Wednesday, June 03, 2015

Egypt's H5N1 Crisis: Forgotten But Not Gone

# 10,138

While our eyes are understandably fixed on the latest developments in Korea's MERS outbreak,  it is worth remembering that for the past 6 months Egypt has been embroiled in the worst human outbreak of H5N1 in history, and seems intent upon casting as little light on the situation as humanly possible.

The last WHO EMRO full update was published on April 9th, which cited 125 cases during the first three months of the year.  The last Egyptian MOH mention of H5N1 was back in March, and by then updates were both sporadic and lacking detail. 

While we saw a WHO: H5N1 Update & Risk Assessment about a month ago (current through May 1st) which added 7 more cases in April,  it isn't at all clear how forthcoming the Egyptian MOH is being regarding the situation.

FAO reports on poultry outbreaks (and human cases) have all but dried up, yet there is little to suggest the crisis is over. 

Three months ago  World Health Organization, along with the  FAO, OIE,  NAMRU-3, CDC & UNICEF were invited to Egypt as a joint mission to investigate and to make recommendations on containing that outbreak. Three weeks ago we saw the  WHO Statement On Joint H5N1 Mission To Egypt,  with specific recommendations for addressing the crisis,

The veil of secrecy shrouding the ongoing H5N1 outbreak in Egypt, and similar (although not as egregious) `strategic reporting'  from China on H7N9 and Saudi Arabia on MERS, represent potentially serious blind spots in global disease surveillance.

Were the avian flu news good - or at least improving - in Egypt, I'd have to believe they'd publically be touting their success instead of projecting abject silence. 

In 2005 the World Health Organization adopted the IHR (International Health Regulations) that – among other things - requires countries to develop mandated surveillance and testing systems, and to report certain disease outbreaks and public health events to WHO.

Although member states had until mid-2012 to meet core surveillance and response requirements, most have requested (and received) multi-year extensions and have yet to meet these basic requirements. 

Even once fully implemented, there is no guarantee that outbreak information will flow readily, and unredacted, from these member nations.  But it would be progress.

Not all of these lapses in reporting are deliberate, of course. Some are due to a lack of resources, societal barriers, political instability or regional conflicts.

It's a messy world out there. 

All of which means, that while we watch outbreaks of MERS in South Korea, or HPAI H5 outbreaks in birds around the world, we shouldn't forget that there are many places around the globe from which we get very little solid real time information.  

And when it comes to self reporting of disease outbreaks, no news isn't always good news.

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