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Two Fatal Familial Bird Flu Cases from Kampot Cambodia

Recombinomics Commentary
January 31, 2005

>> Vietnamese authorities are waiting for test results on a 25-year-old Cambodian woman who was hospitalized on Jan. 28 with a high fever and died Sunday. Her lungs had been badly damaged.

"This case is a worry as her brother had died from respiratory failure before he could be rushed to a hospital," said doctor Nguyen Van Hung, who supervised the Cambodian patient, quoting details given by relatives of the woman……..

"We hope the test results will soon be in place so as to caution the health authorities in Cambodia as people there have been coming over to Ha Tien town very often," Hung said.

The Vietnamese town of Ha Tien borders Cambodia in the southern province of Kien Giang. The town is 340 km (210 miles) southwest of Ho Chi Minh City. <<

Reports of new patients with bird flu symptoms who have not been tested continue in increase.  In November there were reports of patients crossing the border from Cambodia and Laos into Thailand for treatment.  Reports on testing these patients for bird flu were lacking.  Similarly, Vietnam had banned importing of poultry from Cambodia earlier this month, but there are no reports of the bird flu status of the Cambodians "coming over to Ha Tien town very often".

The familial case cluster from Cambodia is very similar to clusters in Vietnam and Thailand last year.  The index cases were not tested and samples were not collected.  The cases were not reported until the caregiver developed symptoms.  The Thailand cluster was published in the New England Journal of Medicine on Friday.  The Vietnamese cluster has not even been officially acknowledged.  Similarly, a retrospective study of suspect cases in Thailand confirmed that 21 had laboratory confirmed bird flu and 14 died, but these cases are not in the official tally, nor are the suspect cases which did not have clinical testing.

The number of H5N1 avian influenza fatalities in Thailand and Vietnam is markedly higher than those reported.  The situation in Laos and Cambodia is almost certainly similar.

The failure to even test these obvious cases is scandalous as is the international response to a situation that is clearly spreading and getting increasingly out of control, as human to human transmission becomes more efficient.

Cluster Update

Kampot Cluster

Index case, brother (14M) of Soc Khol.  Died prior to Jan 21 after developing high fever, bad cough, and breathing problems.  Sister, Sok Khol, (25M) admitted to hospital in Vietnam on Jan 28, died Jan 30.  Reports of dying chickens and ducks in Dec in area.  Additional reports of many patients in Kampot traveling to Ha Tien town for treatment.

Suspect cases will be added to tallies and be considered "still unconfirmed" until two laboratory results suggest that the cases are NOT H5N1 positive.

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