CAMBODIA H1N1 UPDATE #3: 9 CONFIRMED CASES

UNCLAS SECTION 01 OF 02 PHNOM PENH 000490

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, G/AIAG, OES/IHA, MED
STATE FOR USAID/ANE, OFDA AND GH
BANGKOK FOR REO/HHOWARD
BANGKOK FOR OFDA
CDC FOR NCIRD/NCOX, JBRESE, TMOUNTS

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR
AMGT, MG, EAGR, CB
SUBJECT: CAMBODIA H1N1 UPDATE #3: 9 CONFIRMED CASES

REF: A) PHNOM PENH 421, B) PHNOM PENH 272


1. (SBU) SUMMARY. There are currently a total of nine cases of
laboratory-confirmed novel influenza A (H1N1) in Cambodia. Post's
U.S. Centers for Disease Control and Prevention (CDC) office is
waiting for laboratory results on a potential tenth case from
Institut Pasteur in Cambodia (IPC). All four new confirmed cases,
one of which included an Embassy employee, had mild to moderate
illnesses at worst, and the patients have all recovered. The
Cambodian Ministry of Health's (MOH's) response has so far been
adequate. Health officials are prepared to see more cases confirmed
in more populated areas of the country over the course of Cambodia's
flu season (June-November/December). CDC is working with the MOH to
implement a severe acute respiratory infection surveillance system.
END SUMMARY.

CASE UPDATES
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2. (SBU) The first confirmed case since Ref A was a 19-year-old
Cambodian female with no travel history who was exposed through a
personal contact, an Australian man who visited from Vietnam and
tested positive for H1N1 upon his return to Vietnam. The second
case was a 58-year-old Cambodian female with onset one to two days
after returning from Thailand. Cambodian Ministry of Health (MOH)
screeners at the Phnom Penh International Airport detected the third
case, a 15-year-old Australian female who arrived on a flight from
Bangkok.


3. (SBU) The fourth case was a 34-year-old male Embassy employee who
reported to the Embassy medical unit on July 7 with complaints of
fever, sore throat, rhinorrhea, and chills that had started the day
before. The patient had a positive QuickVue Rapid test for
influenza A and was started on Tamiflu for five days and remained in
isolation at his home until seven days after the onset of his
illness. He has since recovered and returned to work. A second
patient with mild flu symptoms reported to the Embassy medical unit
on July 8 but tested negative for influenza A using the QuickVue
Rapid test. He made a full recovery when rechecked on July 13 after
7 days of voluntary isolation. CDC is waiting for results to
confirm whether or not the second Embassy patient had H1N1.


4. (SBU) Acting Management Officer distributed a management notice
July 8 following initial detection of H1N1 in the Embassy employee.
The notice outlined common flu symptoms, procedures if an employee
or family member displays flu symptoms, and guidelines for staying
healthy, such as frequent hand-washing and keeping common surfaces
clean. The Community Liaison Officer forwarded the notice to
Embassy family members.

CAMBODIAN GOVERNMENT RESPONSE TO DATE
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5. (SBU) The MOH's response has so far been adequate. The MOH has:
1) increased influenza-like illness (ILI) surveillance at all MOH
sites nationwide; 2) coordinated with Calmette and other designated
H1N1 referral hospitals in Phnom Penh on proper specimen collection,
isolation, and clinical management procedures for suspect and
confirmed cases; 3) worked with Institut Pasteur to assure that all
confirmatory laboratory test results are promptly and accurately
reported; and 4) aggressively investigated all suspect and confirmed
cases, as well as their exposed contacts. The MOH and the UN have
developed public awareness ads on H1N1 for television, which have
been broadcasting on six to seven channels since June.

H1N1 FORECAST FOR CAMBODIA
--------------


6. (SBU) Cambodia has remained relatively isolated from the H1N1
outbreak so far, as it is somewhat removed from major travel routes.
However, health officials are prepared to see more cases confirmed
in more populated areas of the country over the course of Cambodia's
flu season, which begins in June, peaks in September-October, and
declines in November-December. CDC notes that health officials are
likely not detecting all cases in the country due to the mild nature
of the disease so far. CDC has developed and is leading the
implementation of a severe acute respiratory infection surveillance
system for MOH in some hospitals. This new surveillance system will

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hopefully help identify influenza activity among hospitalized
patients.


RODLEY