The Cambodian Ministry of Health said the 13-year-old girl, from Ponhea Kreak district in Kampong Cham province, developed symptoms April 2, was hospitalized the next day and died April 5. Samples from the girl tested positive for H5N1 at the Pasteur Institute in Phnom Penh.
(Media-Newswire.com) - Washington – The World Health Organization ( WHO ) has confirmed two new human cases of the highly pathogenic H5N1 strain of avian influenza in Egypt and another case in Cambodia – the first to be confirmed in that country in 2007.
The Cambodian Ministry of Health said the 13-year-old girl, from Ponhea Kreak district in Kampong Cham province, developed symptoms April 2, was hospitalized the next day and died April 5. Samples from the girl tested positive for H5N1 at the Pasteur Institute in Phnom Penh.
Sick and dead poultry were reported in the village in recent weeks, according to WHO, and the girl reportedly had eaten part of a sick chicken before she became ill. A team from the Ministry of Health, WHO and the Pasteur Institute there are following up with the girl’s contacts and conducting awareness-raising activities in the area. Of seven cases confirmed in Cambodia, all have been fatal.
In Egypt, the Ministry of Health and Population announced two new human H5N1 cases that were confirmed by the Egyptian Central Public Health Laboratory and U.S. Naval Medical Research Unit No.3 in Cairo.
A 2-year-old female from Menia Governorate developed symptoms April 3 and the next day was admitted to a hospital where she is in stable condition. Investigations show that she had contact with backyard poultry.
Another girl, a 15-year-old female from Cairo Governorate, developed symptoms March 30, was admitted to the hospital April 5 and died April 10. Of 34 cases confirmed in Egypt, 13 have been fatal.
VIRUS SAMPLES AND PUBLIC HEALTH
The announcement brings to 291 the total number of human cases confirmed by WHO since 2003, with 172 deaths.
These totals include all countries except Indonesia, which since January has not shared virus samples from infected people with WHO collaborating centers and does not have a public health laboratory that WHO has certified to confirm human cases of the H5N1 strain of avian flu.
Indonesia Health Minister Siti Fadilah Supari focused global attention over the past few months on the fact that developing countries supply H5N1 samples to WHO collaborating centers for analysis and preparation for vaccine production but are unlikely to be able to afford the vaccines.
On March 27, after a two-day meeting in Jakarta, Indonesia, among officials from WHO and 20 nations that have had animal and human H5N1 outbreaks, WHO agreed not to share virus samples with vaccine makers without approval from the virus-collecting country, and the government of Indonesia agreed to resume sharing H5N1 virus samples. The meeting endorsed WHO's efforts to link vaccine manufacturers in developed and developing countries to speed the transfer of technology to manufacture influenza vaccine. Individual countries will negotiate how vaccine is made available to them. ( See related article. )
So far, WHO has not yet received samples from Indonesia.
“Sometimes these things take time,” said WHO spokesman Gregory Hartl in an April 23 USINFO interview. “This is something I don’t think we really expected to happen overnight, but certainly we hoped that it would happen sooner rather than later.”
WHO can confirm that Indonesia has had 81 avian flu cases since 2003 and 63 deaths, but news reports put the total at 94, with 74 deaths.
China also has been withholding virus samples from infected people since April 2006 for unknown reasons, but its H5N1 case count is up to date at WHO.
“We have confirmed China’s cases," Hartl said, “because if the national laboratory has been certified as being able to do H5N1 testing and it undergoes periodic review, then we will accept their national certification or report.”
Withholding viruses from WHO collaborating centers poses a threat to global public health security and compromises the ongoing risk assessment conducted by WHO collaborating laboratories.
WHO collaborating centers perform several key flu-related activities, including determining if the virus has acquired human genes or made other significant changes, identifying potential vaccine strains, testing to determine if the virus is vulnerable to recommended anti-virals, tracking the virus’s evolution and geographic spread, and updating diagnostic tests because flu viruses constantly mutate. ( See related article. )
On April 25, WHO is scheduled to hold another meeting in Geneva to focus on ways to increase developing-country access to potential pandemic vaccines. The gathering will bring together representatives from WHO, countries affected by H5N1, vaccine manufacturers and donors to discuss strategies for vaccine production and access.
According to WHO, potential outcomes include an agreement on ways to increase access to vaccines, including options for stockpiling vaccines.
For more information on U.S. and international efforts to combat avian influenza, see Bird Flu ( Avian Influenza ).
( USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov )
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