title: Two clustered cases of confirmed influenza A(H5N1) virus infection, Cambodia, 2011.
abstract: In February 2011, a mother and her child from Banteay Meanchey Province, Cambodia, were diagnosed, postmortem, with avian influenza A(H5N1) virus infection. A field investigation was conducted by teams from the Cambodian Ministry of Health, the World Health Organization and the Institut Pasteur in Cambodia. Nasopharyngeal, throat and serum specimens collected from 11 household or three neighbour contacts including two suspect cases tested negative by reverse transcriptase-polymerase chain reaction (RT-PCR) for A(H5N1). Follow-up sera from the 11 household contacts also tested negative for A(H5N1) antibodies. Twenty-six HCW who were exposed to the cases without taking adequate personal protective measures self-monitored and none developed symptoms within the two following weeks. An unknown number of passengers travelling with the cases on a minibus while they were symptomatic could not be traced but no clusters of severe respiratory illnesses were detected through the Cambodian surveillance systems in the two weeks after that. The likely cause of the fatal infection in the mother and the child was common-source exposure in Preah Sdach District, Prey Veng Province. Human-to-human transmission of A(H5N1) virus was unlikely but genetic susceptibility is suspected. Clusters of A(H5N1) virus infection should be systematically investigated to rule out any human-to-human transmission.
authors.affiliation: World Health Organization, Phnom Penh, Cambodia.
authors.forename: N
authors.initials: N
authors.lastname: Chea
authors.forename: S D
authors.initials: SD
authors.lastname: Yi
authors.forename: S
authors.initials: S
authors.lastname: Rith
authors.forename: H
authors.initials: H
authors.lastname: Seng
authors.forename: V
authors.initials: V
authors.lastname: Ieng
authors.forename: C
authors.initials: C
authors.lastname: Penh
authors.forename: S
authors.initials: S
authors.lastname: Mardy
authors.forename: D
authors.initials: D
authors.lastname: Laurent
authors.forename: B
authors.initials: B
authors.lastname: Richner
authors.forename: T
authors.initials: T
authors.lastname: Sok
authors.forename: S
authors.initials: S
authors.lastname: Ly
authors.forename: P
authors.initials: P
authors.lastname: Kitsutani
authors.forename: N
authors.initials: N
authors.lastname: Asgari
authors.forename: M C
authors.initials: MC
authors.lastname: Roces
authors.forename: P
authors.initials: P
authors.lastname: Buchy
authors.forename: A
authors.initials: A
authors.lastname: Tarantola
mesh_terms: D000818:Animals; D001344:Autopsy; D001717:Birds; D002160:Cambodia; D016358:Contact Tracing; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D053124:Influenza A Virus, H5N1 Subtype / Q000302:isolation & purification*; D005585:Influenza in Birds / Q000635:transmission* / Q000821:virology; D007251:Influenza, Human / Q000473:pathology / Q000635:transmission* / Q000821:virology; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018571:Sentinel Surveillance; D055815:Young Adult