Health officials in Cambodia stress that they have not let down their guard against H5N1, despite four fatal cases of human avian flu this year, and are confident the community-based detection, surveillance and containment model remains robust and effective.
“There is no cause for alarm,” Chea Nora, a technical officer within the Emerging Disease Surveillance and Response unit at the World Health Organization (WHO) in Phnom Penh, told IRIN. “Even though Cambodia is the only country [in the Mekong region] that has had cases this year, H5N1 is well under control here.”
The four deaths, in February and March, were the first reported cases of H5N1 in Cambodia since April last year and raised the number of cases in the country to 14 since 2005, 12 of which have been fatal, according to the communicable disease department at Cambodia’s Ministry of Health.
Nora said it was important to note that the cases occurred in different areas of the country, that laboratory tests indicated the virus was neither mutating nor getting stronger, and that the avian flu season, which corresponds with the dry season in Cambodia, from November to May, is nearing its end.
However, he said interviews with villagers had revealed that some believed H5N1 was no longer a threat because there were no more radio alerts, which had been part of the national awareness campaign funded by USAID and the German government.
Ly Sovann, deputy director of the communicable disease control department at Cambodia’s health ministry, said an appeal to mobilize resources would be made at the next meeting of the H5N1 Technical Working Group at the end of this month.
The group comprises officials from the health and agriculture ministries as well as NGOs, including the UN Children’s Fund (UNICEF), the UN Food and Agriculture Organization (FAO), World Vision and Medicam (the umbrella group of health NGOs in Cambodia).
Sovann, the architect of Cambodia’s detection, surveillance and containment model for communicable diseases, stressed that the rapid response to each case of H5N1 demonstrated that his ministry had not let its guard down. The message that H5N1 remains a threat due to the severity of the disease and possibility that the virus might mutate is constantly reiterated by the minister to health officials at the provincial, district and commune levels, as well as village health volunteers, he said.
The Rapid Response Team (RRT) comprises 1,200 people and covers the entire country, he said. Investigations are conducted in every village where there is a case to discover the source of infection and trace all those who had been in contact with the patient, he said. Two-week COMBI (communication for behavioral impact) campaigns are also conducted using flyers, loud-speakers mounted on motorcycles and house-to-house visits by RRT staff.
One difficulty with awareness campaigns about H5N1 is that “the disease is more alarming to health officials than it is to people due to the small number of cases and limited transmission of the virus”, he said.
“Ongoing, sustainable health campaigns are required,” he said, noting that rural Cambodians were more concerned with hunger, dengue fever, malaria, cholera, diarrhoea and road accidents because they were more prevalent threats.
Nora agreed that rising food insecurity in rural Cambodia was a risk factor for H5N1 because hungry families were more likely to eat sick chickens.
Funding for the country’s national H5N1 education campaign dried up at the end of 2008 and the ministry has relied on alerts posted online, text messages sent to staff at health centres throughout the country and a national hotline since then.
According to the WHO, bird flu has killed 320 people in 12 countries since 2003, the vast majority in Asia.
Source: IRIN Global