I've been following H5N1 avian influenza for twenty years.

Today's news of a young girl's death from H5N1 in Cambodia is tragic and the news that 4 of 12 contacts are showing influenza-like symptoms is worrisome.

It's not time to panic yet by any means—we've seen similar events a number of times—but obviously we'll be watching closely.

Whatever happens, we need to be taking steps *now* to improve rapid production capacity for H5N1-specific vaccines.

telegraph.co.uk/global-health/

At of tonight it looks as though only one contact, the girl’s father, has tested positive for H5N1. While human-to-human transmission is not ruled out, parallel zoonotic transmissions from a common environmental source seem far more likely.

When these cases are first announced, information is often sketchy and translation errors, such as yesterday’s that suggested 12 downstream cases, are common.

nytimes.com/explain/2023/bird-

Via @HelenBranswell, it appears that these two cases were infected with an older strain (2.3.2.1c) of H5N1, rather than the strain of current concern that is sweeping the globe. This, coupled with the absence of further reports of human cases, makes it likely that daughter and father both contracted H5N1 directly from their flock of birds and that there was no human-to-human transmission involved.

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Nature's lesson in humility for those like me who immediately assumed it was the current widely circulating avian flu.

Also didn't know that there are around 40 human H5N1 cases per year worldwide.

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