Every morning, Keo Ngor goes to neighboring villages in Prey Veng province to buy chickens and ducks. The 42-year-old poultry vendor in Kampong Trabek district says he moves between 300 and 400 birds a day. And, he says, he now wears a mask.

“We know that bird flu can contaminate you from poultry,” he said recently. “We are wearing masks now. And after transportation, we clean up our truck.”

Many people in this eastern province say they are now aware of the dangers of bird flu, following an outbreak in 2006 that killed a 12-year-old boy in Mesang district.

The disease, which is spread through the H5N1 virus, carried by birds, has killed seven Cambodians so far. Worldwide, it has killed 254 people since 2003. Health experts worry the disease could one day change to be transmitted from human to human, creating a pandemic.

Local health officials say they continue to educate people in Prey Veng, to curb the spread of the disease in birds and to prevent bird-to-human transmission.

“First, vendors should wear masks and gloves, and clean their trucks before transportation,” said Long Bunna, district chief of animal health in production for the Ministry of Agriculture in Kampong Trabek.

Officials also issue licenses for the transportation of birds, thousands of chickens and ducks each day.

“I issue a license to every vendor and check up with the health of the chickens before I let them go,” said Saing Sarong, director of the provincial animal production department for the Agriculture Ministry.

Meanwhile, health and safety officials stay prepared in case of another outbreak.

Tep Samoeun, head of the rapid response unit for Prey Veng’s health department, said one ambulance stands ready for victims.

“If a bird flu case happens in the province, we will drive the ambulance to the area and take [the patient] to neighboring Kampong Cham province,” he said, warning, though, that rural roads still remain bumpy and under-developed.

Four provinces have clinics that can deal with bird flu, Kampong Cham, Kampot, Stung Treng and Siem Reap, along with Phnom Penh, according to Ly Sovann, deputy director of communicable disease control for the Ministry of Health.

“Our health officials have skill at their jobs,” he said recently. “We never spread an epidemic virus to other people while we take a victim to the hospital.”