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Letter
H5N1 Avian Influenza, Kampot
Province, Cambodia
Shaun K. Morris*
*University of Toronto, Toronto, Ontario, Canada
Suggested
citation for this article
To the Editor: As a resident in pediatrics with an interest in
infectious diseases, I was fascinated by the range and scope of conditions
I saw in May and June of 2005 in local children in Kampot Province, a
mainly rural area in southeastern Cambodia. This province, near the Vietnamese
border, is the epicenter of H5N1 avian influenza in Cambodia, with all
4 known human cases of the disease. All of these documented human cases
have been fatal.
While the World Health Organization and the Cambodian Ministry of Health
have engaged in public education, the village-level response to a pathogen
of potential global importance is evolving. As part of my work in Cambodia,
I made numerous information-gathering visits to villages in Kampot Province.
Though village elders and health workers had often heard of the "bird
flu," most of the villagers I spoke to had not. Many persons did
not know whom to contact should their chickens or other birds die. Those
who knew about H5N1 influenza told me that, without adequate compensation
for culling flocks, little incentive would exist to report bird deaths.
In a typical village, chickens, ducks, and pigs intermingled with each
other and with humans underneath or around homes on stilts. General knowledge
of infection control practices among villagers was minimal.
The dissemination of information into a rural, agricultural society such
as that in the southeast of Cambodia is a difficult task. Many rural inhabitants
do not have televisions or radios and may infrequently travel to larger
towns. Health workers from international groups, nongovernmental organizations,
and the government are often required to travel on foot or motorbike through
fields and forests to reach and educate the population. Government health
workers lack the personnel and resources to adequately identify and investigate
potential cases, and Cambodia has substantially fewer microbiology laboratories
than do neighboring Thailand and Vietnam.
Should a pandemic of avian influenza occur, it will almost certainly
originate in Southeast Asia. Cambodian and international health organizations
have recognized the country’s potential key role in propagation of an
impending pandemic agent. However, because of its history and current
economic state, Cambodia is less able to respond to the avian influenza
threat than its neighbors. In recognition of this fact, the World Health
Organization and the Cambodian Ministry of Health have stated that the
prevention, control, and identification of avian influenza are national
priorities. Additionally, international funds have been flowing into Cambodia
to assist with avian H5N1 influenza surveillance and case investigation.
Much work remains to be done; we hope that by combining international
resources and policy with domestic expertise and effort, Cambodia will
mount a successful response against this emerging threat.
Suggested citation
for this article:
Morris SK. H5N1 avian
influenza, Kampot Province, Cambodia [letter]. Emerg Infect Dis [serial
on the Internet]. 2006 Jan [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol12no01/05-0914.htm
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