Concern raised after dual flu infection found in Cambodia

November 7, 2011
ABC Radio Australia

Researchers say a rare case of people being infected with both swine and seasonal flu in Cambodia could lead to a potent combination strain emerging in the future.

A study looking at historical data found a boy and his teacher were infected with both H1N1 and a seasonal flu in 2009 - the year the pandemic swine flu emerged.

In these cases, tests showed there was no "genetic recombination," or mingling of the two flu strains.

The study, published in the American Journal of Tropical Medicine and Hygiene, says that while the cases don't pose a current threat they are a reminder of the dangers that a strain such as avian flu could mix with human flu and affect millions.

Presenter: Sen Lam

Speaker: Dr Ian Barr, deputy director of WHO Collaborating Centre for Reference and Research on Influenza in Melbourne

Click here to listen to the audio program (Windows Media)

BARR: Swine flu has symptoms of any of the standard influenza viruses. It's not particularly different, so normally people will suffer from sudden onset, so something will come on them with a short period of time, 8 to 12 hours, usually involving respiratory symptoms, such as a cough, in many cases a fever greater than 38 degrees centigrade and they'll generally feel unwell and may have muscle soreness, and some of the classic symptoms of influenza-like illness.

LAM: And so what do we know about the rare cases of co-infection?

Global flu watch: Report of rare flu coinfection in Southeast Asia hot spot

November 2, 2011
Medical Xpress

Researchers conducting influenza-like illness surveillance in Cambodia have confirmed a rare incidence of individuals becoming infected with a seasonal influenza and the pandemic strain at the same time, a reminder of the ongoing risk of distinct flu viruses combining in human hosts to produce a more lethal strain, according to a report in the November issue of the American Journal of Tropical Medicine and Hygiene. A pandemic strain is a type of flu against which people have little or no natural immunity.

While the individuals recovered and the two strains did not recombine into a new and different virus, experts say coinfections in Southeast Asia deserve particularly close scrutiny given the ongoing transmission of the deadly avian influenza virus H5N1 and circulation of the pandemic H1N1 influenza that first emerged in 2009. The report comes as flu season gets underway in the United States, and while Cambodia and other tropical parts of Asia are reporting continued flu activity.

BRITAIN ON ALERT FOR NEW SUPER-FLU

Thursday November 3,2011 By Jo Willey, Health Correspondent

A NEW strain of killer flu which could spread to ­Britain within 24 hours is “one of the biggest biological threats of our time”, experts warned.

The alert comes after people started to fall victim to seasonal flu and the more virulent swine flu at the same time.

Such a rare incidence creates the risk of a lethal mutation, leading to an “ominous” super-flu virus for which humans have almost no immunity, said medical scientists.

Dr Peter Hotez, a world-renowned infectious disease expert, warned: “Highly infectious strains of the virus against which humans have little defence can spread from one continent to another within 24 hours.” He said the fact scientists had detected the rare double-flu infection highlighted the need for extreme vigilance against new killer strains around the world.

Dr Hotez, president of the American Society of Tropical Medicine and Hygiene, praised the scientists who had made the discovery.

Dual flu infections in Cambodia raise concern

A Cambodian child (R) receives a vaccine for A-H1N1 (AFP/File, Tang Chhin Sothy)

Thursday, November 03, 2011
AFP

WASHINGTON — A rare case of people being infected with both swine and seasonal flu has been documented in Cambodia, raising concern about the possibility of a potent combination strain, said a study out Wednesday.

The unusual diagnoses were made in a 23-year-old teacher and one of his young male students, who had H1N1 and a human season flu H3N2 at the same time, said the findings in the American Journal of Tropical Medicine and Hygiene.

Neither patient was hospitalized and their illnesses did not appear any more severe than in typical patients who are afflicted with a single strain.

Finding the beauty of life in a Cambodian hospital

Ray of Light. Inside the Bayon Temple, Angkor Thom. It took years to finish but the outcome was priceless.
Angkor Wat is a breathtaking place, filled with energy.
The hospital room, near the border, within Cambodia.
We entertained ourselves with our iPods, Skullcandy, and Coelho books (lucky that I brought two!).
The swab test guy. Double surgical gloves!

CNNGo reader Ara Charissa Sam gets a spiritual boost from the unlikeliest of places -- quarantine

19 August, 2010
By Ara Charissa Sam
CNNGo

During my trip to Siem Reap, the warmth of the magical ruins of Angkor Wat enveloped me. Warmth is when you feel positive energy surround you with undeniable power. It makes you feel overwhelmingly free and safe. It nourishes your innermost thoughts and desires. But most of all, it makes you appreciate the beauty of life. Walking past the walls and carvings transported me through a realm of masterpieces from thousands of years ago. The intelligence and sophistication of the masters that conceptualized the structure radiated.

Marveling at the richness of their culture made me realize how power, might and wisdom withstood the test of time. The kings are long gone, but the artwork on the walls reaches out to visitors. With a pinch of imagination and a thirst for adventure, they come alive in a snap. Apsara dancers illuminate the adorned halls with their energy, lectures being passed on from one generation to another, and elders share inspiring thoughts and knowledge with their people.

Border crossing

After a few days of exploration, my friends and I packed our bags and left Siem Reap. As we crossed the border, one of my friends caught the flu. Since there was an AH1N1 scare, a tight clearance check was about to unfold.

I checked her temperature and felt a tinge of heat. But we thought, if only we could get through these guards everything will be fine. She can rest at the hotel in Vietnam and her temperature will surely go down.

The moment of truth; the border police came with their high-tech gadgets. They immediately started their routine, checking all of the passengers. We saw them getting closer. I was praying they'd leave and let us be. Two more steps. He placed the temperature reader in my ear. It took only a few seconds but it seemed forever. I was cleared. The doctor cleansed the gadget and did the same procedure to my friend. I saw his face -- and I knew that this was the part where we deviated from our itinerary.

Hospital bound

They transported us to a nearby hospital -- or so we assumed, we couldn’t understand what they were saying -- and no one knew how to speak English. After a few minutes, an ambulance showed up. We managed to stay calm, taking pictures, joking that it was our border limo.

It took roughly 30 minutes -- the road to the hospital was dark. We figured we were in a remote area near the border, within Cambodia. They took us into a place which by no means looked like a hospital. But it was. They confiscated our passports and pointed to us a room. We shook our heads but kept our cool. The bed was small and we had to share. No cushions. Just a thin sheet to cover the board. Paint was peeling off the wall and some of the windows were shattered.

There was a man, who was also quarantined, that tried to communicate with us. He used hand signals -- pointing and reaching out because he saw how confused we looked. He reassured us through his actions that the doctor will visit the next day. He gestured that we should accept the food he’s offering so as to regain energy. It struck us that in kindness, language wasn’t a barrier.

Warmth of a stranger

My friend and I realized how blessed we were to have felt the warmth of a stranger. He made us feel safe. A Cambodian that didn’t even know our names and where we were from, but was so hospitable and thoughtful enough to have treated us as his friend.

The next day, they transported us to a bigger hospital in Ho Chi Minh where we spent a few more days in quarantine while waiting for the test results.

We met people from Vietnam who helped us translate and understand what was happening. Such a lifesaver. They went the extra mile by making us feel at home as they shared local insights about their culture.

It was indeed an unforgettable experience, one I wouldn’t trade for anything else. We got more than we bargained for. An adventure which showed us how beautiful life really is.

And that is how you squeeze in tons of positive energy within you. So you can, in turn, share the warmth with the world.

Recommendations:

Mandalay Inn: www.mandalayinn.com
They can even customize the tour for you. Look for Kat (the manager). Their place is filled with warmth and hospitality. Getting a good tour guide is the key. Ask for Bon. He’s well read and knowledgeable. He can speak good English, too.

About the author: Ara Charissa Sam is a Filipino adventurer by heart -- in search of rich cultures and awe-inspiring tales from other countries. Her day job involves dealing with media marketing decisions within the telecommunications industry.

Cambodian PM and 3 ministers treated for swine flu [-Hopefully they would NOT recover]

Wednesday, June 30, 2010
By SOPHENG CHEANG (AP)

PHNOM PENH, Cambodia — Cambodian Prime Minister Hun Sen and three other Cabinet ministers have contracted swine flu and the premier is recovering after several days of medical care, the health ministry said Tuesday.

Hun Sen, 59, required "urgent treatment" after Friday's weekly Cabinet meeting, the Public Health Ministry said in a brief statement released late Tuesday.

"After receiving treatment from medical specialists, the health of Prime Minister Hun Sen is back to normal," the statement said.

The prime minister publicly mentioned last week he had come down with fever and flu-like symptoms, and he was absent from the 59th anniversary of his ruling Cambodian People's Party on Monday.

"Prime Minister Hun Sen has canceled some of his schedule because of his health," said government spokesman Khieu Kanharith.

He said Hun Sen was still receiving medical attention but gave no details.

The statement also said that Yim Chhay Ly, one of several deputy prime ministers, and two other Cabinet-level ministers — Chhay Than and Tao Senghour — had caught the H1N1 virus. It did not give details about their condition.

At least six Cambodians have died from swine flu and at least 600 have contracted it since the virus was first detected in the country last June.

Hun Sen has been at the center of the country's politics since 1985, when he became the world's youngest prime minister at age 33. He has held or shared the top job ever since, bullying and outfoxing his opponents to stay in power.

Cambodia reported A/H1N1 case reaches 591

PHNOM PENH, June 28 (Xinhua) -- Cambodia said Monday that the deadly disease A/H1N1 has reached 591, an increase of 31 cases since early report made in February that recorded with 560 cases.

Ly Sovann, deputy director of the communicable disease control department of Ministry of Health said as of the 26th week of 2010, the record showed 591 cases of A/H1N1, but the number of deaths remains at six since the outbreak last year.

Of all cases have happened in 15 out of 24 provinces and cities across the nation, he said.

The 15 provinces and a city are Phnom Penh, Kandal, Kompong Speu, Takeo, Svay Rieng, Prey Veng, Kompong Cham, Mondulkiri, Banteay Meanchey, Kompong Thom, Udor Meanchey, Battambang, Kampot, Siem Reap and Kompong Chhnang.

Since February this year, Cambodia has conducted vaccination of more than 1 million dozes of new vaccine donated by World Health Organization.

Since the outbreak of the A/H1N1 in June 2009, six deaths were recorded in Cambodia.

300,000 H1N1 Vaccinations Underway

By Win Thida, VOA Khmer
Original report from Phnom Penh
02 April 2010

Health officials are wrapping up an initial round of vaccinations against the H1N1 virus, administering hundreds of thousands of shots in Phnom Penh and three provinces since March 24.

Officials said they expect to give out 300,000 shots in the capital and the provinces of Kandal, Kampong Cham and Kampng Chhnang.

H1N1, sometimes called swine flu, has killed six Cambodians since its onset.

The vaccinations, which began March 24, are the first portion of an estimated 1.5 million doses, provided by the French government and aimed mainly at children and pregnant women.

“The vaccinations will begin again from May to July to vaccinate people in 20 [remaining] provinces,” Sun Chan Soeun, director of the national vaccination program, said.

300,000 H1N1 Vaccinations Underway

By Win Thida, VOA Khmer
Original report from Phnom Penh
02 April 2010

Health officials are wrapping up an initial round of vaccinations against the H1N1 virus, administering hundreds of thousands of shots in Phnom Penh and three provinces since March 24.

Officials said they expect to give out 300,000 shots in the capital and the provinces of Kandal, Kampong Cham and Kampng Chhnang.

H1N1, sometimes called swine flu, has killed six Cambodians since its onset.

The vaccinations, which began March 24, are the first portion of an estimated 1.5 million doses, provided by the French government and aimed mainly at children and pregnant women.

“The vaccinations will begin again from May to July to vaccinate people in 20 [remaining] provinces,” Sun Chan Soeun, director of the national vaccination program, said.

Cambodia Battling Diseases on Two Fronts

By Kong Sothanarith, VOA Khmer
Original report from Phnom Penh
04 January 2010

Cambodia is facing threats from both the H1N1 virus and the avian influenza, health officials warned Monday, announcing that another man fell ill with bird flu in December.

December’s infection brings the total bird flu cases in humans to nine, with seven killed from the disease since in first appeared in 2004.

The most recent case, in Kampong Cham province, was accompanied by the deaths of 143 chickens. (Testing on two of two samples showed positive results for avian influenza.)

Meanwhile, H1N1, sometimes called swine flu, has killed six people and infected more than 500, officials said.

“We have found, every week, two, three or five new cases for H1N1,” said Ly Sovann, deputy director of the Ministry of Health’s communicable disease department. “On Dec. 16, we found a new [bird flu] case in Kampong Cham province, but he has not died.”

“Even though there are a small number of cases of human contamination, we are still worried about these diseases,” he said.

World Health Organization health specialist Nima Asgary confirmed the new case of bird flu, saying Cambodia was now facing infections of both viruses.

However, the H1N1 virus was considered less dangerous than bird flu, he said.

Ly Sovann recommended that Cambodians maintain good hygienic practices, including washing of hands and covering of mouth and nose while coughing, to prevent the spread of H1N1.

He also warned against selling or eating already-dead poultry, to prevent the spread of bird flu.

Cambodian A/H1N1 death case rises to 6

PHNOM PENH, Dec. 18 (Xinhua) -- Cambodia has confirmed another death case of influenza A/H1N1, bringing the total number to six, official news agency AKP reported on Friday.

The new death case has been found on an 18-month baby living in Battambang province, said Ly Sovann, deputy director of the communicable diseases control department of the Health Ministry.

As of Dec. 17, he said, the country's total number of infected cases of A/H1N1 has increased to 531, including 44 new cases during this week.

Dr. Ly Sovann called on people to be more careful and to protect themselves from this deadly pandemic.

Cambodia reports 480 cases of A/H1N1 flu, 5 die

PHNOM PENH, Dec. 7 (Xinhua) -- The Cambodian government said on Monday that the total of influenza A/H1N1 disease in the country has reached 480 cases with five deaths.

Ly Sovann, deputy director of the communicable disease control department of Ministry of Health said that as of today, five Cambodians have died of A/H1N1 flu disease and the total cases reach at 480.

In October, the government announced that four peopled died of the disease and 237 cases were confirmed.

The infected cases are from 13 out of the country's 24 provinces and cities across the country.

Cambodia's Ministry of Health and WHO have continued their efforts in advising people around the country to protect themselves and the families, by saying each individual should cover mouth and nose with a tissue when coughing or sneezing and dispose of tissue in a bin; wash hands regularly with soap and hot water; do not spit in public; and avoid close contact with sick people.

They also advised that for immediate treatment of the disease, the sick person shall drink lots of liquids; rest and paracetamol to reduce fever and muscle aches.

H1N1 Virus Claims Fifth Cambodian

By Heng Reaksmey, VOA Khmer
Original report from Phnom Penh
26 November 2009

A fifth person in Cambodia has died from the H1N1 virus, sometimes called swine flu, health authorities said Thursday.

The victim, a 20-year-old man from Phnom Penh, succumbed late last week after a stay at Calmette hospital, Sok Touch, director of the Ministry of Health’s communicable disease department, told reporters.

The total number of cases of the disease, which is considered a global epidemic, rose to 472, up from 444 cases last week.

The disease has spread across 13 provinces and cities so far: Phnom Penh, Siem Reap, Kandal, Takeo, Kampong Speu, Battambang, Kampong Chnang, Svay Rieng, Kampong Cham, Mondolkiri, Kampot, Prey Veng and Banteay Meanchey.

The Ministry of Health will receive 300,000 doses of flu vaccine from the World Health Organization, to combat the spread of the virus at the end of this month, officials said.

Health experts continue to warn people to avoid crowded places if they have flu-like symptoms, including fever of 38 degrees Celsius, a sore throat, headaches, muscle aches and lethargy.

Only patients with severe cases of H1N1 will be hospitalized.

Death toll of A/H1N1 flu in Cambodia increases to 5

PHNOM PENH, Nov. 26 (Xinhua) -- The death toll of A/H1N1 flu in Cambodia has increased to five and the virus infected rate topped 28 cases for one week, official of the Health Ministry said on Thursday.

"The fifth person who died of the flu late last week is a 20 year-old Khmer man," Ly Sovan, deputy director of the communicable control department of Health Ministry told Xinhua by phone.

He could not elaborate in detail for fatality case. But he said that the cumulative number of confirmed cases in Cambodia are 472, up from 444 cases last week. It spreads in 13 provinces and city in the country including Phnom Penh, Siem Reap, Kandal, Takeo, Kampong Speu, Battambang, Kampong Chhnang, Svay Rieng, Kampong Cham, Mondul Kiri, Kampot, Prey Veng and Banteay Mean Chey provinces.

According to a report from the Cambodian Heath Ministry, the ministry will receive 300,000 doses of A/H1N1 flu vaccine by the end of November from the World Health Organization.

Cambodia to receive flu vaccination late this year: health official

PHNOM PENH, Nov. 6 (Xinhua) -- Cambodia's Health Ministry on Friday said that it will receive the vaccination for A/H1N1 flu from the World Health Organization (WHO) at the end of this year.

"We will receive the vaccination from the WHO late this year after we have appealed for help from other countries and partners," said Ly Sovan, deputy director for the communicable control department of Health Ministry.

"So far, we have not known clear information about the amount of the vaccination that we will get from the WHO," he said, adding that "when we have it, we will consider with our experts about injecting vaccination for people."

Ly Sovan said that up to now, Cambodia has 313 cases of the flu and four people were killed by the virus, including a pregnant woman.

Cambodia to warn people against A/H1N1, HIV/AIDS at water festival

PHNOM PENH, Oct. 30 (Xinhua) -- Cambodian authorities have prepared two messages on prevention of the spread of HIV/AIDS and A/H1N1 virus at the upcoming water festival, government and international organization officials said Friday.

Sok Touch, director of the communicable disease control department of Ministry of Health said his ministry has prepared some 500,000 leaflets to be distributed during the three-day festival.

He said the leaflets recommend the attendees to the event to be well aware of the disease by which it encourages people to avoid the flu by "covering up cough and wash hands among others."

Also, Dan Bora, communication officer of Population Service International (PSI) said about 1,000 volunteers coordinated by PSIand in cooperation with national AIDS authority will hand out 250,000 condoms during the three-day event.

He said brothels will be the main target for distributions of the condoms.

Cambodia is known as a successful country in curbing with the spread of HIV/AIDS through a campaign of "100 percent condom use."

Chea Sokhom, secretary general of the National and International Festival Committee, said Thursday that 391 boats with more than 25,000 racers have been registered to take part in the water festival which is scheduled to begin from Nov. 1 through 3.

Cambodia's boat races or water festival is a three-day event crediting Cambodia's strong armed forces in defeating enemies by using boats.

King Norodom Sihamoni is expected to preside over the races, and will be accompanied by the government leaders, including Prime Minister Hun Sen and members of the foreign diplomatic corps.

Every year, millions of Cambodians are coming from across the country and are flocking to Phnom Penh to view and enjoy the boat races.

The 1,700-meter race is held on the Mekong River in the capital in front of the Royal Palace.

H1N1 Claims Fourth Cambodian

By Heng Reaksmey, VOA Khmer
Original report from Phnom Penh
29 October 2009

A 51-year-old woman succumbed to the H1N1 virus, officials said Thursday, bringing the death toll to four, with the total amount of confirmed cases in the country at 239.

The death comes as Phnom Penh is preparing for the annual Water Festival, which draws millions of people to crowd the capital’s waterfront for three days.

Health officials worry the close proximity of revelers will lead to a rapid expansion of the disease. Following the festival last year, Cambodia reported a new case of bird flu.

The latest victim of the H1N1 virus, sometimes called swine flu, was a Phnom Penh resident who had suffered from liver disease and had been ill for “many years,” Sok Touch, director of the Ministry of Health’s communicable disease department, said.

Symptoms of the pandemic virus are much the same as seasonal influenza, including a high fever, coughing, sore throat, headache, muscle aches and lethargy, health experts say. It can be transmitted at least one day before symptoms appear, after which it is contagious for at least a week.

Health Minister Mam Bunheng encouraged people to cover their mouths and noses with tissue when coughing or sneezing and to deposit the tissue in a bin. Hand-washing with soap and water can also contain the spread of the disease, he said.

The World Health Organization estimates more than 340,000 cases of the disease worldwide have led to 4,100 deaths as of late September.

A/H1N1 flu cases in Cambodia rise to 161

PHNOM PENH, Oct. 19 (Xinhua) -- Cambodian Health Ministry announced on Monday that flu A/ H1N1 in country has risen to 161 cases, killing three people including a pregnant women.

In total Cambodia have 161 cases and 77 of them are women and so far it killed three people and more over, 133 of 161 cases are Khmer, Ly Sovan, deputy director of Communicable disease department (CDC) of Cambodia told reporters at a press conference here.

He added that 28 foreigners infected with the virus include three Australians, four French citizens, six Japanese, one Filipinos, two people from the United Kingdom, nine Americans, one Indian, and two people from Ireland. The flu is spreading among local communities in the country, he noted.

Many people called the flu Hot Line, but only 300 cases of 1,200 phones are asking about ways of prevention of this flu and some important information of this flu, he added. He urged local people to stop making useless phone call and keep time for people in need.

He once again said that his ministry is still concerned about the upcoming water festival which lasts from November 1 to 3 this year on Tonle Sap River in Phnom Penh because millions of Khmer people will join this event. The number of the flu infected cases could increase, he added. But Maggs Mac Guinness, technical officer of pandemic planning for the World Health Organization (WHO) to Cambodia said that even though they should not be afraid of this flu, they could prevent it with easy ways.

According to report of health ministry, it is preparing 500,000 posters and leaflets to raise awareness for people about the flu.

Water Festival Potential Booster for H1N1 Flu

By Heng Reaksmey, VOA Khmer
Original report from Phnom Penh
12 October 2009

Health officials say November’s Water Festival, which draws more than a million people to Phnom Penh each year, could hasten the spread of the H1N1 virus across the country.

The virus, sometimes called the swine flu, has killed three Cambodians and infected 130 people in the country so far.

Health Minister Mam Bunheng said officials had prepared 500,000 leaflets on flu prevention to inform the influx of villagers for the three day festival, schedule for Nov. 1 through Nov. 3.

Boat races on the Tonle Sap river draw huge crowds to each bank, packed tightly together, which can promote the spread of the illness, Mam Bunheng said.

“This gathering is a good chance for the virus, as they are sneezing and coughing,” he told reporters. Those who are feeling ill should stay at home until they get better, he said.

Michel Thieren, a World Health Organization representative in Cambodia, said the festival and its crowds were something to be concerned over.

Ministry Urges H1N1 Patients Moved to Hospitals

By Heng Reaksmey, VOA Khmer
Original report from Phnom Penh
07 October 2009

The Ministry of Health on Wednesday ordered all clinics nationwide to send patients suspected of carrying the H1N1 flu virus to state hospitals, following the third documented death from the disease Tuesday.

Officials estimate around 120 people have been infected with the virus, sometimes called swine flu.

Sok Touch, director of the Ministry of Health’s communicable disease control department, urged clinics to comply with requests that have already been sent.

“In Cambodia, we are trying our best to prevent an AH1N1 virus epidemic for people’s safety,” he said. “We’re trying to cut short [the life] of the swine flu.”

The disease emerged in Cambodia in June, with a group of US travelers from Thailand, but the disease caused no reported deaths until September. Two deaths were reported this week, including a 25-year-old woman on Tuesday.