Showing posts with label Egypt MOH. Show all posts
Showing posts with label Egypt MOH. Show all posts

Monday, April 20, 2015

FAO Reports 6 More Egyptian H5N1 Cases

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# 9960

 

While the Egyptian MOH has pretty much abandoned even mentioning H5N1 on their website, and the local media tries not to stray too far from the `official’ line, we continue to see evidence ongoing human infections, although the rate of new case reports seems to have slowed somewhat over the past few  weeks.


The thoroughness of surveillance, testing, and reporting are issues that plague all disease outbreaks, and so it is impossible to state with certainty just how many people have been – and continue to be – infected with the avian flu virus in Egypt.  


The last `official’ WHO H5N1 Update For Egypt – Thru March 31st listed 125 cases and 33 deaths, but since then we saw an update from the FAO (on 04/08) adding 7 additional cases.

 

Today the FAO has listed 6 more human cases on their RSS feed.  

  1. Confirmed Influenza - Avian in Behera, for human
  2. Confirmed Influenza - Avian in Behera, for human
  3. Confirmed Influenza - Avian in Behera, for human
  4. Confirmed Influenza - Avian in Damietta, for human
  5. Confirmed Influenza - Avian in Qena, for human
  6. Confirmed Influenza - Avian in Kafr El-Shikh, for human

 

Doing her best to keep track of all of this is Sharon Sanders at FluTrackers, who curates their Egypt - 2015 WHO/MoH/Provincial Health Depts H5N1 Confirmed Case List.  Based on the information currently available, Sharon conservatively shows 143 cases in Egypt since the 1st of January.

 

Three times more than Egypt has ever previously reported, and more than double the number that any country has ever reported in a single year.

 

The recent slowdown in case reports – if indeed, that is the case – would not be totally unexpected, as  avian flu transmission tends to decline as the weather warms. 


But the caveat here is - out of these last 6 cases  - 2 were observed in late March and the newest was observed on April 7th.  With reports running two, three, or even more weeks behind it is too soon to celebrate any decline in case reports.

 

Although we’ve not seen any evidence of increased or efficient human-to-human transmission of the H5N1 virus in Egypt, it is worrisome that this outbreak has now gone on for five full months, and nearly 180 people have been infected.


To put that into some kind of perspective, Egypt – with a population 1/16th that of China - has racked up nearly as many H5N1 human cases over the past 6 months (180) as has China with H7N9 (200).

Sunday, March 29, 2015

More Than One Way to `Contain An Outbreak’

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Credit WHO

 

 

# 9879

 

Until the middle of January, Egypt’s Ministry of Health got good marks in reporting this winter’s surge in H5N1 cases, publishing frequent updates that included YTD numbers for cases, deaths, hospitalizations, and recoveries. 

 

That streak ended on January 22nd, when Egypt’s MOH Confirms their 21st H5N1 Case of 2015.

 

Since then, as has been noted often (see The Silence Of The Egyptian MOHMedia: WHO H5N1 Mission To Egypt), the Egyptian MOH has ceased to report most cases on their website and the YTD numbers attributed to MOH spokesmen in the Egyptian media have been `fanciful’ at best.


As a result, we continue to see reports like the one below – published today - which cherry picks a single recent H5N1 case, while at the same dramatically downsizing the YTD impact of this year’s H5N1 outbreak.  

 

While never directly mentioning 2015’s YTD numbers, by admitting to 16 deaths and referring to a CFR of 37.4%, the reader is left with the idea that there have been perhaps 43 or 44 cases this year.  

 

A far cry from the latest World Health Organization numbers (as of March 17th) of 116 cases and 36 deaths for the year (see Avian influenza A (H5N1) in Egypt update, 21 March 2015).

 

Egypt bird flu death toll at 16 in 2015

Sun, 29/03/2015 - 11:43

A 27-year old woman who raised birds in her home in the Sohag governorate, died of bird flu on Sunday.

Tahta Fevers Hospital received the victim, who was suffering from bird flu symptoms, before she was transferred to Assiut Fevers Hospital upon the request of her family, according to a medical source at Tahta hospital.

A medical team inspected the woman's house in Tahta and conducted tests on those who were in contact with the woman as a preventive measure.

(Continue . . .)

Although local media reports are sporadic, and are unlikely to represent the true burden of this year’s outbreak,  FluTracker’s conservatively curated Egypt - 2015 WHO/MoH/Provincial Health Depts H5N1 Confirmed Case List  continues to add cases, with at least 120 cases logged for the year.


Fortunately,  Egypt continues to report cases to the World Health Organization under the IHR (International Health Regulations) - which requires countries to develop mandated surveillance and testing systems, and to report certain disease outbreaks and public health events to WHO – so we are not completely in the dark regarding this H5N1 outbreak.

 

While we don’t have a recent WHO update to compare it to, China’s recent silence on H7N9 is also suspect, with no new cases reported now for 20 days (see last week’s HK CHP Avian Flu Report: 2 Weeks Without An H7N9 Case Report and  H7N9: No News Is . . . . Curious).  

 

This dramatic halt in reporting comes – perhaps coincidentally – at the same time we saw a major study appear in the Journal Nature  (see Dissemination, Divergence & Establishment of H7N9 In China) warning that the H7N9 virus was evolving rapidly, and that it posed a growing pandemic threat.


A search on Xinhua’s English language news site for the term `H7N9’ returns their last article on March 12th of this year, which (again, perhaps coincidentally) dealt with the Nature study above (see Scientists call for effective measures amid H7N9 mutation Xinhuanet 2015-03-12 14:13).

 

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The Chinese language IFENG search engine does return more recent `H7N9’ articles, but they all refer to cases in February and/or steps local and national health officials are taking to prevent new cases.  

 

But if there have been any H7N9 cases detected since early March, they aren’t being reported in the media, or on provincial MOH websites.

 

It is certainly possible that fewer infections are being recorded this winter, and interventions such as the closing of live poultry markets have dramatically reduced transmission.  That all cases should halt abruptly, this early in the year, and across the entire region would be remarkable, however. 


We’ll have more to go on when the next WHO update on China is released.

 

Since China and Egypt are both dealing with high-profile infectious disease outbreaks, their `management’ of the news understandably draws a good deal of attention, but they are far from being the only nations who indulge in `creative disease reporting’.  

 

All governments have an aversion to mobs bearing pitchforks and torches, and therefore want to project the image that they are competent, in control, and (most importantly) vitally important to the people they supposedly serve. 

 

Even in this country I see a number of state and local health and agricultural department websites which seem far more concerned with extolling their services and achievements, than they are in addressing local problems.  Of course, none of them are dealing with a deadly avian flu outbreak, so direct comparisons are hard to make.

 

While it may seem an odd bit of logic, as long as governments can control the message - as we are seeing in Egypt – it is a pretty good sign that avian flu infections remain sporadic and that efficient transmission of the virus is not happening.   

 

So, in a sense, no news can be `good news’ – at least in the short run. 

 

The problem is, the less we know about the early trajectory of an outbreak, the less lead time we’ll have to prepare - if and when something does start to change.

Sunday, March 08, 2015

Egypt: The Operation Was A Success, But . . . .

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# 9793

 

Trying to track and quantify Egypt’s current H5N1 outbreak has been challenging since their Ministry of Health – and by extension, their heavily controlled press – have been slow to release information publically. 

 

For the past 6 weeks case counts, and YTD fatalities, have either been blurred or simply omitted from Ministry reports and we’ve had to try to reconstruct those statistics from a variety of sources, including media accounts, FAO reports, and the WHO.

 

 

Despite these outside accountings, the `official’  numbers released to the public remain stubbornly static, as evidenced by the following report that appeared in  the Aswat Asriya yesterday.

 

Two new bird flu deaths in Egypt - state agency

Saturday, March 07, 2015 7:50 PM

CAIRO, Mar7 (Aswat Masriya) - Egypt's ministry of health reported on Saturday the death of two women infected with the H5N1 bird flu virus, reported the state news agency MENA.

The women are from the governorates of Menufia and Sharqiya, the Health Ministry said in a statement reported by MENA.

The virus has killed over a dozen this year alone, according to Health Ministry figures.

(Continue . . . )

 

While technically true that the virus has killed `over a dozen this year’, that unfortunate milestone appears to have been surpassed more than a month ago.  Exactly when is difficult to know, as the Egyptian MOH hasn’t issued a YTD case count since mid-January (see Egypt’s MOH Confirms 21st H5N1 Case).

 

Today, from `The operation was a success, but the patient died’ department, we get this curiously worded report of a recent bird flu case in Menofia.   

 

Health Menoufia: the death of a housewife after her recovery from bird flu

Saturday 07 / March / 2015 - 18:58

Dr. Reza live, director of the Preventive Medicine Menofia, the death of a housewife in the village of Hnchor of the Center for Ashmun as a result of complications due to being infected with bird flu. The live, the housewife named Amal Ibrahim Mansour "32" years old, was admitted to hospital Shebin fevers after confirmation of bird flu bird flu pointing out that it ended the treatment , but she died as a result of complications occurred with the virus.

For her part, Dr Hana Sorour, Undersecretary of the Ministry of Health Menoufia, that there are no deaths new infected with bird flu confirmed that the housewife who died of pneumonia were completely cured of bird flu, where analysis has confirmed that was sent to Cairo for examination passivity.

 

It is, admittedly, an unusual `spin’ to the story. Given the limited nuances of machine translations, I’ve no idea whether this article was meant to be reassuring, sarcastic, or something else entirely. 

 

Interestingly, the MOH seems to acknowledge that this woman died of H5N1, as a 32-year old fatality is mentioned in their latest report (see below).  Note the lack of any YTD numbers.

 

Health: central laboratory analysis results confirm positive H5N1 infection case بڤيرس

The Ministry of health and population of healing and three confirmed cases infected with بڤيرس (H5N1) avian influenza and to child years and nine months of East County, old girl, three and a half years of Eastern Province and a five-year-old from dakahlia governorate also announces the confirmed infected with bird flu and is an old lady, 43, of Giza governorate and two new confirmed death and two old lady 32 years from Menofia Governorate and the second Lady A 43-year-old from Eastern Province, bringing the total number of cases receiving treatment in the hospitals of the Ministry of health 7.

(Continue . . . )

 

Finally, we have this following item which restates the obvious (that Bird flu is endemic in Egypt), but also announces that the World Health Organization and the FAO will be arriving today (Sunday) to assist local authorities in battling this H5N1 outbreak.

 

Minister of Health: Bird flu has become endemic in Egypt

Saturday, March 7, 2015 - 20:21

Minister of Health announced Dr. Adel Adawi, that bird flu, has solidified in Egypt, stressing the follow-up ministry day of infected foci. The minister added - during his interview for the program "Life Today" - that a delegation from the World Health Organization and FAO will arrive tomorrow to Egypt to check the status of the disease in Egypt, pointing out that the ministry's role in Egypt is to monitor cases and to provide the necessary treatment to them

 

Despite this winter’s unprecedented surge in cases, so far we’ve seen no evidence of large clusters or human-to-human transmission of the virus.   The risk of infection still appears to be through contact with infected birds.


Of course, that would be far more reassuring if there were more clarity in the reporting from the Egyptian government.

Sunday, March 01, 2015

Media: WHO H5N1 Mission To Egypt

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# 9770

 

The Egyptian (Arabic & English) press is filled this morning with reports that the World Health Organization will send an expert envoy (led by Dr Keiji Fukuda) to Cairo later this month to assist the MOH in dealing with their H5N1 outbreak.

 

Aside from the news that Egypt has invited the WHO in, these reports provide some interesting insight on how the MOH continues to `manage’  the outbreak news information.

 

First, the English language version of the report, after which I’ll have a bit more:

 

WHO experts to visit Cairo mid March to curb H5N1: Health Minister

Mar. 01, 2015 11:26

By THE CAIRO POST

CAIRO: An international delegation from the World Health Organization (WHO) is due in Cairo mid-March to discuss ways to tackle Egypt’s endemic outbreak of H5N1 avian influenza, Health Minister Adel Adawy announced Sunday.

The international experts, in collaboration with the health ministry, will work on developing a strategy to ensure the eradication of the H5N1 avian influenza virus in Egypt in a short time,” Adawy was quoted by Youm7 Sunday.

<SNIP>

In Feb. 14, a 35 year-old man died of H5N1 avian flu in Cairo, marking the 11th death in the country from the disease in 2015, according to the Health Ministry. The death toll reached 10 in 2014.

(Continue . . .)

 

Aside from the good news that Egypt has invited an expert mission to consult on their H5N1 outbreak, there are a couple of things that stick out about this report.


First, the overly ambitious statement that they will `will work on developing a strategy to ensure the eradication of the H5N1 avian influenza virus in Egypt in a short time.’

 

Considering how well entrenched the virus is across Egypt - and that it has been for nine years - one marvels that the words `ensure the eradication and `in a short time’ could ever find themselves in the same sentence about H5N1.  


Moving on, we continue to see the `watered down’ case counts for the year (see The Silence Of The Egyptian MOH), even though the World Health Organization released a statement earlier this week saying:

 

H5N1 infections in Egypt

The sudden increase in the number of H5N1 human infections in Egypt that began in November 2014 and continued during January and February 2015 awakened concern. From the start of November to 23 February, Egypt reported 108 human cases and 35 deaths. The number of cases over this period is larger than yearly totals reported by any country since human H5N1 virus infections re-emerged in late 2003.

 

The WHO’s statement, and updated case counts, have been noticeably absent from Egyptian media coverage.  The last MOH statement that included YTD cases was more than 5 weeks ago (see Egypt’s MOH Confirms 21st H5N1 Case).

 

Since the WHO’s most recent tally for 2014 showed Egypt with 31 cases and 9 deaths - even allowing for minor adjustments - one can deduce we must be somewhere in the vicinity of 75-80 cases and well over 20 deaths already for 2015 (based on numbers that are more than a week old). 

 

Yet today’s article continues to quote numbers from a Cairo Post report of February 14th (33 cases & 11 deaths) that at the time, was already far behind FluTracker’s 2015 Global WHO & Ministries of Health Confirmed H5N1 Human Cases List, which showed 53 cases, and at least 17 deaths.

 

While the flow information from the MOH to the Egyptian media may be less than desired, the good news is the Egypt continues to update the World Health Organization under the IHR, the MOH has asked WHO to consult on this outbreak, and our NAMRU-3 team in Cairo is – at last report – still assisting the Egyptians in their epidemiological investigations

 

Despite large surge in  cases, so far we’ve seen no evidence of large clusters or human-to-human transmission of the virus.   The risk of infection still appears to be through contact with infected birds.

Sunday, February 22, 2015

Egypt H5N1: Poultry Losses Climbing, Prices Up 25%

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# 9739

 

Ideally, the Ministries of Health (and agriculture) around the world would be quick to release detailed disease outbreak information, both to their own public, and to the international community. Sadly, there are often economic, political, and societal priorities that can trump full and timely disclosure.

 

There are notification rules in place – such as the International Health Regulations (IHR) adopted in 2007– but eight years later many countries have yet to meet even the core surveillance and response requirements (see WHO: IHR & Global Health Security) and have requested repeated extensions.

 

And as a purely practical matter, sovereign nations are pretty much on the honor system when it comes to reporting disease outbreaks.  And finally, their ability to conduct good surveillance varies greatly, as does their political will.

 

Up until a month ago Egypt’s Ministry of Health was doing a laudable job announcing H5N1 cases (50 over a 60 day period), that closely mirrored media reports, and that always included a YTD total (cases, fatalities, under treatment & recovered).

 

That format changed after the report of January 22nd (see Egypt’s MOH Confirms 21st H5N1 Case), and since then official updates have been infrequent, have listed a fraction of the cases mentioned by the media, and glaringly no longer include YTD numbers.


Presumably timely case reports are still being made to the World Health Organization under the IHR, and we will be privy to that information at some point, but the WHO only issues H5N1 reports once a month or so (the last one was January 26th)

 

Media reports – including statements by local Governorate officials – continue, albeit without details and YTD tallies.  Sharon Sanders’s conservatively curated  FluTrackers 2015 Egypt H5N1 Case List has the number of cases this year approaching 60, but the real number could well be higher.


The focus of the MOH, and much of the media, appears to have shifted from reporting cases to reporting on the government’s efforts, and progress, in combating the avian flu threat. No doubt in hopes of calming an increasingly alarmed population.

 

When human avian flu reports become difficult to pin down, we often look at `secondary indicators’, including outbreaks in wild birds and commercial poultry, poultry price increases or shortages, or reductions in feed imports. 


And here we’ve seen almost daily stories about the impact that H5N1 is having on Egypt’s poultry industry.  Losses are reportedly as high as 70% on some farms, and the price of poultry has jumped by 25% in recent weeks – in part due to cold weather losses – but mostly due to bird flu.

 

As point of reference for the following reports, an `Egyptian pound’ is roughly .13 cents US.  So 20 pounds per Kilo is about $2.60 USD.

 

A couple of reports from the Egyptian press describe the situation.

 

Poultry industry collapse .. and mortality farms exceed 70%

Muhammad Ali

Sunday 22/02/2015 - 11:55

Currently facing the poultry industry a severe crisis threatens to collapse and loss of investments worth more than 28 billion pounds, and the displacement of about two million workers, especially with the bypass mortality rates of all farms 70% of the size of the flocks of poultry, which caused the rise in poultry prices are crazy for up to 20 pounds per kilo due to lack of supply.

Dr. Nabil Darwish, head of Poultry Federation, the industry is already facing currently a major crisis and losses Halal current season beyond and a half billion pounds at least, now, educators are living a real tragedy on the national level, both in farm systemic committed or random farms.

He Darwish it is time to develop a real plan to address the crises of the poultry industry on top of which protect them from diseases, particularly the avian flu, which has become a disaster for the industry and the control of high feed prices and the provision of gas to the farmer for the purpose of heating.

He pointed out that the General Union of Poultry Producers has prepared a full funding any industry to promote and protect national plans through compensation avian influenza Ministry of Agriculture Fund, which exists by about 800 million pounds.

Vice President of Poultry Division: 6.5 pounds higher net prices because of the flu .. and I demand to open the door of import

Joseph Ganzouri

22-2-2015 | 16:00

Abul Fotouh Congratulations, vice president of the Division of poultry Cairo Chamber of Commerce, the high prices of poultry by 25%, which jumped retail price of 16 pounds last month to 22.5 pounds because of the deaths of mothers poultry, after being infected with bird flu.

It warns Congratulations from the widening gap between consumer needs and supply in the market, particularly as the deficit is estimated at 800 thousand chickens per day, demanding quickly import of poultry parts for a specific period to close the gap of domestic production.

He continued: "We are embarking on the holy season, and possible import of poultry parts for a specified period, to import shall be in accordance the conditions and standards under the supervision of the Egyptian General - Authority for Veterinary Services

These sorts of reports can be particularly probative when you consider that much of Egypt’s commercial poultry is supposedly vaccinated against H5N1, suggesting either lapses in vaccination (or worse) reduced vaccine effectiveness.

 

The most recent FAO/EMPRES Animal Influenza Update # 636 lists:

A total of 66 outbreaks occurred in household poultry, 9 in commercial farms and 1 detected in a live bird market (LBM); 5 outbreaks occurred in vaccinated farms, the rest were in unvaccinated birds.

 

Update #635 lists 1 outbreak in a vaccinated farm, while Update # 634 lists 3 outbreaks among vaccinated ducks and chickens.

 

In 2012, in Egypt: A Paltry Poultry Vaccine, we looked at a study – conducted by the Virology department at St. Jude Children’s Research Hospital -  appearing in the journal Poultry Science, that looks at the effectiveness of six commercially available H5 poultry vaccines currently deployed in Egypt.

 

Of the 6 vaccines tested, only one (based on a locally acquired H5N1 seed virus) actually appeared to offer protection.  We’ve seen similar vaccine performance issues in China, Vietnam, and Indonesia in the past.

 

While poultry vaccination has been adopted by a number of countries to control their avian flu problems, they are an imperfect solution for the control of avian viruses (for earlier blogs see OIE: Countries That Vaccinate Poultry Need An `Exit Strategy' & Food Insecurity, Economics, And The Control Of H7N9).

 

Admittedly,  the impact of H5N1 on Egypt’s poultry industry doesn’t tell much about the current impact the virus is having on human health, but it does give us a pretty good feel for just how well entrenched the virus has become, and how difficult the task of controlling this virus is likely to be.

Sunday, February 15, 2015

Approximate H5N1 Case Counts & A New Egyptian MOH Statement

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# 9714

 

Despite media reports that continue to announce new H5N1 cases (suspected & confirmed) almost daily across Egypt, their Ministry of Health has only posted a couple of brief statements on their website over the past two weeks, where they mention only a handful of cases. 

 

If things weren’t confusing enough, these infrequent statements are undated and have occasionally appeared out of chronological order in the long list of announcements on the MOH website, further decreasing their visibility.

 

Missing from recent statements are the YTD tallies (cases, recoveries, hospitalized, deaths)  which had – until late January – been a regular feature.

 

Yesterday the Cairo Post reported that the number of cases for the year had reached 33, with 11 deaths – which appears to be an outdated number - as 18 days ago the media had already reported 31 cases and 10 deaths (see Egyptian Media Reports Additional H5N1 Cases & Deaths), and we’ve seen perhaps 20 additional cases reported in the media since then.  

 

Doing her best to keep track of MOH statements, local Health Ministry announcements, FAO reports, WHO summaries, and credible press reports is Sharon Sanders whose FluTrackers 2015 Global WHO & Ministries of Health Confirmed H5N1 Human Cases List shows (as of yesterday) 53 cases, and at least 17 deaths since the first of the year.

 

Lending credence to the FluTracker’s count we have two other reports:

  • On January 6th (updated in Feb.) the World Health Organization released their end-of-year H5N1 case summary, which showed 30 cases reported in Egypt in 2014, resulting in a grand total of 203 cases since 2006. 

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Reformatted list from WHO

 

 

An apparent increase of 52 cases and 21 deaths over the January 6th numbers posted by WHO.  

 

There are, admittedly gaps and discrepancies in all of these reports, and even the best surveillance system will inevitably miss some cases.  So I wouldn’t suggest taking any of these tallies to the bank.

 

But the FluTrackers and FAO numbers are probably closer to reality than the barely rising tallies reported by the press.  Frankly, it shouldn’t require these sorts of daily mathematical gymnastics to come up with a case count for an outbreak as important as this is.

 

While its probative value may be limited, I’ve reproduced the latest MOH statement (posted overnight), which lists 3 `new’ H5N1 cases (all of which appear to be already captured on FluTracker’s list) .

 

Health: results of the analysis of the Central positive 3 لڤيروس confirm H5N1 as the healing and the departure of two hospitals

The Ministry of health and population of infection 3 confirmed بڤيروس H5N1 (bird flu), they are:-two-year-old boy, from the Lake, is still under treatment in hospital, the second case in Damanhour fevers of 39-year-old man, from the Eastern Province, and is still under treatment in hospital Central, and Jacksonville the third man, a 42-year-old from Cairo, is still under treatment in hospital, fevers of Helwan.


It also announces the exit, heal two two of the two-year old child of Suez, and the second case of a 42-year-old from Asyut province.


It also announces the death of a confirmed case of bird flu and 35-year-old man from Cairo.


Therefore calls upon the Ministry of health and population of citizens who handle poultry to go immediately to the nearest hospital to receive health service if they have flu symptoms since receiving infected of bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the healing rates of disease and reduces mortality, the Health Ministry advised people who deal with poultry to be careful and prudent when dealing with birds that show symptoms of the disease and the need to take preventive action to prevent such infection Cover your mouth and nose when handling poultry, wash hands with SOAP and water after handling birds and children not accompany poultry or slaughter premises as well as the need to separate from living birds.
Source: Media Center

 

 

Although we are clearly seeing the biggest ongoing outbreak of human H5N1 cases in a decade, thus far we’ve seen no evidence that the virus is transmitting any differently than it has in the past. 

 

Human-to-human transmission remains rare, and the biggest risk remains direct contact with infected birds.

Friday, February 13, 2015

An H9N2 Infection In Egypt & Updated H5N1 Count – FAO/EMPRES

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# 9707

 

We’ve news of a human H9N2 infection in Aswan, as well as a bit of confirmation of our H5N1 count for Egypt this year, courtesy of the latest FAO/EMPRES Animal Influenza Update # 636  and a head’s up overnight to FluTrackers and myself by @nlintelligence  (see FluTrackers post)

 

First the H9N2 case, which is described as:

 

10/02/2015 – H9N2 infection in a human, Aswan
Source: National Authorities


On 10 February 2015, a human case of A (H9N2) influenza was detected by the routine national avian influenza surveillance system in Aswan Governorate. The case was a 3 years old male, avian influenza was suspected on 16 January 2015. Samples tested at Aswan subnational laboratory and subsequently the reference laboratory (NAMRU3) were positive for H9N2 Investigations revealed that the case had a history of contact with apparently healthy backyard poultry. H9N2  positive poultry has been detected in Egypt since 2011, yet this is the first confirmed human case.

 

Although ubiquitous in Asian poultry, and endemic in Egyptian poultry as well, H9N2 has only rarely been reported in humans. We’ve seen it  reported a handful of times, including in Hong Kong in 1999 (2 cases), 2003 (1 case), and 2007 (1 case), and most recently in December of 2013 (see Hong Kong: Isolation & Treatment Of An H9N2 Patient).

Several additional human H9N2 virus infections were reported from China in 1998-99, and all known cases were mild.  More recently, in 2011 we learned Bangladesh To Share H9N2 Bird Flu Virus after detecting a case there.


Since the virus is most common in areas where testing and surveillance are less than optimal, we really don’t know how many people end up infected by it.  Most cases are mild, and would be indistinguishable from ordinary flu.

 

Although viewed as having at least some `pandemic potential’ (see H9N2: The Other Bird Flu Threat), perhaps more importantly H9N2 appears to play a central role in the evolution of other HPAI viruses, including H5N1, H7N9, H5N6, and H10N8.

 

All of which share several important features,  which we’ve discussed previously.

 

  1. They all first appear to emanate from Mainland China
  2. They all appear to have come about through viral reassortment in poultry
  3. And most telling of all, while their HA and NA genes differ - they all carry the internal genes from the avian H9N2 virus

 

The avian H9N2 virus – unlike the H5 and H7 avian viruses – is not considered a `reportable’ disease by the OIE since it is viewed as a relatively stable LPAI (Low Pathogenic Avian Influenza), not prone to evolving into a more dangerous HPAI form.

 

Also included in this FAO/EMPRES report is an update on human H5N1 cases in Egypt, and that – combined with another FAO/EMPES document posted by Flutrackers this morning – appears to corroborate our ongoing count of H5N1 cases for the year.

 

29/01/2015 to 05/02/2015 - H5N1 infections in humans,
Behera, Cairo, Giza, Dakahlia, Fayoum, Iskandariyah, Menia,
Menoufia, Qina, Sharkia, Sohag and Sharkia Governorates
Source: National Authorities


According to the Ministry of Health, between 9 January and 2 February 2015, 22 new human cases of H5N1 infection were detected of which three have been fatal:


- Cases were reported in 13 out of Egypt’s 27 governorates namely: Alexandria (1), Behera (2), Cairo (3), Dakahlia (1), Fayoum (1), Giza (2), kalyoubia (2), Menia (2), Menoufia (2), Qena (1), Sharkia (3), Sohag (1) and Suez (1);

- Patients affected are aged between 1.6 and 75 years old, 9 of them are children;


- All cases, except one, whose source of infection is still under investigation, had contacts with backyard or market poultry few days prior to illness. Of the 254 confirmed human cases in Egypt since 2006, 93 were fatal, and at least 233 cases had contact with domestic poultry

 

Sharon Sanders has updated her FluTrackers 2015 Global WHO & Ministries of Health Confirmed H5N1 Human Cases List, which now shows 49 H5N1 cases for the year in Egypt. 

Thursday, February 12, 2015

Media Reports Of H5N1 Continue In Egypt

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# 9701

 

The disconnect between what is being reported by the Egyptian press, and the number of cases being publically acknowledged by the Egypt’s Ministry of Health, continues with almost daily reports of new H5N1 cases (suspected & confirmed) in the Arabic media which are only rarely listed on the MOH site. 

 

Of note, the MOH hasn’t released a YTD total of cases, or fatalities, in over three weeks (see The Silence Of The Egyptian MOH).  They do, however, continue to urge people to seek medical care immediate if they suspect bird flu infection.

 

The last officially acknowledged YTD total came on January 22nd (see Egypt’s MOH Confirms 21st H5N1 Case), but based on local health ministry and media reports, the number of cases since then appears to have incremented significantly. 

 

How much is anybody’s guess, but Sharon Sanders of FluTrackers has been dutifully trying to keep track, and her conservatively curated FluTrackers H5N1 Case List indicates (as of yesterday) 39 cases, and 16 deaths for the year.

 

Today the Egyptian media already has reports of four H5N1 cases, all supposedly confirmed by lab tests.  How accurate these reports really are is debatable, but given the restrictive press environment in Egypt, I have doubts many would risk publishing reports like these without substantial corroboration.


First stop, almasryalyoum.com. 

 

Health Qalubia»: the detention of three persons infected with «bird flu»

2 hours ago | wrote: Abdel-Hakam soldier , Mohammed Mahmoud Khalil

Directorate of Health Affairs announced Balqlliopip, on Thursday, the detention of three people, for being infected «bird flu» preservation, noting that the stable situations, and respond to treatment, where he was given the drug «Tamiflu» and a number of medications.

Said Dr. Mohammed Lachin, Undersecretary of the Ministry of Health Balqlliopip, had been detained three cases hospitals «Banha University, and fevers Banha, and diets», pointing out that samples were taken from the injured, and sent to the central laboratories of the Ministry of Health in Cairo, which proved positive cases, in addition to sampling of their families, and the work of the inquiry Mkhaltin them, to show the extent of the injury or not

 

And this from elwatannews.com.

 

The emergence of new cases of bird flu in Assiut

Wrote: Suad Ahmed Thursday 12/02/2015 09:37

Confirmed samples sent by al-Sadr hospital in Assiut Governorate, to the central laboratory in Cairo injury housewife from coast sound of bird flu results.

He explained the source of the Directorate of Health in Assiut, that the situation of a woman named (n, p, P- 24 years) have been converted from the Central Coast Salim hospital on suspicion of being infected with bird flu.

The source added, that Ms. booked Chest Hospital in Assiut, samples were withdrawn and sent to labs central Cairo shows the result of analysis of the received by the health Assiut being infected with the virus

 

As we tend to see about updates from the MOH every 5 to 7 days, we may or may not get confirmation of these cases.  Hopefully these cases (if, indeed, they are confirmed) will get sorted out in the next WHO GAR update.


Assuming FluTracker’s case count is reasonably close - and these four cases are eventually certified by the WHO – that would mean that in the first 6 weeks of 2015 Egypt has already exceeded their 2011 record (n=39) for the number of cases in a year.  


All the more impressive when you add in the 30 cases racked up in the last six weeks of 2014. 


Whatever the precise count (and even with the best surveillance and reporting, cases will be missed), Egypt’s H5N1 outbreak this winter of 2014-15 is shaping up to be the biggest run of human cases reported from one country that we’ve seen in a decade. 

 

Egypt appears on pace to rival or even exceed Vietnam’s record of 61 cases and 19 deaths in 2005.

 

Why, after two years where only 8 cases were reported in Egypt, we are seeing this sudden bloom of cases is unknown.

 

In January, in CIDRAP: FAO Reports Mutations In H5N1 Virus From Egyptian Poultry, we did see a report that found some signs suggestive of `mammalian adaptations’ in viruses collected from local poultry, but those changes were not present in two human samples tested.

 

A few days laterthe World Health Organization published their latest WHO H5N1 Update & Risk Assessment, which stated:

 

Although all influenza viruses evolve over time, preliminary laboratory investigation has not detected major genetic changes in the viruses isolated from the patients or animals compared to previously circulating isolates. The increase in reported human cases is likely a consequence of several factors. These includes increased circulation of influenza A(H5N1) viruses in poultry, lower public health awareness of risks in middle and upper Egypt and seasonal factors such as closer proximity to poultry and longer survival of the viruses in the environment because of cold.

 

The good news is that we’ve yet to see any evidence that the virus is spreading from person-to-person, and while a handful of small family clusters have been mentioned, the risk still appears to stem from close contact with infected birds.

 

Still, whatever the current source of infection, anytime we see this many human infections with a novel flu virus, we watch carefully for any signs of changes in the behavior of the virus.

Sunday, February 08, 2015

Regarding The Silence Of The Egyptian MOH

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Note:   Within minutes of posting this entry the Egyptian media reported 4 new H5N1 cases, supposedly announced by the MOH. Nothing has been updated on the MOH site as of this time, but the media report reads:

 

Ministry of Health announced the injury of four confirmed cases of bird flu, and they are: a man of 44-year-old Sohag Governorate and is still under treatment in hospital Abbasid fevers, and a child of two years and a half old from Alexandria Governorate and is still under the hospital released the globe treatment, and a girl of Giza-year-old and a half and still under treatment Fever Hospital Imbaba, lady of the Cairo Governorate and is still under treatment, a hospital Abbasid. The Ministry of Health announced the healing 3 cases, they are: a child of the province of Assiut 3 years old, and the lady of the lake province, 19-year-old, and a girl from Qena Governorate old 13 years.

Once again, no updated YTD numbers are provided.

 

 

# 9687

 

Although media reports continue to appear in the Arabic press describing suspected or confirmed H5N1 cases (today including The death of a secondary student of bird flu in Minya & 6 suspected injury as "bird flu" in Damietta),  the Egyptian Ministry of Health’s website remains largely silent on the issue. 

 

The last official update was posted five days ago (see Egyptian MOH Statement On H5N1) describing a solitary case, and before that, you have to go back to January 27th.

 

Prior to that, the MOH was doing a laudable job announcing cases (50 over a 60 day period), that closely mirrored media reports, and always included a YTD total (cases, fatalities, under treatment & recovered).


That format changed after the report of January 22nd (see Egypt’s MOH Confirms 21st H5N1 Case), and since then we’ve seen no official update containing YTD numbers. Nearly two weeks ago  media reports had the total for the year at 31 cases, with 10 deaths, but the reliability of that number is unknown, and recent media reports have simply ignored the YTD count.


At this point it is safe to say we’ve pretty much  lost visibility of the H5N1 outbreak in Egypt.  


While it is possible that after two months of reporting nearly a case a day, the number of new cases has fallen abruptly -  ancillary news reports about declarations of emergency, the formation of emergency committees, and constant calls to the public to report to the hospital if they have signs of avian flu - would all seem to argue against that.

 

Since I find limited value in posting unconfirmed media reports – particularly since the Egyptian media appears to be `piling on’ a bit in protest of the absence of official information – Egypt has gotten little mention here the past week or so. 


Nevertheless, I (along with Crof, and  the very capable newshounds on FluTrackers and the Flu Wiki) continue to scour official and unofficial (Arabic media, twitter & social Media) sources daily for credible information.   

 

Hopefully the World Health Organization is being kept fully informed, as a well as our NAMRU-3 team in Cairo, and all will be revealed in time.

 

While it is always disconcerting when official reports are suddenly slow in coming, the good news is, so far there are no outward indications that anything has changed in Egypt regarding the spread and behavior of the H5N1 virus. 

Tuesday, February 03, 2015

Egyptian MOH Statement On H5N1

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# 9665

 

While Egypt’s H5N1 outbreak (in poultry & humans) apparently continues, their reporting of cases changed both in style and frequency a little over 10 days ago. 

 

Until January 22nd (see Egypt’s MOH Confirms 21st H5N1 Case) official announcements usually followed press reports within 24-48 hours, closely matched the media reports, and always included a YTD total (cases, fatalities, under treatment & recovered)

.

After announcing 50+ cases in just over 2 months, MOH announcements have abruptly become less frequent, often don’t include all of the cases we’ve seen mentioned in the media, and no longer provide any sort of YTD accounting.

 

Whether this represents some sudden slowdown in human infections after two hectic months, or simply a desire to keep the incessant drumbeat of new case announcements off the front page, is impossible to tell.  Hopefully we’ll get another update from the World Health Organization that will clarify matters.

 

We still see media reports of cases, declarations of `bird flu emergencies’  by individual Governorates, the creation (with much fanfare) of emergency committees, and promises of government action – all suggesting the outbreak continues – but very little in the way of official acknowledgement of cases. 

 

A week ago media reports had the total for the year at 31 cases, with 10 deaths, but the reliability of that number is unknown.  Since then, few media stories have included any sort of tally.

 

All of which leaves us without a clear idea of the current size, or trajectory, of their ongoing H5N1 outbreak. 

 

What we do have today is a short announcement of a single H5N1 infection (and 3 recoveries) – the first official statement on H5N1 from the MOH in a week.

 

 

Health: central laboratory analysis results confirm positive H5N1 infection بڤيروس

The Ministry of health and population, wounding confirmed بڤيروس H5N1 (bird flu): the case of 13-year-old girl from Qena Governorate, is still under treatment in hospital fevers Qena.

It also announced the heal-three and out is an old lady, a 47-year-old from Minya Province Department of Beni Mazar, Lady 35-year-old from Minya governorate of Minia, management and a 42-year-old from Eastern Province of Department hehia.

Therefore calls upon the Ministry of health and population of citizens who handle poultry to go immediately to the nearest hospital to receive health service if they have flu symptoms, where the infected bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the healing rates of disease and reduces the mortality and Health Ministry advised people who deal with poultry to be careful and prudent when dealing with birds that show symptoms of the disease and the need to take preventive action to prevent such infection cover The mouth and nose when handling poultry, wash hands with SOAP and water after handling birds and children not accompany poultry or slaughter premises as well as the need to separate from living birds.

Monday, January 26, 2015

Egyptian MOH Statement On NAMRU-3 & H5N1

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# 9628

 

A little over a week ago, in Egypt MOH: Three H5N1 Statements & Confirmation Of 17th Case, we learned that the Egyptian Ministry of Health had formally invited our Naval Medical Research Unit 3 (NAMRU-3), stationed in Cairo, to assist in their current H5N1 outbreak. 

 

Billed as the `largest DoD overseas laboratory, with biosafety level 3 biocontainment space and field and hospital study sites located throughout Egypt.’ , NAMRU-3 is particularly well suited for this type of work, and their involvement is a good sign the Egyptian Government is taking this outbreak seriously.

 

Today the MOH has posted two H5N1-related items on their website.  A description of two more H5N1 cases (although noticeably absent is an updated tally of cases), and a statement regarding NAMRU-3’s involvement.

 

First this translation of the NAMRU statement:

 

Meet Dr. Adel, Minister of health and population of infection by the President of the US Naval Research Unit "alnamro 3", and the accompanying delegation to discuss the most important developments of bird flu

Meet Dr. Adel, Minister of health and population of infection today with the President of the US Naval Research Unit "alnamro 3", and the accompanying delegation to discuss the most important developments of bird flu and precautionary measures to be followed by the Ministry of health to control the spread of the disease.

The Health Minister emphasized the importance of a meeting with international development partners, for the transfer of expertise and support in responding to bird flu, noting that only American Naval Research Unit provides technical support to the Ministry of health to create a third level uses Laboratory Biosafety, and to be able to isolate the virus, in addition to the arrival of a delegation of experts from the Center for disease control in the United States, to provide technical assistance to Egypt to understand the disease, its causes and risk factors associated with it, as well as measures to avoid Infection.

Called "infection" of the importance of supporting studies that contribute to the development of the treatment and prevention of avian influenza, in particular to the possibility of manufacturing vaccines to prevent HIV infection.

For his part, the President of the US Naval Research Unit that is being analyzed for the bird flu virus, the control center for disease control in the United States, the findings suggest that there is no genetic mutation is important in the virus, as well as no signs of resistance to the drug Tamiflu.

Source: Media Center

The second statement has dropped the running tally of cases, recoveries, number in treatment, and deaths that have been a staple in earlier dispatches from the MOH, leaving us with far less clarity on the progress of this outbreak. This update also does not address a number of cases mentioned by the media over the past several days.

 

Health: central laboratory analysis results confirm positive لڤيروس H5N1 cases

The Ministry of health and population of the healing of a child of 10 years of Aswan, and positive two new injury بڤيروس H5N1 (bird flu), the first case of 60-year-old woman from Western Province and seized a hospital, abbassia-general condition of medium, and the latter for the 35-year-old woman from the governorate of Matrouh Morsi, was booked at a Damanhur-died.

Therefore calls upon the Ministry of health and population of citizens who handle poultry to go immediately to the nearest hospital to receive health service if they have flu symptoms, where the infected bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the healing rates of disease and reduces the mortality and Health Ministry advised people who deal with poultry to be careful and prudent when dealing with birds that show symptoms of the disease and the need to take preventive action to prevent such infection cover The mouth and nose when handling poultry, wash hands with SOAP and water after handling birds and children not accompany poultry or slaughter premises as well as the need to separate from living birds.

 

Without an MOH tally, my `best guess’  is we are between 25 and 30 cases so far in the month of January. Hopefully this is one-time omission, and not a new reporting format by the MOH.  We’ve essentially lost `real-time’ visibility of H7N9 in parts of China, it would be a shame if the same thing happened with H5N1 in Egypt.

 

Doing her best to keep some kind of logical track of these cases is Sharon Sanders, whose FluTrackers 2015 Global WHO & Ministries of Health Confirmed H5N1 Human Cases List carries both MOH, and local government confirmed reported cases.

 

A job that would become all the more difficult without updated MOH generated checksums to compare against.

Thursday, January 22, 2015

Egypt’s MOH Confirms 21st H5N1 Case

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# 9610

 

In yesterday’s report, Egyptian Media: 21st H5N1 Case, 6th Fatality of 2015,  I promised to update when the MOH confirmed these cases.   Overnight the MOH posted a report - with the lede being the recovery of 2 cases – but that also confirms the sixth fatality and 21st case.

 

The Ministry of health and population exodus recovery of H5N1 cases

The Ministry of health and population has announced the departure of two recovery of H5N1 "bird flu" on 20/1/2015 from the governorates of Minya and menoufia, also announced a new confirmed case of H5N1 bird flu, "بڤيروس", a case of a child of three and a half years of Asyut province, is still under treatment in hospital of korba in Cairo, as the DOH announces the death of a new status for the old lady, 36, of Cairo, bringing the total number of cases of flu Birds through 2015 so far 21 cases (8 cases of healing, 7 cases under treatment, and 6 deaths)

Therefore calls upon the Ministry of health and population of citizens who handle poultry to go immediately to the nearest hospital to receive health service if they have flu symptoms, where the infected bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the healing rates of disease and reduces the mortality and Health Ministry advised people who deal with poultry to be careful and prudent when dealing with birds that show symptoms of the disease and the need to take preventive action to prevent such infection cover The mouth and nose when handling poultry, wash hands with SOAP and water after handling birds and children not accompany poultry or slaughter premises as well as the need to separate from living birds.

Source: Media Center

Wednesday, January 21, 2015

Egyptian Media: 21st H5N1 Case, 6th Fatality of 2015

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# 9606

 

Although I’ve not found an official MOH announcement on their website, multiple Arabic news sources are reporting this morning on Egypt’s 21st H5N1 case of the year, and the death of a previously announced case.  Today’s case makes Egypt’s 50th human infection reported since this current outbreak began in mid-November.

 

Egyptian media reports quoting the MOH have been very reliable in recent weeks, and often appear hours or even days before an official statement is published. 

 

I’ll update this blog with a link to the MOH’s announcement when it is posted.


Health: the death of the sixth case b «bird flu» through 2015

Liberation Announced the Ministry of Health said in a statement on Wednesday, for the death of a new case of infection, "bird flu", a condition of a woman from the Cairo governorate, also confirmed a child at the age of three and a half years of Assiut Governorate injury, and is still under hospital capital Cairo treatment.

The ministry said in a statement that it had been healing the cases of the virus, "bird flu" and they came out of the hospital on Tuesday from the governorates of Minya and Menoufia, bringing the total number of cases of bird flu during 2015 so far 21 cases (8 cases of healing of 0.7 cases under treatment, 6 deaths ( .

It also directed the Ministry of Health and Population call for citizens who deal with poultry to go immediately to the nearest hospital for the health service in the event of the appearance of flu symptoms on them, where that had infected bird flu for "Tamiflu" during the first 24 hours of the onset of symptoms increases the cure rates of disease and reduces mortality rates

(Continue . . . )

 

 

Yesterday, in Egypt: Government Statements On H5N1 Response & Latest Fatality, we saw several strong statements by both local and national health authorities regarding this current outbreak, and measures being taken to try to bring it under control.

Tuesday, January 20, 2015

Egypt: Government Statements On H5N1 Response & Latest Fatality

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# 9600

 

With 20 reported H5N1 cases already in the first 3 weeks of this new year, and 5 deaths, Egypt continues to see its largest string of human H5N1 infections in its 9 year history of dealing with this avian virus.  Over a little more than 2 months they’ve reported 49 cases, and 16 deaths – and there are few signs that this outbreak is waning.


Thus far, we’ve seen no credible reports suggesting community spread of the virus, and nearly all appear to have had direct contact with infected poultry.

 

Yesterday, in Egypt MOH Confirms 20th H5N1 Case Of 2015, we looked at some of the speculation over the likely cause of this surge in human cases, but the bottom line is no one really knows. Hopefully we’ll get some definitive answers via the World Health Organization or our NAMRU-2 station in Cairo in the coming days or weeks. 


In the meantime the Egyptian Government has announced the creation of a high-level `Supreme National Committee On Bird Flu’, ordered by  the Chairman of the Council of Ministers, to be chaired the first year by the Minister of Agriculture.

 

Mahlab issued a decision to form the Supreme National Committee to follow up the position of bird flu

Ryan and Kamal Mahmoud Mattawa

Tuesday 20/01/2015 - 12:27

Issued Engineer Ibrahim Mahlab, Chairman of the Council of Ministers, a decision to form the Supreme National Committee to follow the position of the bird flu, chaired by the Minister of Agriculture and Land Reclamation, for the first annual session, and membership of, the Minister of Local Development, and Minister of Health and Population, and the Environment Minister, in addition to the Governors (Giza / Cairo / Kafr el-Sheikh / Dakahlia / Qalubia / Minya / lake / Fayoum / Menoufia).


The Committee also includes head of SIS, the head of crisis management room cabinet, and the head of veterinary services at the Ministry of Defense, and a representative of the Medical Services Department Defense, and a representative of the Ministry of Interior (waterbodies police), and a representative of the Ministry of Foreign Affairs, and President of the General Authority for Veterinary Services, and representatives of preventive affairs and endemic sector. The Committee is concerned with the follow-up of bird flu, and to provide periodic report the results of its work and recommendations to the Chairman of the Board Ministers to take the necessary action, and shall preside over the Commission rotates Ministers Committee members annually, they also have to employ someone who sees their use of experts and specialists in the field of work

 

Meanwhile, the Governor of hard-hit Assuit Governorate - Maj. Gen. Ibrahim Hammad - has issued his own statement on their avian flu crisis. 

 

Assiut Governor: take all preventive measures to reduce the «Bird Flu»

Assiut - ASHA Posted on: Tuesday, January 20, 2015 - 13:33 | Last updated: Tuesday, January 20, 2015 - 13:33

Issued Gen. Ibrahim Hammad governor of Assiut, instructed aggravating administrators directorates of health, veterinary medicine, preventive medicine, to intensify surveillance campaigns in any place where cases of positive HIV infection show "bird flu", with the need for medical and preventive follow-up of cases, pointing to entrust the main operating room to maintain next Rooms operations centers immediate and ongoing follow-up.

He called Hammad, in a statement, today, to intensify awareness campaigns for citizens in the centers and villages, to raise awareness of the culture and the face of this virus, and the emphasis on them not to deal with live birds, whether buying or breeding houses.

(Continue . . . )

 

And finally, this sad Ministry of Health confirmation of Egypt’s 5th fatality of the new year, that of a 6 year old from Minya.

 

The Ministry of Health and Population for the death of a confirmed case of bird flu, a condition of a child at the age of 6 years from the province of Minya

The Ministry of Health and Population for the death of a confirmed case of bird flu, a condition of a child at the age of 6 years from the province of Minya, bringing the total number of cases of bird flu in 2015, so far 20 cases (6 cases of healing and 9 cases under treatment, 0.5 deaths).

Therefore, calls on the Ministry of Health and Population citizens who deal with poultry immediately go to the nearest hospital for medical service in the case of the emergence of symptoms of influenza them where to receive the injured bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the cure rates of the disease and reduces death rates and advises the Ministry of Health of citizens who deal with poultry exercise caution and prudence when dealing with birds, especially that shows symptoms of sick and need to take preventive measures to prevent infection, such as cover your mouth and nose when dealing with poultry, wash your hands with soap and water after handling birds and not to take children to places of birds breeding or slaughter, as well as the need to separate the birds from the living quarters. Source: Media Center

Monday, January 19, 2015

Egypt MOH Confirms 20th H5N1 Case Of 2015

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# 9596

 

We’ve had a busy avian flu weekend in Egypt, with the MOH issuing multiple statements which have added 7 new H5N1 cases, bringing the total so far for 2015 to 20 cases, and 4 deaths.  Ten cases remain under treatment.

 

Health: Central analysis results confirm the three cases confirmed بڤيروس H5N1

DOH Announces population of infection three cases and certain بڤير and H5N1 (bird flu), the first case of a 47-year-old from Asyut province, the general situation is critical and has been reserved in a hospital intensive care of Asyut died on 19 February 2015, the second Lady of the 36-year-old from Cairo is still under treatment in hospital Cairo specialist, the third case is a child of 6 years of Minya province, is still under treatment in hospital Assiut University. Bringing the total number of cases of bird flu during the 2015 date 20 (6 cases of healing, 10 cases under treatment, and 4 deaths).

Therefore calls upon the Ministry of health and population of citizens who handle poultry to go immediately to the nearest hospital to receive health service if they have flu symptoms, where the infected bird flu drug Tamiflu within the first 24 hours of the onset of symptoms increases the healing rates of disease and reduces the mortality and Health Ministry advised people who deal with poultry to be careful and prudent when dealing with birds that show symptoms of the disease and the need to take preventive action to prevent such infection cover The mouth and nose when handling poultry, wash hands with SOAP and water after handling birds and children not accompany poultry or slaughter premises as well as the need to separate from living birds.

Source: Media Center

 

Despite Egypt’s unusual surge in cases reported (49 cases in just over 2 months) - which shows no signs of abatement - we’ve not seen anything in these (admittedly, sparse)  MOH reports to suggest community spread of the virus. 

 

For now, at least, infections appear to derive from direct contact with infected birds.

 

The question becomes: Why this year, so much more so than in previous years?  

 

We really don’t have an answer, although earlier this month in CIDRAP: FAO Reports Mutations In H5N1 Virus From Egyptian Poultry, we looked at an FAO  report that had found some signs suggestive of `mammalian adaptations’ in viruses collected from poultry, but that were not present in two human samples tested.

 

A few days later, however, in the most recent WHO H5N1 Update & Risk Assessment, the World Health Organization wrote:

 

Although all influenza viruses evolve over time, preliminary laboratory investigation has not detected major genetic changes in the viruses isolated from the patients or animals compared to previously circulating isolates. The increase in reported human cases is likely a consequence of several factors. These includes increased circulation of influenza A(H5N1) viruses in poultry, lower public health awareness of risks in middle and upper Egypt and seasonal factors such as closer proximity to poultry and longer survival of the viruses in the environment because of cold.

 

Meanwhile, Egypt’s Ministry of Health continues to distribute additional supplies of Tamiflu to the Governorates, and reassures that they have the resources to deal with a much larger outbreak.   This from youm7.

 

Health" is facing bird flu 700 thousand packaging "Tamiflu" and 100 million "Mask"

Monday, January 19, 2015 - 7:10 Dr. Amr Kandil, Assistant Minister for Health Affairs Preventive Medicine, Ministry of Health Dr. Amr Kandil, Assistant Minister for Health Affairs Preventive Medicine, Ministry of Health Wrote Walid Abdul Salam Dr. Amr Kandil, Assistant Minister of Health Affairs of Preventive Medicine, Ministry of Health and Population, the ministry distributed in Cairo and other governorates 250 thousand explosive tablets and syrup of the drug "Tamiflu", special treatment of bird flu on hospitals and health care units, referring to the provision of 700 thousand explosive tablets and syrup for children and adult stores ministry.

Dr. Amr Kandil, Assistant Minister of Health Affairs of Preventive Medicine, Ministry of Health and Population, in particular for the "seventh day" statements, he has been supporting and providing prevention supplies for infection control through the distribution of 100 million Mask on hospitals and health units, pointing out that the strategic reserve the Ministry of sampling kits, reagents and equipment sufficient for a period of 6 months


After a couple of years where H5N1 had seemingly taken a back seat to China’s emerging H7N9 virus, this granddaddy of avian flu viruses seems once more on the ascendant. 

 

For now, H5N1 is primarily a threat to poultry, and to a lesser extent, those who work with or come in close contract with infected birds.

 

The concern for more than a decade has been is that over time the virus could adapt further to mammalian hosts and someday pose a pandemic threat to humans.