PHNOM PENH, Cambodia (AP) — A 2-year-old girl is the second person in Cambodia to die of bird flu this week, and the third this year, the country’s Health Ministry has announced.

Laboratory tests confirmed that the girl, who lived in the southeastern province of Prey Veng, died Monday with H5N1 avian influenza, the ministry said in a statement.

The ministry had announced on Sunday that a 50-year-old man in neighboring Svay Rieng province also had died from bird flu. In February, an 11-year-old girl became the country’s first bird flu fatality since 2014. Her father was also found to be infected but survived.

According to a global tally by the U.N.‘s World Health Organization, from January 2003 to July 2023, there have 878 cases of human infection with H5N1 avian influenza reported from 23 countries, 458 of them fatal. Cambodia had recorded 58 cases since 2003 of humans infected with bird flu.

“Since 2003, this virus has spread in bird populations from Asia to Europe and Africa, and to the Americas in 2021, and has become endemic in poultry populations in many countries,” the WHO says on its website. “Outbreaks have resulted in millions of poultry infections, several hundred human cases and many human deaths. Human cases have been reported mostly from countries in Asia, but also from countries in Africa, the Americas and Europe.”

The United States’ Centers for Disease Control and Prevention said last month that bird flu outbreaks were on the rise globally, with more than 21,000 outbreaks across the world between 2013 and 2022. Bird flu only rarely infects humans.

Scientists worry that rising cases of H5N1, particularly in animals that have frequent contact with humans, might lead to a mutated version of the disease that could spread easily between people, triggering another pandemic.

Chhuon Srey Mao, the 22-year-old mother of the dead girl, told The Associated Press by phone from Chhmar Lort village that her daughter fell sick on Oct. 1 with symptoms of coughing, high temperature and vomiting. The girl received treatment from a local physician for five days, but was sent on Oct. 5 to the capital Phnom Penh for advanced care when her condition worsened. She died at the children’s hospital.

The mother said that from late September, several chickens in her village, including at least four of her own, had died. She added that she had discarded the chickens that died, not cooking them for food. People have caught the virus both from domestic fowl and from wild birds such as ducks.

“I have no idea why my daughter would contract bird flu because she never touched or ate the dead chickens,” Chhuon Srey Mao said, “But I presume that she may have become infected with the virus when she played in the yard, as she normally did, where the chickens had been.”

She said the five surviving members of her family are in good health, but she is worried about them. Health officials have been to her village to deploy a virus-killing spray at her home and others, and advised all the villagers to report if they get sick.