makeshift shrine containing an urn with his wife’s ashes, Sanh Rann said that he was exhausted from worry about his children, 8-month-old Tit Rachha and 6-year-old Tit Theara, now that their mother was dead.
Sanh Rann said that doctors in Vietnam never told him what killed his wife.
“They didn’t say anything. They told me that the disease was strange, and when she died they sprayed the room with disinfectant,” he said.
“They would not let us look at the body or take it home.”