VZCZCXRO9775
RR RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHPF #0421 1771006
ZNR UUUUU ZZH
R 261006Z JUN 09
FM AMEMBASSY PHNOM PENH
TO RUEHC/SECSTATE WASHDC 0855
RUEHBK/AMEMBASSY BANGKOK 2735
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEHGV/USMISSION GENEVA 1701
RUEKJCS/SECDEF WASHINGTON DC

UNCLAS PHNOM PENH 000421 
 
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 - FIRST 5 CASES DETECTED 
 
¶1. (SBU) SUMMARY.  As of June 25, the Cambodian Ministry of Health 
(MOH) has reported five cases of laboratory-confirmed novel 
influenza A (nH1N1) in humans, representing the first identified 
nH1N1 infections in Cambodia.  Four of the five cases occurred among 
a 40-member church mission delegation from the U.S. that arrived in 
Phnom Penh on June 19.  The fifth case, unrelated to the U.S. 
delegation, arrived at the Poipet border crossing from Thailand on 
June 24.  All cases were initially hospitalized for mild to moderate 
illnesses and have since shown clinical improvement, with the four 
AmCits being discharged to their delegation's guest house in Phnom 
Penh on June 25.  The fifth case remains hospitalized but has shown 
clinical improvement.  The MOH and World Health Organization (WHO), 
with technical support from Institut Pasteur in Cambodia (IPC) and 
the U.S. Centers for Disease Control and Prevention (CDC), have 
rapidly investigated all suspected and confirmed cases to date, and 
continue to conduct surveillance for new suspect cases among 
potential contacts of the confirmed cases.  A MOH-WHO press release 
issued on June 24 re-emphasized general prevention measures and 
provided MOH Influenza Hotline numbers for public inquiries or 
suspected case reporting.  END SUMMARY. 
 
¶2. (SBU) The first confirmed case, a 16-year-old female, developed 
fever, cough, and headache on June 20 and was seen at a local health 
clinic in Phnom Penh on June 22.  A diagnosis of suspect nH1N1 
infection was made, and clinical samples were collected for real 
time polymerase chain reaction (rt-PCR) testing at IPC.  Test 
results on June 23 confirmed nH1N1 infection.  The patient was 
transferred to Calmette Hospital, a designated national nH1N1 
referral hospital, later that evening for isolation and treatment 
with Tamiflu (oseltamivir). 
 
¶3. (SBU) Subsequent to the identification of the first case, three 
additional cases among the U.S. delegation, ages 18 to 20 years, 
developed fever and flu-like symptoms between June 21-24 and later 
tested positive for nH1N1.  All three were also hospitalized at 
Calmette Hospital for isolation and treatment with Tamiflu. 
 
¶4. (SBU) To prevent further transmission among the delegation, the 
MOH, WHO, and CDC decided to provide prophylactic doses of Tamiflu 
to the rest of the unaffected members, along with ample amounts of 
disposable face masks and alcohol hand wash as part of general 
infection control measures.  The delegation was also instructed to 
isolate the recently discharged confirmed cases in a separate area 
of the guest house until at least seven days after the onset of 
their illnesses have passed.  Delegation supervisors agreed to this 
plan after detailed discussions with MOH, WHO, and CDC on June 25. 
 
¶5. (SBU) CON Chief, CDC Director and post health unit local employee 
visited the four AmCit patients on June 25.  All took appropriate 
precautions to ensure no further risk of contagion during the visit. 
 The four AmCits provided verbal Privacy Act waivers allowing the 
Consular Section to communicate with their parents and group leaders 
regarding their condition.  Written Privacy Act waivers could not be 
obtained without entering the isolation ward.  CON Chief observed 
the four patients through a clear glass window into the isolation 
ward and spoke with them via telephone.  None reported any concerns 
with their ongoing treatment or with their medical conditions, and 
none requested that CON Chief pass any messages to family or 
friends.  All four patients had been in direct contact with their 
parents and group leaders (they had a cell phone in their isolation 
ward). 
 
¶6. (SBU) The fifth case, a 53-year-old Filipino male, presented to 
quarantine officials at the Poipet border crossing on June 24 with a 
two-day history of fever and difficulty breathing.  A MOH Rapid 
Response Team (RRT) was dispatched to Poipet, and the patient was 
promptly transferred to Siem Reap Referral Hospital by ambulance. 
Clinical samples were collected upon hospital admission that 
evening, and rt-PCR results from IPC the next day confirmed nH1N1 
infection.  The patient remains hospitalized but has demonstrated 
clinical improvement. 
 
 
RODLEY