Country update on AI situationCountry update on AI situation

Ly SovannLy Sovann, MD, DTMH, MCTM, MD, DTMH, MCTM

Deputy of CDC Department, MoH, CambodiaDeputy of CDC Department, MoH, Cambodia

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Current situation of Current situation of H5N1H5N1

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2nd and 3rd case

1st and 4th case

6th case5th case

7th case

8th case

Cambodia

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Current situationCurrent situation

First detected January First detected January 20052005Total cases : 8Total cases : 8– 7 lost life7 lost life– 1 survived1 survived

SexSex– 3 Male3 Male– 5 female5 female

Age rangeAge range– 3-20 : 6 cases3-20 : 6 cases– 25-28 : 2 cases 25-28 : 2 cases

20052005 20062006 20072007 20082008

44 22 11 11

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Current situation (Cont’)Current situation (Cont’)

Type of transmissionType of transmission– 6 cases : have history of contact with dead poultry6 cases : have history of contact with dead poultry

Playing with sick chickenPlaying with sick chickenSelling the sick poultrySelling the sick poultryPrepared the died chicken for foodPrepared the died chicken for foodPlaying the fighting chickenPlaying the fighting chickenPrepare the wild bird for foodPrepare the wild bird for food

– 2 cases : No history of contact with dead poultry2 cases : No history of contact with dead poultryVery close contact with the patientVery close contact with the patientSwimming in the pond which duck also swim thereSwimming in the pond which duck also swim there

Outbreak experience periodOutbreak experience period– From December - AprilFrom December - April

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Description of case number 8Description of case number 8Pick up by Febrile disease surveillancePick up by Febrile disease surveillanceContact with dead poultry on 16 November 2008Contact with dead poultry on 16 November 2008On set 28 November 2008On set 28 November 2008

– high feverhigh fever– CoughCough– and felt chest oppressionand felt chest oppression– Bough medicine in the villageBough medicine in the village

30 November 200830 November 2008– Went to private clinicWent to private clinic

2 December 2008 Public Health Center2 December 2008 Public Health Center– Collect sample for the Febrile study Collect sample for the Febrile study

3 December went to other private clinic3 December went to other private clinic– Suspected TBSuspected TB– Refer to TB treatment centerRefer to TB treatment center– TB treatment courseTB treatment course

11December confirmed H5N111December confirmed H5N1– Refer to Public isolate wardRefer to Public isolate ward

18 December 2008 : discharge18 December 2008 : discharge

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Description of case number 8Description of case number 8

Outcome of investigationOutcome of investigation– Long incubation period : 13daysLong incubation period : 13days– Many private and public visit : 5 placesMany private and public visit : 5 places– 64 close contacted: Negative H5N164 close contacted: Negative H5N1– 45 suspected: Negative H5N145 suspected: Negative H5N1– Intensive AntibioticIntensive Antibiotic– Treat with Tamiflu at late periodTreat with Tamiflu at late period– SurviveSurvive

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MoH surveillance and responseMoH surveillance and response

Continue vigilance surveillanceContinue vigilance surveillance– Event base : Hotline and MediaEvent base : Hotline and Media– Hospital base surveillanceHospital base surveillance– ILI sentinel surveillanceILI sentinel surveillance– SARI surveillanceSARI surveillance– SISEASISEA

ResponseResponse– Refresh training to 1200 RRTRefresh training to 1200 RRT– Supply medical equipment Supply medical equipment – Continue RRT staff supportContinue RRT staff support– They are ready to response They are ready to response

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Hospital preparednessHospital preparedness5 isolated wards nationally for case 5 isolated wards nationally for case

managementmanagement

Separate rooms for other hospitalsSeparate rooms for other hospitals–CountrywideCountrywide–Equipped and staffedEquipped and staffed–Simulation exercise Simulation exercise

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Laboratory Laboratory Pasteur Institute CambodiaPasteur Institute Cambodia

–NICNIC–Timely resultTimely result

2 others lab2 others lab–National lab NIPHNational lab NIPH–NAMRU 2 (NIPH)NAMRU 2 (NIPH)

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Thank youThank you