At first blush, it seems like good news.
The dozen known cases of human H5N1 infection in Egypt this year have been, for the most part, uncharacteristically mild infections.
Even though Egypt has seen greater success in treating bird flu patients than have most countries, having a 100% survival rate (so far) this year is remarkable.
Also of note, 10 of the 12 cases in 2009 have involved toddlers, under the age of 3. This is a decided shift from previous years when roughly half of all cases have been over the age of 10.
All of which has raised speculation that something has changed about the virus in Egypt.
Exactly what that change might be remains to be seen.
While a milder virus would seem a `good thing’, it could also set the virus up to be more easily spread – and that could give the virus more opportunity to mutate towards a more human adapted virus.
Over the weekend The Independent ran an article with quotes from two of virology’s heaviest hitters – Dr. Robert Webster of St Jude Children’s Research Hospital and Dr. John Oxford of of Queen Mary, University of London – both of whom expressed concern over the trend in Egypt.
Professor Robert Webster, of St Jude Children's Research Hospital in Memphis, Tennessee – who is the world's leading authority on the disease – told The Independent on Sunday that, while he himself had not seen firm data, the WHO in Egypt was raising "a very, very important issue" which should receive "maximum attention". He added: "I hope to hell they are wrong. If this damn thing becomes less pathogenic, it will become more transmissible."
And Professor John Oxford, of Queen Mary, University of London, said that any evidence that H5N1 was becoming less deadly would be serious, as the greatest cause for concern was the disease's ability to spread.
Obviously, when people like Webster and Oxford publicly worry, the subject is worthy of our attention.
But it should be noted that as of this time, most of the evidence of a `change in the virus’ is anecdotal.
The WHO (World Health Organization) is proposing to remedy that by conducting serological studies among people exposed to sick or dead poultry in Egypt to see if they may have been sub clinically (asymptomatically) infected with the virus.
Studies such as these, take time of course. Months to collect the data, and more months to analyze the results.
One has to hope that we have the luxury of time to determine exactly what is going on here.
Meanwhile the bird flu situation in Egypt –based on reports from the Arabic Press – continues to deteriorate.
While machine translations from the Arabic leave a good deal to be desired, what is emerging is a picture of ineffectual control and rising concern in that country.
A few examples:
In this first story (hat tip Florida1 of Flutrackers) the Egyptian government acknowledges that they’ve yet to commit sufficient resources to the fight against bird flu.
They vow to add 1500 veterinarians to the battle (a promise that may be complicated by protests by Veterinarians over hazardous duty pay – see below).
The government recognizes the limitations of financial and human resources allocated to combat bird flu in Egypt - Reuters
4/13/2009 10:31:00 AM
CAIRO - Editor Masrawy - called Dr. Ahmed Nazif, Prime Minister, leaders of the General Authority for services of veterinary re-evaluation of the plan in place to cope with bird flu and to identify deficiencies and strengthen the positive to be able to surround the disease, which is heading to the epidemiological situation in Egypt.
Nazif agreed to the appointment of a veterinarian body 1500 to strengthen anti-bird flu task.
He acknowledged Mr. Amin Abaza, Minister of Agriculture and Land Reclamation, that there is a defect in the financial and human resources allocated to combat bird flu, adding that in contrast to the optimal exploitation of available resources.
The next three reports were found, translated, and posted by Sally of Flutrackers over the weekend.
Red Sea Governorate announced a state of emergency and tightened control over the southern port cities of Safaga and the short to fight with any suspected cases of avian influenza.
The Secretary-General Majid Obwafattouh Sunday to maintain the continued control campaigns and tighter control of the port 85 km, which connects between Safaga and Qena to prevent the entry into or the circulation of live poultry to maintain and remove all the nests near the house to prevent the breeding of poultry and intensify campaigns Investigation of Supply and veterinary control of vehicles carrying poultry.
Salem wrote Metwaly 4-13-2009
Revealed an international workshop, organized by FAO in collaboration with the General Authority for Veterinary Services in Cairo, yesterday, that the veterinary vaccines «cover only 36%» of the total birds in the rural education of the 300 million birds, which means that 64% of birds do not get these vaccines.
Other reports indicate steep drops in poultry production due to the bird flu virus, major hikes in the price of eggs and poultry, and the relocation of poultry (and pig) farms away from human habitation.
There are also reports suggesting that the vaccines currently being used to protect their poultry are losing effectiveness.
Meanwhile, Veterinarians who are on the front lines combating the bird flu epidemic in Egypt are demanding hazardous duty pay.
«Veterinary public» Demands reassignment doctors It calls for the establishment of a Ministry of livestock
Omar Abdel-Halim, Hisham wrote 4-12-2009
Vets waving protest banners during the General Assembly on
The General Assembly emergency veterinarians until permanent convened to meet all of their demands on: the reassignment of physicians, and the establishment of a Ministry of livestock, and to expedite the issuance of the law to oversee the animal reserves, allowances and adoption of the risk of infection and without a ceiling.
He also called for about 500 veterinary doctors, during the of their public yesterday, the abolition of ambushes in the presence of veterinarians, police and support the development of the profession by the Law of the People's Assembly.
Most of these stories never get picked up by the English Press, and so most of the rest of the world remains oblivious to Egypt’s ongoing daily battle against the virus.
Three years after the H5N1 virus first showed up in Egypt, the battle against the virus shows no signs of being won. Well over 1,000 outbreaks have been documented in Egyptian poultry, and now there are fresh concerns over the virus’s spread in humans.
Whether these perceived changes in the behavior of the virus constitute a dangerous trend is too soon to tell. It could mean a lot of things.
The only thing we know for sure is that the virus remains a threat, and we are going to have to keep a close eye on events in Egypt over the coming months.