Monday, March 30, 2015

FAO: Egypt’s H5N1 Case Count Continues To Climb

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Although the Egyptian MOH remains largely silent on their H5N1 outbreak, and the Egyptian media continues to publish numbers from some alternate reality (this report today cites only 13 deaths for the year), we’re able to keep some semblance of track via updates from the World Health Organization, releases from the FAO EMPRES website, and the hard work of Sharon Sanders who curates the Egypt - 2015 WHO/MoH/Provincial Health Depts H5N1 Confirmed Case List.


Our last update from the FAO came two weeks ago (see Egypt’s H5N1 Bird Flu Beat Goes On . . . .),  which was followed up a few days later by a WHO EMRO Update On Egypt’s H5N1 Outbreak, which pegged the number of H5N1 cases in Egypt for the year at 116, with 36 deaths (as of March 17th).


While we’ve seen scattered reports in the media of additional cases over the past two weeks, we rarely see a confirmation by Egyptian authorities.  Luckily, they still continue to report to International agencies like the WHO and FAO under the rules established under the IHR (International Health Regulations).

 

Today the FAO has announced 11 more H5N1 cases, the links you’ll find below:

 

  1. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Assiut, for human
  2. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Port Said, for human
  3. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Fayoum, for human
  4. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Shrkia, for human
  5. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Shrkia, for human
  6. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Menoufia, for human
  7. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Dakahlia, for human
  8. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Suhag, for human
  9. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Shrkia, for human
  10. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Behera, for human
  11. 30/03/2015: Egypt - Influenza – Avian  Confirmed Influenza - Avian in Shrkia, for human

Based on this report, previous reports, and FluTrackers2015 Egypt H5N1 Case List , Egypt is up to 128 cases for the year. Deaths are often reported late (or sometimes not at all), but the WHO’s last tally was 36, and several more appear to have died since then.

While it is not entirely clear what is behind this sudden increase in H5N1 cases, Egypt has reported heavy rates of poultry infections this winter – even among vaccinated flocks (see Egypt H5N1: Poultry Losses Climbing, Prices Up 25% - which calls into question the effectiveness of the vaccines currently being used.

 

Poorly matched vaccines can often protect poultry against illness – but with increasingly diverse and rapidly evolving avian flu viruses - they cannot always prevent infection. The end result is that healthy looking chickens can harbor undetected infections, that viruses continue to circulate, and new variants or reassortants continue to emerge.

 

And without the traditional warning signs of sick or dying chickens, people who handle them are not aware of the the danger they pose.

 

While we’ve not seen any evidence of increased or efficient human-to-human transmission of the H5N1 virus in Egypt, it is worrisome that this outbreak has now gone on for five full months, and that in excess of 150 people have been infected. 

 

Twice as many human cases as has ever been reported by one country in a single year.  And each human infection provides the virus with another opportunity to better adapt to human physiology.

 

Although the future threat from H5N1 is unknown, these outbreaks in  Egypt and the rapid emergence and spread of new HPAI H5 reassortants around the globe over the past year recently prompted the World Health Organization to issue a pointed warning (see WHO: H5 Currently The Most Obvious Avian Flu Threat).

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