Thursday, February 12, 2015

Media Reports Of H5N1 Continue In Egypt



# 9701


The disconnect between what is being reported by the Egyptian press, and the number of cases being publically acknowledged by the Egypt’s Ministry of Health, continues with almost daily reports of new H5N1 cases (suspected & confirmed) in the Arabic media which are only rarely listed on the MOH site. 


Of note, the MOH hasn’t released a YTD total of cases, or fatalities, in over three weeks (see The Silence Of The Egyptian MOH).  They do, however, continue to urge people to seek medical care immediate if they suspect bird flu infection.


The last officially acknowledged YTD total came on January 22nd (see Egypt’s MOH Confirms 21st H5N1 Case), but based on local health ministry and media reports, the number of cases since then appears to have incremented significantly. 


How much is anybody’s guess, but Sharon Sanders of FluTrackers has been dutifully trying to keep track, and her conservatively curated FluTrackers H5N1 Case List indicates (as of yesterday) 39 cases, and 16 deaths for the year.


Today the Egyptian media already has reports of four H5N1 cases, all supposedly confirmed by lab tests.  How accurate these reports really are is debatable, but given the restrictive press environment in Egypt, I have doubts many would risk publishing reports like these without substantial corroboration.

First stop, 


Health Qalubia»: the detention of three persons infected with «bird flu»

2 hours ago | wrote: Abdel-Hakam soldier , Mohammed Mahmoud Khalil

Directorate of Health Affairs announced Balqlliopip, on Thursday, the detention of three people, for being infected «bird flu» preservation, noting that the stable situations, and respond to treatment, where he was given the drug «Tamiflu» and a number of medications.

Said Dr. Mohammed Lachin, Undersecretary of the Ministry of Health Balqlliopip, had been detained three cases hospitals «Banha University, and fevers Banha, and diets», pointing out that samples were taken from the injured, and sent to the central laboratories of the Ministry of Health in Cairo, which proved positive cases, in addition to sampling of their families, and the work of the inquiry Mkhaltin them, to show the extent of the injury or not


And this from


The emergence of new cases of bird flu in Assiut

Wrote: Suad Ahmed Thursday 12/02/2015 09:37

Confirmed samples sent by al-Sadr hospital in Assiut Governorate, to the central laboratory in Cairo injury housewife from coast sound of bird flu results.

He explained the source of the Directorate of Health in Assiut, that the situation of a woman named (n, p, P- 24 years) have been converted from the Central Coast Salim hospital on suspicion of being infected with bird flu.

The source added, that Ms. booked Chest Hospital in Assiut, samples were withdrawn and sent to labs central Cairo shows the result of analysis of the received by the health Assiut being infected with the virus


As we tend to see about updates from the MOH every 5 to 7 days, we may or may not get confirmation of these cases.  Hopefully these cases (if, indeed, they are confirmed) will get sorted out in the next WHO GAR update.

Assuming FluTracker’s case count is reasonably close - and these four cases are eventually certified by the WHO – that would mean that in the first 6 weeks of 2015 Egypt has already exceeded their 2011 record (n=39) for the number of cases in a year.  

All the more impressive when you add in the 30 cases racked up in the last six weeks of 2014. 

Whatever the precise count (and even with the best surveillance and reporting, cases will be missed), Egypt’s H5N1 outbreak this winter of 2014-15 is shaping up to be the biggest run of human cases reported from one country that we’ve seen in a decade. 


Egypt appears on pace to rival or even exceed Vietnam’s record of 61 cases and 19 deaths in 2005.


Why, after two years where only 8 cases were reported in Egypt, we are seeing this sudden bloom of cases is unknown.


In January, in CIDRAP: FAO Reports Mutations In H5N1 Virus From Egyptian Poultry, we did see a report that found some signs suggestive of `mammalian adaptations’ in viruses collected from local poultry, but those changes were not present in two human samples tested.


A few days laterthe World Health Organization published their latest WHO H5N1 Update & Risk Assessment, which stated:


Although all influenza viruses evolve over time, preliminary laboratory investigation has not detected major genetic changes in the viruses isolated from the patients or animals compared to previously circulating isolates. The increase in reported human cases is likely a consequence of several factors. These includes increased circulation of influenza A(H5N1) viruses in poultry, lower public health awareness of risks in middle and upper Egypt and seasonal factors such as closer proximity to poultry and longer survival of the viruses in the environment because of cold.


The good news is that we’ve yet to see any evidence that the virus is spreading from person-to-person, and while a handful of small family clusters have been mentioned, the risk still appears to stem from close contact with infected birds.


Still, whatever the current source of infection, anytime we see this many human infections with a novel flu virus, we watch carefully for any signs of changes in the behavior of the virus.

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