VZCZCXRO7466
RR RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHPF #0490/01 1960250
ZNR UUUUU ZZH
R 150250Z JUL 09
FM AMEMBASSY PHNOM PENH
TO RUEHC/SECSTATE WASHDC 0943
RUEHBK/AMEMBASSY BANGKOK 2744
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEHGV/USMISSION GENEVA 1702
RUEKJCS/SECDEF WASHINGTON DC

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 
------------ 
 
¶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 
------------------------------------- 
 
¶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 
 
PHNOM PENH 00000490  002 OF 002 
 
 
hopefully help identify influenza activity among hospitalized 
patients. 
 
 
RODLEY