# 2549
Although hundreds of suspected bird flu cases have been tested over the past few months, Egypt hasn't reported a positive H5N1 result since last April.
Outbreaks in poultry continue to remain common, however.
Today, we learn that a 16-year-old girl has died, and has tested positive for the avian flu virus. She is the 23rd fatality, and the 51st case recorded in Egypt.
Egyptian girl dies of bird flu
Mon 15 Dec 2008, 20:25 GMT
CAIRO (Reuters) - A 16-year-old girl died of the deadly H5N1 strain of bird flu Monday, the 23rd fatality and 51st case of the disease among humans in Egypt, state news agency MENA said.
Samiha Salem from a village in the central Egyptian province of Asyut caught the disease after exposure to sick household poultry, MENA quoted a health ministry official as saying.
The official said Salem began suffering symptoms a week ago, after two of the household ducks died and the remainder of the flock was slaughtered in the house.
Salem was subsequently admitted to hospital with a high fever, vomiting and diarrhoea, and then transferred to intensive care. She was treated with the antiviral drug tamiflu, but suffered a pulmonary infection and respiratory failure, and died Monday.
Her symptoms - which included vomiting and diarrhea - are a little unusual for avian flu infections, but not unheard of. Just as with SARS, gastrointestinal symptoms in avian flu patients have sometimes been reported.
This NEJM article from 2007 tells of two H5N1 patients from Vietnam that presented with Diarrhea.
Fatal Avian Influenza A (H5N1) in a Child Presenting with Diarrhea Followed by Coma
Menno D. de Jong, M.D., Ph.D., Bach Van Cam, M.D., Phan Tu Qui, M.D., Vo Minh Hien, M.D., Tran Tan Thanh, M.Sc., Nguyen Bach Hue, M.D., Marcel Beld, Ph.D., Le Thi Phuong, M.D., Truong Huu Khanh, M.D., Nguyen Van Vinh Chau, M.D., Tran Tinh Hien, M.D., Do Quang Ha, M.D., Ph.D., and Jeremy Farrar, F.R.C.P., D.Phil.
SUMMARY
In southern Vietnam, a four-year-old boy presented with severe diarrhea, followed by seizures, coma, and death. The cerebrospinal fluid contained 1 white cell per cubic millimeter, normal glucose levels, and increased levels of protein (0.81 g per liter). The diagnosis of avian influenza A (H5N1) was established by isolation of the virus from cerebrospinal fluid, fecal, throat, and serum specimens. The patient's nine-year-old sister had died from a similar syndrome two weeks earlier. In both siblings, the clinical diagnosis was acute encephalitis. Neither patient had respiratory symptoms at presentation. These cases suggest that the spectrum of influenza H5N1 is wider than previously thought.
