1. Country update on AI situation Ly Sovann, MD, DTMH, MCTM Deputy of CDC Department, MoH, Cambodia

2. 2 Current situation of H5N1

3. 3 2 nd and 3 rd case 1 st and 4 th case 6 th case 5 th case 7 th case 8 th case Cambodia

4. 4 Current situation First detected January 2005 Total cases : 8 –7 lost life –1 survived Sex –3 Male –5 female Age range –3-20 : 6 cases –25-28 : 2 cases 2005200620072008 4211

5. 5 Current situation (Cont’) Type of transmission –6 cases : have history of contact with dead poultry Playing with sick chicken Selling the sick poultry Prepared the died chicken for food Playing the fighting chicken Prepare the wild bird for food –2 cases : No history of contact with dead poultry Very close contact with the patient Swimming in the pond which duck also swim there Outbreak experience period –From December - April

6. 6 Description of case number 8 Pick up by Febrile disease surveillance Contact with dead poultry on 16 November 2008 On set 28 November 2008 –high fever –Cough –and felt chest oppression – Bough medicine in the village 30 November 2008 –Went to private clinic 2 December 2008 Public Health Center –Collect sample for the Febrile study 3 December went to other private clinic –Suspected TB –Refer to TB treatment center –TB treatment course 11December confirmed H5N1 –Refer to Public isolate ward 18 December 2008 : discharge

7. 7 Description of case number 8 Outcome of investigation –Long incubation period : 13days –Many private and public visit : 5 places –64 close contacted: Negative H5N1 –45 suspected: Negative H5N1 –Intensive Antibiotic –Treat with Tamiflu at late period –Survive

8. 8 MoH surveillance and response Continue vigilance surveillance –Event base : Hotline and Media –Hospital base surveillance –ILI sentinel surveillance –SARI surveillance –SISEA Response –Refresh training to 1200 RRT –Supply medical equipment –Continue RRT staff support –They are ready to response

9. 9 Hospital preparedness 5 isolated wards nationally for case management Separate rooms for other hospitals –Countrywide –Equipped and staffed –Simulation exercise

10. 10 Laboratory Pasteur Institute Cambodia –NIC –Timely result 2 others lab –National lab NIPH –NAMRU 2 (NIPH)

11. 11 Thank you