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Bird Flu Cluster in Banteay Meas Cambodia at Grows to Four

Recombinomics Commentary
March 25, 2005

>>  Cambodia is awaiting results of tests on an 18-year-old man suspected of carrying the bird flu virus who would be the third case found in the kingdom if confirmed.

Health minister, Nuth Sokhom, says the man suspected of carrying the virus is from Banteay Meas district in Kampot province, which borders Vietnam.

Cambodia's first two victims were from the same district. <<

The above case increases the geographical cluster for the Banteay Meas district in Kampot province to four.  The first two cases formed a familial cluster which involved likely human-to-human transmission.  The index case developed symptoms after gathering dead chickens in the village.  His 25 year-old sister developed symptoms after his funeral.  She eventually sought treatment in Vietnam where she tested positive and died.

The familial cluster grew into a geographical cluster with the death of a 26 year old male, Meas Ran, on Tuesday.  He was just confirmed to be H5N1 positive.  If the 18 year old is confirmed, he will be the 4th case in Cambodia.  This season all reported cases in the south in Vietnam and Cambodia have been fatal.

However, there has been only one reported suspect case in southern Vietnam.  The fatality was in adjacent Kien Giang province.  Only about 20% of the patients in the south who have been placed in isolation with bird flu symptoms and exposure to sick poultry test positive for H5N1.  Testing samples at NIID suggests that only about 20% of the H5N1 infections are detected with the PCR test used in southern Vietnam .

The additional confirmed or suspect cases in Kien Giang and the adjacent Banteay Meas district in Cambodia suggests more complex cases in both countries.  After the familial cluster in Cambodia, the area was declared to be bird flu free.

The latest cases raise serious questions about surveillance, testing, and reporting of H5N1 infections.

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