Thursday, March 16, 2017

Egypt: MOH Statement On Investigation of Undiagnosed Cluster Of Illness


Reports of unknown or `mysterious' viral illnesses are fairly common around the world, and after investigation we usually discover they weren't quite as `mysterious' as first reported.  In December of 2015, the reports from Indonesia: `Mystery Illness’ Kills 56 Children In Papua, was eventually determined to be due to a combination of Pertussis and pneumonia

There are exceptions, of course.

  • In the spring of 2009 a clustering of severe influenza in Mexico alerted us to the start of the H1N1 pandemic
  • In the summer of 2012, a single patient in Saudi Arabia was diagnosed with a new coronavirus infection - what we now know as MERS-CoV. 
  •  In the spring of 2013, 3 patients hospitalized with atypical pneumonia in Eastern China heralded the emergence of H7N9.
 So we take reports, such as the one published overnight in ProMed Mail, seriously.
Published Date: 2017-03-15 21:01:26
Subject: PRO/EDR> Undiagnosed virus - Egypt: RFI
Archive Number: 20170315.4903834
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Wed 15 Mar 2017
Source: Egypt Independent [edited]

Several people are being held at Imbaba and Abbassiya specialized fever hospitals after contracting a virus that doctors are still unable to diagnose, medical sources said amid a media blackout on the part of the Health Ministry.

An informed source said a secret meeting was held at the ministry on Monday [13 Mar 2015] to discuss the issue. Further meetings are ongoing. The number of patients held at the hospitals does not exceed 5 cases, the source added.

A medical source inside Imbaba hospital said some of the infected have been isolated because until the virus is identified, doctors in Egypt are unable to prescribe a suitable treatment.

Al-Masry Al-Youm toured the hospital, trying to reach out to these patients, but the reporter was unable to enter the building where they are held.
(Continue . . .)
This morning Arabic media, and social media, are alive with reports - and rampant speculation - over the cause of this outbreak, which is now reported to include 11 people, and the deaths of 3 children.

Typical of the reporting, is this (translated) story from, which stresses the `contagious' nature of the illness.

Contagious virus infected 11 people in Shubra and caused the death of three children

Wrote: Reza Abdalla

Dr. Ahmed Emad El Din, Minister of Health and Population, said that the new virus that hit the 11 citizen Shubra Al Khaimah area, contagious virus and can infect anyone.

He said Imad al-Din, that the ministry received a report injured four people in February 28 last symptoms of a strange virus, Shubra Al Khaimah area, and were immediately detained Fever Hospital Imbaba, conducting many tests and medical examinations, but they did not produce any result, stressing the number of injured increased to 11 cases from the same family after visiting their relatives, which is confirming that the virus is contagious.

The Minister of Health, to the death of three children succumbed to this unknown virus, explaining that there are two left the hospital tomorrow going on their symptoms and book the rest in the hospitals, in addition to the use of nuclear medicine and the ministry in a bid to gain access to the virus.

Egypt's Ministry of Health, which in recent years has been slow to publicly comment on any disease outbreak (but particularly H5N1), posted the following (translated) statement overnight, which is more suggestive of a environmental toxin or food poisoning than a viral disease.

Injuring 11 cases of flu-like gastroenteritis and suspected poisoning ..oganh for fact-field epidemic did not discover new people with the same symptoms
March 15, 2017

The Ministry of Health and Population injuring 11 people like symptoms of gastroenteritis and suspected poisoning, for two families linked by kinship and Mqamyin in independent houses in Shubra Al Khaimah Qaliubiya province.

Dr. Amr Qandil, head of preventive medicine sector and pointed out that immediately after reporting the first case of which is the old lady, 63, was booked Fever Hospital Imbaba, the Ministry of Health and Population, immediately formed a committee to investigate the field epidemiological and reported its findings that a number of the back of the onset of 11 people consisted symptoms in a sudden severe vomiting, diarrhea, abdominal pain, and increased severity of symptoms in some cases, especially among children and the elderly.

He added that all the infected cases hesitated to public hospitals and clinics and private to receive the necessary treatment, and died three cases, while 6 cases corresponded to a full recovery and came out better, and there are only two cases so far under treatment.

The "jellyfish" to carry the team to follow up the ministry's Preventive number of 17 people in contact Mounzlen, stressing not appear or discover any symptoms satisfactory to them, as was the work of finding and endemic neighboring homes for two houses was not detected any similar medical conditions.

Head of Preventive Medicine in Gaza and said he was taking several preventive measures, whether for people or for the two houses, referred to them to carry out tests laboratory for advanced viruses and potential bacteria can be the cause of the appearance of these symptoms, where it was the work of testing toxins and heavy metals cases, scanning the peaks of radioactive objects by a team of nuclear energy Commission, and finding work for insects and disease vectors, and monitoring and measuring air pollutants, and tests for all types of dry food, cooked and water from the houses referred to detect the presence of any bacteria or toxins nurse.

As has been the formation of a committee of Egyptian university professors in the field of public health, children, and toxins as well as experts from the Ministry of Health in the field of epidemiology, laboratories, fevers, where the Committee recommended to continue in the work of epidemiological investigation and take further laboratory and environmental testing in search of likely group to be the cause of the onset of symptoms Previous.

And The Ministry of Health and Population that these cases that have emerged are only linked by kinship and there is a final of any other cases in neighboring houses, or for people who have dealt with these cases in the workplace or in hospitals and the ministry are looking and investigating to find the cause behind these limited cases occurrence of two families .

She appealed to the Ministry of Health and Population and the media not to be deceived by rumors tendentious which would raise Azaar and confusion for citizens, and took proper data and information from sources at the Ministry of Health, For the benefit of the Egyptian citizen.

(Continue . . .)
For now, these cases appear to be restricted to these two, linked, households.  And the MOH is reporting that 6 have already recovered, and only two remain hospitalized.

 A somewhat less alarming update than what is being reported by the media. 

Still, since Egypt's MOH has been known to downplay disease outbreak reports in the past (see More Than One Way to `Contain An Outbreak’), we'll be watching for any signs this illness has spread beyond these two families and (hopefully) some definitive lab work that identifies the cause.

Stay tuned.

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