Avian flu causes concern in Cambodia as 6th victim dies

PHNOM PENH — What's causing Cambodia's potent outbreak of avian flu, otherwise known as H5N1 — a poultry-driven disease with pandemic potential, that has already killed 6 since the start of the New Year?

Increasingly mobile poultry, an expanding urban population living in close quarters with birds, and a government that doesn't compensate farmers for reporting their ill livestock may all help explain the problem, says World Health Organization in Cambodia spokesman Sonny Krishnan.

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"If you don't have a re-compensation policy and are depending on your poultry as a source of protein and income, there's no incentive to report your sick chickens or birds," says Krishnan of the Cambodian government, which currently does not offer farmers any economic redress if their ill livestock are culled.

Chinese New Year, a colorful holiday celebrated by many Cambodians, also means more feast-time birds are being transported both via the nation's ever-improving road system — often strapped uncomfortably to motorbikes by their necks or on the top of trucks, in an informal poultry-moving system that's hard for authorities to keep track of.

"If you go to villages, poultry, are part of the household," said Krishnan, observing that Cambodians tend to live in very close quarters with their poultry — even, in one recent case, allowing the birds to sleep on the bed.

That's all bad news for disease specialists, who are especially concerned that H5N1 could mutate into a form potentially transmissible from person to person, leading to pandemic.

Cambodia saw eight cases of avian flu, ending in 8 deaths in the whole of 2011, according to WHO figures, while 2012 saw 3 cases and 3 deaths.

That figure has already been surmounted in a little over a month in 2013, with the death of a 3-year-old girl on February 13th, bringing the year's total to 7 cases and 6 fatalities.

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Although avian flu can be treated if the ill person is swiftly brought to a hospital, that's rarely the case in Cambodia, added Krishnan.

"There's a window of opportunity within 48 hours within the onset of illness when we can save the patient," notes Krishnan. "Ninety percent of cases presented at the hospital, it's already too late."

According to the Cambodian Ministry of Health, 27 cases of H5N1 have been reported in the country since record-keeping began. Eighteen of the 27 confirmed cases occurred in women, who are more likely to assist with cooking.

Both the Cambodian Ministry of Health and the WHO advised Cambodians to take pains to keep children away from live chickens and ducks, and to wash their hands often.

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The recent Cambodian outbreak of avian flu isn't related to EV-71, the so-called "mystery disease" that struck down Cambodian children over the summer of 2012, garnering much international media attention.

EV-71 was eventually identified as a form of hand, foot and mouth disease, a potentially deadly ailment that does not have the potential to become a pandemic, according to Krishnan.