Outbreak News

15 May 2006 Volume 32 Number 10

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Avian Influenza, Cambodia

On 24 March 2006, the Ministry of Health (MoH) in Cambodia confirmed the country's fifth case of human infection with the H5N1 avian influenza virus. The case, a 3-year-old girl from Kampong Speu Province (west of Phnom Penh in the southern part of the country), developed fever on 14 March. Her condition deteriorated rapidly. She was hospitalized in Phnom Penh on 20 March and died on 21 March. Samples from the child tested positive for H5N1 infection at the Pasteur Institute in Cambodia.

A team of officials from the MoH and WHO have investigated the situation in the remote village where the child lived. Backyard poultry began dying in the village in February 2006, and this phenomenon has continued. The child is known to have played with chickens, including some showing signs of illness.

The investigation found seven residents with fever but no respiratory symptoms. All had a history of recent contact with diseased birds or had been involved in caring for the child. Although none of these residents presently show symptoms compatible with H5N1 infection, all have been placed under medical observation as a precaution. Samples have been taken from these people and other close contacts of the child. Test results are expected shortly.

The Ministry of Agriculture has taken samples from chickens in the area. Testing is under way.

This is the fifth confirmed case in Cambodia and the first in almost a year. The four previous cases, all from the adjacent Kampot Province which borders Viet Nam, and all fatal, occurred from the end of January 2005 to the middle of April 2005.

Cholera, Southern Sudan - Update

Between 28 January and 20 March 2006, a total of 8,923 cases and 238 deaths (case-fatality rate, 2.67%) from acute watery diarrhoea were reported for the whole of southern Sudan. The two most affected areas, Juba and Yei, reported a cumulative number of 4,543 cases and 88 deaths, and 1,807 cases and 54 deaths, respectively.

The situation in Yei is stable and improving daily, with the last reported case received on 20 March and only sporadic cases appearing in the town. The outbreak in Yei was declared officially over by the Under Secretary of Health of the Government of southern Sudan on 14 March. The situation in Juba is improving, with the number of cases consistently decreasing over the past 3 weeks, although the full rainy season has not yet arrived.

However, a total of 2,573 cases and 96 deaths (case-fatality rate, 3.73%) - with some laboratory-confirmed cases for Vibrio cholerae Inaba - were reported in locations outside Yei and Juba. Monitoring of the outbreak is crucial. Control measures including strenthening of the surveillance and reporting system, improving uniform case management and water chlorination are continuing.

Poliomyelitis, Somalia

On 24 March 2006, two new cases of poliomyelitis were reported from two new regions: Lower Juba (southern Somalia) and Mudug Region (north-eastern Somalia). These regions, in which there are security-related restrictions, present a risk to neighbouring countries.

The cases also threaten the progress made in Mogadishu, formerly the epicentre of the outbreak, which has affected a total of 199 children to date but which appears to be declining in the city.

A nationwide polio vaccination campaign launched on 26 March aims to inoculate 1.4 million children in an effort to halt further spread of the virus and protect the gains made in Mogadishu.

Source: WHO Weekly Epidemiological Record, Vol 81, No. 13, 2006.

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