Thursday, March 05, 2015

An Egyptian H5N1 Roundup

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# 9783

 

Although details are often absent from official statements and media reports, we continue to see signs that Egypt’s bird flu crisis continues to worsen, both in poultry and in humans. 

 

New emergency committees are formed seemingly on a weekly basis, new cases (suspected and confirmed) are announced daily in the media, and repeated warnings go out to the public to seek medical care if they suspect avian flu infection.

 

Since the MOH has become increasingly uncommunicative on the subject over the past six weeks, we are left with gleaning what we can from local media reports.   Today I’ve included a few examples:

 

First, the formation of yet another high level committee to address the crisis (see Egypt: Government Statements On H5N1 Response & Latest Fatality & Egypt MOH: Three H5N1 Statements & Confirmation Of 17th Case for other committee announcements).

 

A supreme committee to combat the "bird flu" in Fayoum

Thursday 05 / March / 2015 - 10:19

Print Issued adviser Wael Makram, the governor of Fayoum, a decision No. 100 for the year 2015 to form a higher committee under his chairmanship to combat bird flu in Fayoum. committee shall take all necessary measures to combat bird flu and prevention measures, as well as follow-up to provide the necessary vaccinations to citizens and birds, and patient follow-up cases and the work of inventory Comprehensive their numbers, as well as assigning competent hospitals to lift the state of emergency for the reception of these cases.

The Commission in its membership, secretary general of the province , Assistant General Secretary, and Chairman of the Central Department for the governor's office as a member of the National Committee of crises and disasters, and the agents and the Ministries of Health and Agriculture and Veterinary Medicine in Fayoum, and general manager IDSC, and Director of Crisis Management, and Director of Environmental Affairs, and President of the bodies of water police, and the heads of local units of cities and centers.

 

Next, a report on the setting up of roadblocks to interdict the illegal transporting of poultry in and out of Menofia:

Menofia facing bird flu ambushes # Police

Monofia announced the face of bird flu tighten ambushes on the roads to monitor the tanker cars for birds and stop the transfer of birds to and from the provinces.

 (continue . . . )

 

And this report, which indicates that 359 outbreaks of avian flu have been detected in Egypt since the first of the year, and that also concedes that  Egypt is only capable of producing roughly 10% of the vaccine that would be required to fully immunize their nation’s poultry. .  

 

Ministry of Agriculture: the arrival of the hotbeds of infection with bird flu to focus 359

Latest update: Wednesday, March 4, 2015 - 12:48

Lightning News - Egypt, announced the report, issued by the Central Department of Preventive Medicine, attached to the Veterinary Services, Ministry of Agriculture, the arrival of the foci of infection with bird flu, observed from the fact teams disease, to 359 focus, from the first of January, until last Monday.

The report, that one of the outposts 0.236 of highly pathogenic type, and 123 weak virulence, and that the total bosses of poultry in rural education, arrived at the 6 million birds, just last month in the nursery education and wards of Education municipal birds such as chickens, ducks, ranging from ages between 15 days to 45 days.

(Continue . . . )

 

While greater vaccination coverage is often cited as a major component of their bird flu response, a couple of weeks ago in Egypt H5N1: Poultry Losses Climbing, Prices Up 25%, we looked at the impact that H5N1 has had on their poultry industry, and reports that a growing number of outbreaks are occurring among vaccinated poultry.

 

For a discussion on the limitations of poultry vaccination, you may wish to revisit yesterday’s blog Study: Recombinant H5N2 Avian Influenza Virus Strains In Vaccinated Chickens or 2012’s Egypt: A Paltry Poultry Vaccine.

 

Today, the creation of an emergency hotline to report suspected bird flu outbreaks was also announced.

 

Activate the service hotline for reporting bird flu and queens

Thursday 05 / March / 2015 - 13:52

General Authority for Veterinary Services, announced the Ministry of Agriculture and land reclamation for the activation of the hotline 19561 service, to report any emergency to the pathogenesis of animal and poultry bird flu. For its part .. said Dr. Amal Abdel-Fattah, Director General of Veterinary Medicine, and queens, he was the service support a team of doctors and Aladrain for two morning starting at nine in the morning until two o'clock pm, and the evening Tbdomn o'clock pm and finished seventh pm.

 

And of course we continue to see a steady parade of media reports on suspected or confirmed human cases, which may or may not be eventually confirmed by the MOH.  Some examples from the last 24 hours include:

 

Egypt announces the death of a woman infected with bird flu

Injury to a child by «bird flu» lake

High injured bird flu Sharqia for 13 cases

 

While we are hampered by the Egyptian MOH’s reluctance to discuss or divulge case information (except, presumably to the WHO per the IHR), we know from the FAO, media, and World Health Organization reports that over the past four months Egypt has seen the largest outbreak of H5N1 in humans since the virus emerged nearly 20 years ago.


The MOH (and by extension, the Egyptian press) stopped updating case counts in January, and so we get dubious headlines and reportage like this week’s Two die from bird flu bringing Egypt's 2015 death toll to 10, which doesn’t even come close to reflecting reality.

 

FluTracker’s conservatively curated Egypt - 2015 WHO/MoH/Provincial Health Depts H5N1 Confirmed Case List puts the number at nearly 80 cases, and at least 21 deaths since the start of the year (note: deaths are harder to quantify because follow up reports are less likely to be printed in the media).

 

Numbers which tally pretty well with recent FAO and WHO dispatches.

 

The most recent FAO/EMPRES Animal Influenza Update # 637 contains the following update on Egypt.

EGYPT
 
12, 17, 22 & 23/02/2015 - H5N1 infections in humans, Behera, Cairo, Giza, Dakahlia, Fayoum, Iskandariyah, Menia, Menoufia,Qina, Sharkia, Sohag and Sharkia Governorates

Source: National Authorities


According to the Ministry of Health, between 9 January and 2 February 2015, 22 new human cases of H5N1 infection were detected in 13 out of Egypt’s 27 governorates namely: Asyiut (1), Behera (3), Cairo (6), Damietta (1), Fayoum (4), Giza (1), Menia (4), Menoufia (2), Qalyubia (3) and Sharkia (4), of which 8 have died. Patients affected are aged between 0.8 and 42 years old, 13 of them are less than 6 years old, and 29 cases had contacts with backyard or market poultry few days prior to illness. Of the 285 confirmed human cases in Egypt since 2006, 102 were fatal.


 

Since the WHO case count sat at 177 cases and 63 deaths last October, these numbers reflect a net gain of 108 cases and 39 deaths since November 1st, 2014.  Of those (based on the WHO report of January 26th), roughly 27 cases and 9 deaths reportedly occurred between November 1st and Dec 31st, 2014.


All of which leaves us in the ballpark of 80+ cases, and approximately 30 deaths in Egypt since the start of the year.  

 

These numbers are as of a couple of weeks ago, and as we continue to see (unconfirmed) media reports of new suspected and `confirmed’ cases on a daily basis,  today’s total is no doubt even higher.

 

The World Health Organization and the FAO are reportedly scheduled to arrive in Egypt later this month to assist the government in their bird flu response this month (see Media: WHO H5N1 Mission To Egypt). 

 

Hopefully their after-mission reports will provide us with a better understanding of the scope of Egypt’s H5N1 outbreak.

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