Just shy of a year ago Egypt began reporting on what would turn out to be the largest human H5N1 outbreak on record, one that over the ensuing six months would result in 160+ infections, and 51 deaths (see EID Dispatch: Increased Number Of Human H5N1 Infection – Egypt, 2014-15).
At first the MOH was quite open about the size and severity of the outbreak, but stopped issuing daily reports in late January (see Revisiting Egypt’s Murky H5N1 Battle).
In May, after the outbreak had wound down, we saw the WHO Statement On Joint H5N1 Mission To Egypt, with specific recommendations for addressing the crisis.
The 7-page executive summary, warns:
` . . . the presence of H5N1 viruses in Egypt with the ability to jump more readily from birds to humans than viruses in other enzootic countries is of concern and requires a high level of vigilance from the Ministries of Health and Agriculture.’
This unprecedented H5N1 outbreak in Egypt, along with the sudden proliferation of several other HPAI H5 reassortant viruses around the globe (H5N6, H5N8, H5N2, H5N3, etc.) no doubt influenced last February’s announcement WHO: H5 Currently The Most Obvious Avian Flu Threat.
With the approach of cooler weather, we are beginning to see Egypt’s Ministries of Health and Agriculture publically prepare for another round of bird flu. Last week we saw the deployment of thousands of doses of Tamiflu ® to local hospitals (see Egypt Readies For The Return Of H5N1).
Today local Arabic media are reporting on the the formation of a special bird flu committee, and on the MOH’s plan to combat the return of H5N1. The following are machine translations.
Health»: the formation of a committee comprising the ministries of environment, agriculture and local development to combat bird flu
The Ministry of Health and Population announced for San Dr Mohammed Geneidi, chairman of the Central Administration of Preventive Medicine has been the formation of a committee comprising the ministries of local development, agriculture, the environment and the Radio and Television Union and the queries next to the Ministry of Health to implement counter bird flu plan.
He explained, "Geneidi" in a statement to "Echo of the country" that the role of the Ministry of Agriculture of the Commission is in the application of bio-safety standards and monitor the implementation of infection control during disposal of the birds in the affected areas, in addition to putting in place to deal with the epicenter of the positive incidence of poultry for the disease and will be plans implemented in these outposts surrounding areas.
He explained that the role of the Ministry of State for Environmental Affairs of the Commission is the development and implementation of safe disposal of dead birds plan, pointing out that the role of the Ministry of State for Local Development is to develop and implement a plan at all levels for safe disposal of dead birds as well as coordination with the Ministry of Agriculture to control the disease and work to prevent its spread from infected regions to another.
He stressed, "Geneidi" The role of the (Radio and Television Union - SIS) and various media is to raise the awareness of citizens in the bird flu and how to prevent it
Wednesday 28.10.2015-06:54 am
The Ministry of health and population has announced it has implemented a series of measures, including the revitalization of surveillance for influenza and pneumonia in all hospitals of the Republic daily to assess the epidemiological situation and follow up continuously for viruses.
As well as the follow-up to the global situation and the recommendations of the World Health Organization in this respect, as well as genetic mutation at the global and regional levels, and follow-up of contacts for positive foci show injury in bird training and print case definition.
The remarks, reported by media that drug Tamiflu used to treat bird flu and necessary to deal with the disease in all hospitals in large quantities, with the support of the central laboratories of the Ministry and regional laboratories for screening influenza viruses, balkwashf supplies needed to examine cases.
She said the Ministry has trained its personnel on how to drag and save and transfer the necessary samples, as well as sharing samples with who reference laboratories and national research center of the Ministry of scientific research.
She noted that the plan also included the need to immediately report to veterinary medicine for all cases in humans in the case of suspicion, in the framework of coordination between the Ministry of health and Ministry of agriculture to address bird flu.
For the better part of two decades the H5N1 virus has been on the `verge’ of sparking a pandemic, beginning with its first outbreak in Hong Kong in 1997. Skeptics point out that if it hasn’t happened after 18 years, it probably won’t.
But the H5N1 viruses in circulation today are a far cry from the ones that first plagued Hong Kong, or re-emerged in Southeast Asia in 2003. They have evolved from a single clade (0), to literally dozens of clades . . . with new clades, and variants, forming all the time.
(click to load larger image) (Note: Chart only goes through 2011, and not all clades continue to circulate)
Last winter’s exceptional Egyptian H5N1 outbreak has tentatively been linked to changes in the virus which began to show up in the summer of 2014 (see Eurosurveillance: Emergence Of A Novel Cluster of H5N1 Clade 18.104.22.168), another indication that H5N1 is truly a moving target.
The future threat from H5N1 is far from certain, for while the virus continues to change, not all changes will drive it towards human adaptation.
But in recent years H5N1 has been joined by a new generation of novel flu subtypes - H5N6, H5N8, H5N2, H5N3, H7N9, H10N8 – all of which continue to evolve and diversify. We seem to be facing a growing number of threats every year.
As the WHO stated last February in Warning signals from the volatile world of influenza viruses:
An influenza pandemic is the most global of infectious disease events currently known. It is in every country’s best interests to prepare for this threat with equally global solidarity.