Egypt Apr 7 2009 to May 12, 2009

Toddler to Toddler H5N1 Transmission in Beheira Egypt

Commentary

Recombinomics Commentary 18:29
April 7, 2009
http://www.recombinomics.com/N...

Boy, age 2, began experiencing fever and cough symptoms on March 27.
Boy, age 2, began experiencing fever, cough and runny nose on March 31.
=======================

The above comments describe the two most recently H5N1 confirmed toddlers in Egypt. These two cases were next door neighbors in the Kom Hamada district of Beheira and represent toddler to toddler transmission of H5N1. This cluster follows a spate of toddler cases in Egypt this year. 10 of the 12 confirmed cases have been toddlers and 9 of the 10 toddler cases have been mild. Both patients above are described as being in "good general condition" and will likely be discharged soon. None of the H5N1 cases this year in Egypt have died, which is similar to the mild cases of H5N1 in Egypt in the spring of 2007. However, unlike earlier cases, which included 6 toddlers over a three year period, the percentage of toddler cases has dramatically increased in 2009.

Although the two cases above are said to have had contact with dead or sick poultry, the confirmation of neighboring cases who developed symptoms four days apart is unlikely to be due to two independent poultry infections. There have been no confirmed poultry cases in the Kom Hamada area. Since March 1 there were 24 confirmed H5N1 poultry outbreaks in Egypt, and although 7 were in Beheira, these outbreaks were well to the north and not near the toddler cluster (see updated map). Over 60 outbreaks have been confirmed this season, and none were close to Kom Hamada. Similarly, the toddler case preceding the cluster was in Qena, and there have been no confirmed poultry outbreaks in Qena this season (see updated map).

Although there are clearly more H5N1 outbreaks than those confirmed, the targeting of toddlers raises concerns that old age groups have developed protective immunity, signaling a significant silent spread of H5N1 in Egypt. Over 6000 patients with poultry links have been hospitalized, but less than 1% have tested positive. However, it remains unclear if the low confirmation rate is due to an aggressive testing program, or a lack of sensitivity in the testing.

Confirmed H5N1 clusters have been rare in Egypt have been rare. The largest was the Ghabiya cluster at the end of 2006, but the prior clusters were among relatives and did not have the gap in disease onset dates. The Beheira cluster has the classical gap and there has been no indication that the two toddlers were related. Although it is likely that mild H5N1 has was transmitted human to human, based on the sequence identity between isolates from unrelated cases, the current cluster has the time and space signature associated with human to human transmission.

Sequences from this cluster, as well as testing of toddlers that have symptoms but lack a poultry link would be useful.

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by: Pixie @ Tue Apr 07, 2009 at 13:05:04 PM CDT

Thank you BB. n/t

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Tue Apr 07, 2009 at 14:36:22 PM CDT

Concerns arise over symptomless Egypt bird flu cases

8 April 2009
http://www.khaleejtimes.com/da...

CAIRO - The World Health Organisation is concerned some Egyptians may carry the highly pathogenic bird flu virus without showing symptoms, which could give it more of a chance to mutate to a strain that spreads easily among humans.

Whether such cases exist still has to be put to the test and will be the focus of a planned Egyptian government study backed by the global health body, said John Jabbour, a Cairo-based emerging diseases specialist at WHO.

"This is a concern only, now. It is a question to be asked," Jabbour told Reuters. He said a change in the pattern of human bird flu infections this year in Egypt had raised concerns about the existence of so-called sub clinical cases.

The most populous Arab country, which has been hit harder by bird flu than any other country outside of Asia, has seen a surge in infections this year.

While the H5N1 virus only rarely infects people, experts fear it could mutate into a form that humans could easily pass to one another, sparking a pandemic that could kill millions.

The emergence of symptomless human carriers of the virus would be a worrisome development because it could allow the virus, undetected and untreated, more time to mutate inside the human body, Jabbour said.

"If there is any sub clinical case in Egypt, the aim is to treat immediately to stop the reproduction of the virus. Because whether (through) mutation or reassortment, this will lead to the pandemic strain," he said.

Of the 11 Egyptians infected with bird flu this year, all but two have been children under age three while adult cases have all but dried up. All have survived.

That is starkly different from the same period a year ago, when seven people-mostly adults and older children-contracted the virus and three died.

'Something strange happening'

Jabbour said the rise in infections in children without similar cases among adults had triggered questions as to whether adults were being infected with the virus but not falling ill.

"There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."

Jabbour said there had been no known instances of sub clinical bird flu cases in humans in other countries where the disease was present. Some birds, like ducks, are known to carry and spread the virus without showing symptoms, he said.

The Egyptian study, which Jabbour said should begin in the coming months, would test the blood of people who may have been in contact with infected birds but had not become sick.

Since 2003 the avian influenza virus has infected more than 400 people in 15 countries and killed 256 of them. It has killed or forced the culling of more than 300 million birds across Asia, the Middle East, Africa and Europe.

Some 23 Egyptians have died after contracting the virus, most after contact with infected domestic birds in the country where roughly 5 million households depend on domestically raised poultry as a major source of food and income.

But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt.

He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other.

"There is no change in the virus at all in the virus strain in Egypt. It is the same since the beginning of the outbreak. There is no mutation, nothing," he said.

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by: Pixie @ Wed Apr 08, 2009 at 08:49:46 AM CDT

Characterization of conserved properties of hemagglutinin of H5N1 and human influenza viruses: possible consequences for therapy and infection control

Published on: 2009-04-07
http://tinyurl.com/cvvosb

Epidemics caused by highly pathogenic avian influenza virus (HPAIV) are a continuing threat to human health and to the world's economy. The development of approaches, which help to understand the significance of structural changes resulting from the alarming mutational propensity for human-to-human transmission of HPAIV, is of particularly interest.

Here we compare informational and structural properties of the hemagglutinin (HA) of H5N1 virus and human influenza virus subtypes, which are important for the receptor/virus interaction.

Results: Presented results revealed that HA proteins encode highly conserved information that differ between influenza virus subtypes H5N1, H1N1, H3N2, H7N7 and defined an HA domain which may modulate interaction with receptor.

We also found that about one third of H5N1 viruses which are isolated during the 2006/07 influenza outbreak in Egypt possibly evolve towards receptor usage similar to that of seasonal H1N1.

Conclusions: The presented results may help to better understand the interaction of influenza virus with its receptor(s) and to identify new therapeutic targets for drug development.

Author: Veljko Veljkovic, Nevena Veljkovic, Claude P Muller, Sybille Muller, Sanja Glisic, Vladimir Perovic and Heinz Kohler

Credits/Source: BMC Structural Biology 2009, 9:21

===================

Link to Article: http://www.biomedcentral.com/1...

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by: Pixie @ Wed Apr 08, 2009 at 09:08:02 AM CDT

Confirmation of Toddler H5N1 Transmission in Beheira Egypt

Commentary

Recombinomics Commentary 17:44
April 8, 2009
http://www.recombinomics.com/N...

Both boys had contact with sick/dead poultry prior to the illness onset.

Close contacts of both boys have been identified and none has shown symptoms of the infection.
==================================

The above comments from the latest WHO update represent glaring commission by omission.  The update claims "contact with sick/dead poultry", but fails to give results of testing of such poultry.  The SAIDR site, which has poultry results through April 3 does not include any confirmed poultry cases in the proximity (see updated map) of the Beheira cluster.

Moreover, the above comments imply that neither confirmed case has transmitted H5N1 to any contact, yet the update fails to mention that the two confirmed cases live "in adjacent houses", and are cousins.

The four day gap in disease onset dates leaves little doubt that the index case infected his cousin, who lives text door.  This toddler to toddler transmission is cause for concern, because both cases had mild H5N1, including the index case, who began oseltamivir treatment after the recommended 48 hours after disease onset.

These mild bird flu cases in Egypt are not new, and were cause for concern in 2007, when children between the ages of 3-10 rapidly recovered and were infected with H5N1 sequences that were virtually identical and signaled extensive human to human transmission because the cases with identical H5N1 sequences were not epidemiologically linked.

Although WHO has recently acknowledged concern for silent transmission of H5N1, the above commissions by omission of an obvious case of human to human transmission raises serious pandemic concerns about WHO's ability to analyze scientific data and transparently present results of such analysis.

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by: Pixie @ Wed Apr 08, 2009 at 13:04:25 PM CDT

Avian influenza - situation in Egypt - update 10

http://www.who.int/csr/don/200...

8 April 2009 -- The Ministry of Health of Egypt has reported 3 new confirmed human cases of avian influenza.

The first case is a 2 year-old boy from Kom Hamada District, El Behira Governorate. He developed symptoms on 27 March and was admitted to Naaora Fever Hospital on the 30 March where he was started on oseltamivir the same day (30 March). He remains in a stable condition.

The second case is also a 2 year-old boy from the same district and was detected through the investigation around the above-mentioned case. He developed symptoms on 31 March and was admitted to Damanhor Fever Hospital on 1 April where he was started on oseltamivir the same day (1 April ). He remains in a stable condition.

Both boys had contact with sick/dead poultry prior to the illness onset. Close contacts of both boys have been identified and none has shown symptoms of the infection.

The third case is a 6 year-old boy from Shubra El Khema District, Qaliobia Governorate. He developed symptoms on 22 March and was admitted to Ain Shams University Hospital on the 28 March where he was started on oseltamivir on 3 April. He was exposed to sick/dead poultry prior to the illness onset. He is in a critical condition.

For all of the three cases reported above, infection with H5N1 avian influenza virus was tested positive by the Egyptian Central Public Health Laboratory and subsequently confirmed by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3).

Of the 63 cases confirmed to date in Egypt, 23 have been fatal.

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by: Pixie @ Wed Apr 08, 2009 at 13:07:47 PM CDT

This bit from the WHO Update #10 regarding the two confirmed

toddler cousins in Behira is interesting:

The second case is also a 2 year-old boy from the same district and was detected through the investigation around the above-mentioned case.

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by: Pixie @ Mon Apr 20, 2009 at 04:20:21 AM CDT

[ Parent ]

Egypt must intensify efforts....

Egypt must intensify efforts to combat avian flu, say experts

By Tamim Elyan

CAIRO: As the number of reported bird flu cases continues in Egypt, attention is directed towards the government's efforts in controlling and eradicating the disease.

H5N1 first hit Egypt in February 2006. So far, 63 people have contracted the virus, 23 of which died and 35 were treated. Three patients are still undergoing treatment.

On Wednesday, another case was reported of a two-year-old from a village in Giza.

This week, the Ministry of Health announced that 6,337 cases were isolated for suspicion of carrying the virus. From Cairo alone 843 cases were tested but were all found negative.

The highest infected cases were found in Menufiya with seven people carrying the disease. Six cases were reported in Fayoum and Qena each; while Menya, Qaliubiya and Gharbeya reported five cases each.

Three cases were reported in each of Cairo, Aswan, Kafr El-Sheikh and Daqahleya, two cases in each of Assiut, Sohag, Beni Suef, Damietta, and Sharqeya, while Alexandria, Suez and Beheira only reported one case each.

Young victims

The disease has spread among children between the ages of one and two over the past month.

An 18-month-old child was reported to contract the H5N1 virus on March 10.

full story
http://www.thedailynewsegypt.c...

United we stand: Divided we fall

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by: cottontop @ Thu Apr 09, 2009 at 20:32:05 PM CDT

From Zenobia's blog:

Suspicion does not mean Confirmation

http://egyptianchronicles.blog...

I do not know what to say except that I have been worried since I read the headlines of Al Wafd newspaper in the front page.

"The ministry of health hided 27 H5N1 human infection cases in 3 days !!"

Do not be shocked because inside you will find that Al Wafd newspaper claims that it has documents proving that the ministry of health had hided 27 H5N1 suspected infection cases in 3 days !! So all those 27 cases are suspected and were not declared to be H5N1 positive. This is silly and unscientific talk because from now and then we read in the newspapers about suspected cases across the country especially that the symptoms of H5N1 may start as severe flu.

The newspaper continues describing the spread of the disease as alarming and that there would be a cabinet meeting to discuss the situation .

Dangerous allegation to the health ministry for sure ; already it has not passed 24 hours when it issued a quick press release denying these allegations. It is clever and wise act from the ministry in order not to spread panic in the country because of these headlines. I understand the kind of worry of those who really care about the country but there is no use to spread panic in this way. Already the ministry of health can't hide any case what so ever from the WHO. The WHO fears that fearful scenario would take place in Egypt thanks to the rapid infection rate in Egypt.

The government knows the challenge it is facing currently and unfortunately it can't act as it is doing with the rest of the problems in the country because this is time it is an international issue , the government is monitored internationally and this is why it is honest compared to other issues in the country , it is sad thing but true.

Ahmed Nazif ,the prime minister is thinking of a very dangerous decision that will make the people more mad and angry from him than they are already. The e-prime minister wants to ban raising domestic poultry !! I do not want to imagine how much anger this decision will cause among the Egyptians especially in the country side and among the working classes who raise poultry as sort of cheap food and also a source of income. Yes domestic poultry is the source of infection in Egypt , the main source of infection but it is not like that Egyptians are the only people in the world who raise domestic poultry.

The e-cabinet can come with other solutions for sure including other substitute food price reduction !!

I believe what we suffer from is an awareness problem , you should increase the awareness campaigns outside Cairo ,go to the radio stations especially the Holy Quran radio station , the songs radio station and that new football radio station which I do not know its name. The preachers in Mosques and Churches in country side should speak about H5N1 and how it is important to have the domestic poultry vaccinated and how it is more important to get rid from dead domestic poultry !!

Imposing ban on raising domestic poultry means forcing people to buy frozen poultry ,which is much more expensive than domestic poultry in a cost wise way; the Egyptians can't take anymore economic burdens. Anyhow I do not expect that the people will even listen to this ban if it is imposed.

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by: Pixie @ Fri Apr 10, 2009 at 08:42:31 AM CDT

Link for the Al-Wafad story referenced above:

http://www.alwafd.org/details....

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by: Pixie @ Fri Apr 10, 2009 at 08:43:19 AM CDT

[ Parent ]

More:

Learned "delegation" Dr. Ahmed Nazif, Prime Minister responded to the delegation on the first raised on the Government to ignore the crisis, and decided to hold an emergency meeting next week attended by Dr. Abdel Salam Mahgoub, Minister of Local Development and the Secretary of Abaza, Minister of Agriculture, Dr. Hatem el-Gabali Minister of Health to discuss coping with the disease as well.

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by: Pixie @ Fri Apr 10, 2009 at 09:27:40 AM CDT

[ Parent ]

Ministry of Health to cover up 27 cases of bird flu during 3 days !!

Issue Date: 10/4/2009
http://www.alwafd.org/details....

The emergence of new hotbeds of satisfactory and the position of the American experts

Emad wrote the best: the bird flu crisis escalated over the past few weeks. Failed government attempts at addressing the disease, and stopping the spread.

Dr. Amr Qandil, Director of Infectious Disease in the Ministry of Health, increase the incidence of the disease during the last three months, 12 cases against 7 situations only during the same period last year. Also increased suspected cases to 348.

As Dr. Hamed Samaha Chief of Veterinary Services for the increase in the number of spots during the last three months, 44 focused in 12 provinces compared to 128 focused over the past year in 19 counties.

Attributed Dr. Samaha, crisis is due to a lack of funds, demanded upwards, and support of the veterinary services so that they can deal with the hotbeds for the spread of.

Obtained "delegation" documents revealed by the Ministry of Health uncovering 27 cases of suspicion of injury within days 2 and 3 and 4 April.

The Ministry of Agriculture had sent me to Dr. made Director of the Institute of Animal Health Research, Dr. Mohamed Hassan coach laboratory to the United States for the presentation of the reality of the disease in Egypt American experts, and access to the best methods to meet the advance of the disease and its spread.

Learned "delegation" Dr. Ahmed Nazif, Prime Minister responded to the delegation on the first raised on the Government to ignore the crisis, and decided to hold an emergency meeting next week attended by Dr. Abdel Salam Mahgoub, Minister of Local Development and the Secretary of Abaza, Minister of Agriculture, Dr. Hatem el-Gabali Minister of Health to discuss coping with the disease as well.

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by: Pixie @ Fri Apr 10, 2009 at 09:42:34 AM CDT

The detention of two suspected bird flu in Upper Egypt

Saturday, April 11 2009

Qena (Egypt) -, AP -

Authorities have detained the health in Qena, Upper Egypt on suspicion of two children infected with bird flu.

Said Ayman Abdel-Moneim, Under-Secretary, Ministry of Health Rawash said Saturday the detention of children was Nabil Abdel-Naim (eight years), Muhammad Arif (six years), we inaugurated the Center of the hospital admitted Qena (approximately 700 km) south of Cairo, after displaying symptoms similar to the disease after ... bird .

He added: "Samples were taken and sent them to the central laboratory in Cairo for analysis and description of how bird flu or not, and to take preventive action with members of their families."

translated from arabic
http://www.alquds.com/node/152845

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sat Apr 11, 2009 at 16:21:29 PM CDT

New bird flu cases suggest the danger of pandemic is rising

.
Infections in Egypt raise scientists' fears that virus will be spread by humans

By Geoffrey Lean, Environment Editor
Sunday, 12 April 2009
REUTERS
http://www.independent.co.uk/n...

First the good news: bird flu is becoming less deadly. Now the bad: scientists fear that this is the very thing that could make the virus more able to cause a pandemic that would kill hundreds of millions of people.

This paradox - emerging from Egypt, the most recent epicentre of the disease - threatens to increase the disease's ability to spread from person to person by helping it achieve the crucial mutation in the virus which could turn it into the greatest plague to hit Britain since the Black Death. Last year the Government identified the bird-flu virus, codenamed H5N1, as the biggest threat facing the country - with the potential to kill up to 750,000 Britons.

The World Health Organisation is to back an investigation into a change in the pattern of the disease in Egypt, the most seriously affected country outside Asia. Although infections have been on the rise this year, with three more reported last week, they have almost all been in children under the age of three, while 12 months ago it was mainly adults and older children who were affected. And the infections have been much milder than usual; the disease normally kills more than half of those affected; all of the 11 Egyptians so far infected this year are still alive.

Experts say that these developments make it more likely that the virus will spread. Ironically, its very virulence has provided an important safeguard. It did not get much chance to infect other people when it killed its victims swiftly, but now it has much more of a chance to mutate and be passed on.

The WHO fears that this year's rise in infections among small children, without similar cases being seen in older people, raises questions about whether adults are being infected but not falling ill, so acting as symptomless carriers of the disease. Its investigation, due to start this summer, will see if this is happening by testing the blood of people who may have been in contact with infected birds, but who have not themselves become sick.

John Jabbour, who works with WHO in Cairo, told Reuters last week: "There is something strange happening in Egypt. Why in children now and not in adults? We need to see if there are sub-clinical cases in the community." He added that if the research did find such cases, they would be the first to be discovered anywhere in the world.

Though he stressed that there was still no evidence of the disease passing from person to person, other experts are also becoming alarmed. 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.

Even a much less virulent strain of the virus could result in a devastating pandemic. Studies show that an outbreak that killed as few as 5 per cent of those it infected could still cause hundreds of millions of deaths around the world.

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by: Pixie @ Sat Apr 11, 2009 at 22:06:58 PM CDT

Curious ProMED Comments on Mild H5N1 In Egypt

Recombinomics Commentary 06:50
April 13, 2009

"On the other hand, all the patients had exposure to diseased or dead poultry, and they likely contracted infection from that source and not from human carriers. Furthermore, there has been no evidence of
onward transmission of infection to family members.

Several of the children are still in critical condition, and all may not survive."

The above comments at ProMED are curious. They are made in association with another English language report raising concerns associated with the H5N1 cases in Egypt. The concerns center on the concentration of confirmed cases in toddlers, between the ages of 1 ½ and 2 ½, as well as the mild nature of the cases. None of the confirmed cases in 2009 have died and 10/12 cases are toddlers. Moreover, the cases not only recover, but the courses are mild.

Only one of the 10 toddler cases was in critical condition, and that case along with nine other toddlers has been discharged. The three cases that are currently hospitalized include two toddlers, and both have been characterized as being in "good general condition". There was no indication that these two cases or any of the seven other cases were ever in critical condition or had developed pneumonia or had been placed on a respirator. Moreover, the most recent case, who was not a toddler, was said to be improving, reducing the likelihood of death. Thus, it is clear that there is little likelihood that any of the confirmed H5N1 cases in toddlers will die, and survival is in question for only one of the 12 confirmed cases.

This low case fatality rate is similar to the cases in the spring of 2007. Those cases were generally older and were large children between the ages of 3 and 10. Among this group, 16/17 survived and again the cases were mild and few developed pneumonia or were placed on a respirator. There was little evidence to suggest this low case fatality rate was tied to prompt oseltamivir treatment because the 10 cases prior to the mild cases in 2007 were fatal and the cases between the mild cases in 2007 and the mild case in 2009 involved patients in critical condition and most of those cases also died.

Thus, the mild cases involving children in 2007 and toddlers in 2009 has raised concerns that H5N1 has been spreading via mild cases and this spread has produced protective immunity in older cases, resulting in a high concentration of toddler cases in 2009.

This concern has been increased by the lack of testing of patients that have symptoms but no connection to dead and dying poultry, as well as the high number of patients hospitalized with symptoms and poultry contact. Less than 1% of these patients are PCR positive, raising concerns of a high number of false negatives among these hospitalized patients.

Similarly, the detection of H5N1 in two cousins who were next door neighbors and developed symptoms four days apart raise additional concerns that there was onward transmission to a relative, linkages to dead or dying poultry notwithstanding. There have been no H5N1 confirmed poultry deaths reported near the Beheira households of the cousins (see updated map) and these has also been no confirmed poultry deaths in Qena (see updated map), the location of H5N1 infected toddler confirmed prior to the Behiera cousins. The lack of reports of confirmed poultry deaths near these recent confirmed cases has raised concerns further.

Therefore the comments in ProMED, which extend the number of commentaries denying human to human transmission of H5N1, continue to be hazardous to the world's health.

http://www.recombinomics.com/N...

United we stand: Divided we fall

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by: cottontop @ Mon Apr 13, 2009 at 05:43:20 AM CDT

3 detained in Qena Qalubia on suspicion of bird flu

12/Apr/09

Hospital admitted Qena arrested yesterday on suspicion of two children infected with bird flu, also detained in hospital fevers Qaliubiya Banha, a young man for the same reason, and the Vice-Suez requested a briefing in which he accused the government of failing to cope with the disease, describing the plans of combating b «imaginary».

In Qena, was arrested Nabil fever hospital Abdalenaim «8 years», and Muhammad Arif «8 years», on suspicion of SARS after the emergence of the disease symptoms similar to them, said Dr. Ayman Abdel-Moneim, Under-Secretary, Ministry of Health, said that the two samples were taken and sent to labs central Cairo for analysis, and sampling of domestic birds to be sent to the Agriculture Ministry's labs for analysis and clean up the houses and the adjacent houses.

In Qaliubiya detained hospital milk fevers, Desouk Tantawi Mohamed Tantawi «25 years», on suspicion of being infected with the disease, said Dr. Abdul Qadeer Faraj, Under-Secretary of the hospital, the patient was hospitalized for almost 6 days with a fever and was transferred from the hospital, thanked the Kafr Central, who tend to show that the birds were taken from the sample and sent to central laboratories for analysis, and isolation and to take necessary action.

For his part, the Saad al-Khalifa, a member of the People's Chamber of Suez, for notification to the President of the Council of Ministers, ministers of health, agriculture and finance, on the government's inability to combat the disease, criticized the number of infections to 63 cases, according to official figures of the Ministry of Health, despite warnings from scientists virus may mutate into a human infection directly, which would lead to disaster.

Khalifa said that the directors of the general discussion of Veterinary Medicine in the provinces, revealed the existence of a large financial deficit of around 85%, have been appropriated for the plan to combat the disease in 2009, explaining that he had been allocated 177 million pounds is not only the provision of only 27 million,

He pointed out that the plan has already faced a shortfall last year, also financially, with the allocation of 188 million pounds, did not have only 36 million only, which indicates a lack of government's seriousness in the face of the disease.

Khalifa and asked about the reasons for the lack of funds allocated to fight the disease and to develop realistic plans rather than plans, which he has been monitoring Balohmip large sums on paper without implementation on the ground.

http://translate.google.com/tr...

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by: cottontop @ Mon Apr 13, 2009 at 05:51:30 AM CDT

Avian Influenza, Human (72): Egypt, Virulence

Infections in Egypt raise scientists' fears that the virus will be spread by humans.  This paradox -- emerging from Egypt, the most recent epicentre of the disease -- threatens to increase the disease's ability to spread from person to person by helping it achieve the crucial mutation in the virus which could turn it into the greatest plague to hit Britain since the Black Death.  Last year [2009], the government identified the bird-flu virus H5N1 as the biggest threat facing the country, with the potential to kill up to
750 000 Britons.

The World Health Organization (WHO) is to back an investigation into a change in the pattern of the disease in Egypt, the most seriously affected country outside Asia.  Although infections have been on the rise this year [2009], with 3 more reported last week, they have almost all been in children under the age of 3, while 12 months ago, it was mainly adults and older children who were affected.  And the infections have been much milder than usual; the disease normally kills more than half of those affected; all of the 11 Egyptians so far infected this year are still alive.

Experts say that these developments make it more likely that the virus will spread.  Ironically, its very virulence has provided an important safeguard.  It did not get much chance to infect other people when it killed its victims swiftly, but now it has much more of a chance to mutate and be passed on.  The WHO fears that this year's [2009] rise in infections among small children, without similar cases being seen in older people, raises questions about whether adults are being infected but not falling ill, so acting as symptomless carriers of the disease.  Its investigation, due to start this summer, will see whether this is happening by testing the blood of people who may have been in contact with infected birds but who have not themselves become sick.

John Jabbour, who works with WHO in Cairo, told Reuters last week:

"There is something strange happening in Egypt.  Why in children now and not in adults?  We need to see if there are sub-clinical cases in the community." He added that if the research did find such cases, they would be the 1st to be discovered anywhere in the world.  Though he stressed that there was still no evidence of the disease passing from person to person, other experts are also becoming alarmed.
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 [12 Apr 2009] 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.  Even a much less virulent strain of the virus could result in a devastating pandemic.  Studies show that an outbreak that killed as few as 5 percent of those it infected could still cause hundreds of millions of deaths around the world.
**************************************************************

As of 5 Apr 2009, it remained true that there had been no deaths among patients in Egypt with confirmed avian H5N1 influenza virus infections since the resurgence of the illness in Egypt in late 2008.
11 of these 13 patients have been children 6 years of age or younger. These data do indeed suggest that there may have been a reduction in the virulence of the outbreak strain, and there is a perceived risk of progression of the virus to less a virulent but more transmissible form.

On the other hand, all the patients had exposure to diseased or dead poultry, and they likely contracted infection from that source and not from human carriers.  Furthermore, there has been no evidence of onward transmission of infection to family members. Several of the children are still in critical condition, and all may not survive.  Another relevant factor in evaluation of the Egyptian situation is the immediate resort to treatment with the influenza virus neuraminidase inhibitor Tamiflu.

The proposed WHO study is an important initiative in attempts to define properties of avian influenza virus that may convert it into a human pathogen. More info here:

http://apex.oracle.com/pls/otn...

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by: cottontop @ Mon Apr 13, 2009 at 07:09:21 AM CDT

Insufficient resources to combat avian flu, say experts

By Tamim Elyan
First Published: April 13, 2009

CAIRO: Vaccines available against avian flu only cover 36 percent of 300 million birds in rural farms, according to a workshop held Sunday by the UN Food and Agriculture Organization (FAO) and the General Authority for Veterinary Services.

Titled "Evaluation of the National Campaign to Combat Avian Flu," the workshop brought together experts who said that veterinary authorities' efforts only cover 10 percent of poultry production.

They also criticized the inefficiency in testing for other diseases and monitoring animal slaughterhouses.  

"The amount of vaccinations is barely sufficient to cover the workforce that will distribute them and the responsive farmers who are willing to vaccinate their birds," Saber Abdel Aziz, head of the epidemic and poultry diseases at the General Authority for Veterinary Services, told Daily News Egypt.

Abdel Aziz said that 600 million doses are needed to cover the entire poultry sector; however, the authority can only afford to provide 120 million doses.

Participants at the workshop criticized the lack of sufficient human and financial resources and called for a more active role by the veterinary services authority in combating the virus.

"Out of 13,000 registered veterinarians, we only have 6500 available, 70 percent of which are unqualified for field work because they are over 50 years old. We end up with only 1,200 veterinarians while at least 5,000 are needed," Abdel Aziz said

He explained that no new veterinarians have been appointed since 1994 because of the lack of funds.

Abdel Aziz added that there is a lack of preventive equipment such as special vests or cars to transfer veterinarians. "We only have 1,350 cars, that's one car for every 20 veterinarians."

Hamed Samaha, head of the General Authority for Veterinary Services said that Minister of Agriculture Amin Abaza filed a request to Cabinet, asking them to assign the faculty of veterinary medicine graduates to work in various governorates to contain avian flu.

"Only two percent of poultry farms apply bio-security measures," Samaha said.

According to Abdel Aziz, in 2006 the first avian flu campaign vaccinated 90 million birds. However, subsequent campaigns didn't achieve the same level of success because farmers were unresponsive.

"It is a problem of awareness," he said.

"At first farmers were concerned so they cooperated with the authorities but now they are more confident so they don't respond to our efforts," he said.

He was, however, optimistic about efforts this year.

http://www.thedailynewsegypt.c...

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by: cottontop @ Tue Apr 14, 2009 at 05:32:29 AM CDT

Egypt Seeks UN Bird-Flu Probe .....

Egypt Seeks UN Bird-Flu Probe After Non-Fatal Cases (Update1)

By Jason Gale

April 13 (Bloomberg) -- Egypt asked the World Health Organization to help investigate an outbreak of bird flu after a dozen non-fatal cases of the disease this year prompted speculation the virus may be becoming less virulent.

Two WHO doctors and a scientist will travel to Cairo later this week at the request of Egypt's Ministry of Health, said Gregory Hartl, a spokesman for the United Nations agency in Geneva, in an interview today. The UN team will assist local authorities identify how the patients were infected with the H5N1 strain of avian influenza and whether there have been any significant changes in disease patterns or in the virus itself.

Scientists have been following H5N1 for more than a decade because of concern it could spark a pandemic if it becomes as infectious for humans as it is for poultry. A less lethal strain could be more contagious because people would have longer to transmit it through coughing and sneezing. None of the 12 Egyptian cases reported to the WHO this year has been fatal.

"These data do indeed suggest that there may have been a reduction in the virulence of the outbreak strain, and there is a perceived risk of progression of the virus to a less virulent but more transmissible form," the International Society for Infectious Diseases said today in an e-mail via its ProMED-mail program.

The survival of H5N1 patients in Egypt also may reflect early treatment with antiviral medicines, ProMED said.

At least 417 people in 15 countries have contracted the virus since 2003. Three of every five cases worldwide were fatal. Most cases were caused by contact with infected poultry, such as children playing with them or adults butchering them or plucking feathers, according to WHO.

full story
http://www.bloomberg.com/apps/...

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by: cottontop @ Tue Apr 14, 2009 at 05:48:56 AM CDT

Suspected cases of bird flu in Fayyoum

Suspected cases of bird flu in Fayyoum citizen and the Governor of Kafr El-Sheikh recognize some farms the disease, injury

Mohamed Magdy Farghali Oboualainin 4-13-2009   Detained hospital admitted yesterday Fayyoum Ibrahim Ibrahim (50 years) suspected of having bird flu. "Said Dr Hussein Sophie Abutaleb, Under-Secretary, Ministry of Health to preserve, the situation of the village of Nasiriyah, Ibcoay Center, and was admitted to hospital suffering from a very high temperature, samples were taken from the plants to be sent to the central ministry to know whether he was infected with the virus or not.

The quality of the mind, Dr. Mahmoud, Director of Veterinary Medicine in the government, was formed from the Directorate of the Commission moved to the house of the citizen, and the execution of the existing domestic birds, and the neighboring houses, as a precautionary measure following the withdrawal of samples for analysis to indicate whether the carrier of the virus or not.

In Kafr el-Sheikh admitted conservative Abdin Ahmed Zaki injured some farms with bird flu, and pointed to the recent session of the local province, in response to a question submitted by a member Ahmed copper, to the rumors of the existence of bird flu in parts of heavily blacked out, is the preservation of the executive branch and that, following the situation daily and cost-Azim Al-Hussein, Undersecretary of the Ministry of veterinary medicine, the transition to self-reported places of infection of people, the latest Safan Sidi Salem village, where the injury turned out a poultry farm was destroyed.

http://translate.google.com/tr...

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by: cottontop @ Tue Apr 14, 2009 at 08:21:27 AM CDT

H5N1 Receptor Binding Domain Changes In Egypt

Commentary

Recombinomics Commentary 04:27
April 15, 2009
http://www.recombinomics.com/N...

Similarly the results of H5N1 strains from Egypt (Figure 2) may be indicative of a possible viral evolution towards receptor usage similar to that of H1N1 viruses, which efficiently replicate in the upper respiratory tract. The protein domain, which seems to be involved in this subtle change, corresponds to amino acid domain 99-132.
=========================

The above comments, from "Characterization of conserved properties of hemagglutinin of H5N1 and human influenza viruses: possible consequences for therapy and infection control" describe a subset of H5N1 sequences from Egypt that have chacteristics that match H1N1 seasonal flu. These matches include sequences from the Ghabiya cluster, as well as two Qena siblings with mild H5N1 in the spring of 2007. The sequences from the siblings had a 3 BP deletion that produce S129del, which is within the region listed above, Although the disease onset date of the index case was withheld from the WHO update, the hospital admission dates were four days apart, signaling the infection of the brother (4M) by his sister (6F). The sequences from the Qena siblings were identical, further supporting H2H transmission. Moreover, additional family members had symptoms, but tested negative.

This year there has been another cycle of mild cases in Egypt, but instead of affecting children between the ages of 3 and 10, like the siblings above, 10/12 cases are toddlers. However, like the cases in the spring of the 2007, the case fatality rate is low (in 2007 only 1/17 died, and this year 0/12 have died) and most patients did not develop pneumonia. These mild cases, coupled with the younger age group, raise concerns that H5N1 spread in the past two year was far more extensive than indicated by the confirmed cases, and were missed by current testing, which requires a poultry contact for H5N1 PCR testing.

Although NAMRU-3 has not released any human or poultry sequences this year, the first two human isolates were represented in a recent HA tree of vaccine targets. Although public sequences are not on the branch with the 2009 isolates, the location of the branch suggests these isolates also have the 3 BP deletion and are closely related to the sequences in the siblings from 2007.

The four day gap in admission dates for the Qena siblings, matches the four day gap in the disease onset dates for two cousins (both 2M) from Beheira. The cousins are next door neighbors, and the four day gap also indicated human to human transmission, further supporting the spread of mild H5N1.

The 3 BP deletion produces S129del and position 129 is in the receptor binding domain. This deletion maps to the region in H5N1 with similarities with H1N1, suggesting more efficient transmission, consistent with the clusters in Qena and Beheira.

Release of the sequences from the H5N1 cases this year would be useful. If these sequences have the same deletion as seen in the Qena cluster, an extensive screening of toddlers without a poultry connect is critical.

The failure to recognize the significance of the mild cases in 2007 is cause for concern. The failure to aggressively act at this time is beyond scandalous, and is hazardous to the world's health.

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by: Pixie @ Wed Apr 15, 2009 at 01:59:07 AM CDT

Egyptian woman contracts bird flu: agency

CAIRO (Reuters) - A 33-year-old Egyptian woman has contracted the highly pathogenic bird flu virus, (Snip)
MENA said the woman came from the northern province of Kafr el-Sheikh. Her case brings to 64 the number of confirmed cases of the H5N1 avian flu virus in Egypt, which has been hit harder by bird flu than any other country outside Asia.

Health Ministry spokesman Abdel Rahman Shahine said the woman had started to show symptoms on April 7 after coming into contact with dead birds.
(Snip)
Since 2003 the H5N1 avian influenza virus has infected at least 411 people in 15 countries and killed 254. It has killed or forced the culling of more than 300 million birds in 61 countries in Asia, the Middle East, Africa and Europe.

Some 23 Egyptians have died after contracting the virus. Most came into contact with infected domestic birds in a country where roughly 5 million households depend on domestically raised poultry as a significant source of food and income.

The World Health Organization said this month it was concerned some Egyptians may carry the bird flu virus without showing symptoms, which could give it more of a chance to mutate to a strain that spreads easily among humans.

http://www.reuters.com/article...

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by: cottontop @ Wed Apr 15, 2009 at 20:56:11 PM CDT

H5N1 Human Infection No.64 in Egypt

From Zenobia's blog:

Wednesday, April 15, 2009
http://egyptianchronicles.blog...

The ministry of health has announced today officially H5N1 human infection No.64. 33 years old Sadia Ahmed Abdel Latif from Kafr El-Sheikh is no.64 in the long human infections record of Egypt.

She showed the symptoms of the virus starting on the 6th of April , she entered the hospital on the 8th of April ,she was given tamflu still her condition is critical right now , insh Allah she will pass this critical phase and recover soon.

Of course the regime is busy fighting the fearful Hezbollah cell that will bomb the high dam in Aswan and is ignoring the big health time bomb in Egypt right now.

It is reported that 40% of poultry in the market are infected by H5N1 and the WHO believes the virus will evolve to human to human infection in Egypt and we act in a very passive mode as if we do not have a serious matter to deal with. I do not eat chicken anymore for God Sake !!!

By the way I heard that we are importing H5N1 infected poultry ,I do not know how if we have this so-called Vet. inspection committee but I won't be shocked if this is true.
_______________

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by: Pixie @ Thu Apr 16, 2009 at 07:18:18 AM CDT

Kafr El-Sheikh woman critically...

Kafr El-Sheikh woman critically ill with bird flu

CAIRO: A 33-year-old woman has contracted bird flu, the 64th recorded case since the first outbreak of the disease in Egypt in 2006, the health ministry announced on Wednesday.

The woman from the Kafr El-Sheikh province of northern Egypt is in critical condition and on an artificial respirator, state-run news agency MENA quoted a health ministry official as saying.

She first showed symptoms of the flu more than a week ago after being exposed to dead fowl thought to have been carrying the disease, the official said.

Egypt has seen an increase in bird flu cases over the past month. The World Health Organization (WHO) called last month for an investigation into why many of the victims have been young children.

Twenty-three people have died of bird flu in Egypt. Most of the victims have been young girls or women, who are generally in charge of looking after poultry in rural areas.

Egypt hosted an international conference on bird flu in October, when Washington pledged an additional $320 million to the fight against the disease amid fears it may yet escalate into a global pandemic.

The H5N1 strain of the virus that is most dangerous to humans first emerged in Asia in 2003 and has since caused nearly 250 deaths, according to WHO figures.

Scientists fear that a mutation of the bird flu virus resulting in a strain easily transmitted among humans could create a pandemic, potentially affecting up to one-fifth of the world's population. -AFP

http://www.thedailynewsegypt.c...


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by: cottontop @ Fri Apr 17, 2009 at 07:29:23 AM CDT

WHO update

http://www.who.int/csr/don/200...

17 April 2009 -- The Ministry of Health of Egypt has reported a new confirmed human case of avian influenza . The case is a 33 year old female from Kellin district, Kfr El Sheikh Governorate. Her symptoms began on 7 April and she was hospitalized at Kfr El Sheikh Fever Hospital on 15 April where she was started on oseltamivir the same day (15 April). She is in a critical condition.

Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 15 April.

Investigations into the source of her infection indicate a history of close contact with dead and sick poultry prior to becoming ill.

Of the 64 cases confirmed to date in Egypt, 23 have been fatal.

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by: AlohaOR @ Fri Apr 17, 2009 at 22:57:43 PM CDT

[ Parent ]

Egypt Reports 65th Human Case of Bird Flu

2009-04-18 05:53:53     Xinhua      Web Editor: Sun Yang

The Egyptian Health Ministry said Friday that a 25-year-old woman has contracted bird flu virus, bringing the human cases of the fatal avian influenza to 65 in the populous country.

The woman, Hadiye Salah Ragab who comes from a northern neighborhood of Cairo, was admitted to hospital on April 11 and is now in critical condition after receiving treatment, the ministry said in a statement.

Earlier on Wednesday, Saadia Abdul Latif, a 33-year-old Egyptian woman from the Kafr el-Sheikh governorate, was also hospitalized after contracting the deadly virus.

Egypt is the most affected country by the deadly avian influenza outside Asia. It reported its first H5N1 virus in dead poultry in February 2006 and the first human case in March of the same year.

The death toll of the human cases of bird flu is 23 so far in Egypt.

According to the latest statistics of the World Health Organization on its website, some 418 people in 15 countries and regions have contracted the virus and 257 of them died of the disease.

http://english.cri.cn/6966/200...

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by: cottontop @ Fri Apr 17, 2009 at 19:08:32 PM CDT

8 cases of detention of Damanhour....

hat tip hattip Fla1

8 cases of detention of Damanhour admitted to hospital on suspicion of bird flu

Books - Tareq Aziz, Mohammad Eissawi:

Detained hospital fevers Damanhour 8 cases of suspected bird flu patients who are: Kawther Abdul Raouf «50 years of age - housewife» Fawzia Mohamed «51 years of age - housewife» Ramadan full faith and «38 years» and Ihab Abdul-Muttalib, son 8 years, Sarah Khalil «7 years »Amr Abdel Nasser« 3 years »and meet the warrior rather than« 33 years housewife »Mbrokp Ghazi Bader and« 42 years housewife », after the emergence of symptoms of the disease are similar to high temperature, sore throat and difficulty in breathing, where blood samples were taken from the injured and sent to central laboratories for testing.

For his part, Major General Mohammad Sha'rawi governor lake several resolutions to combat bird flu to prohibit the transfer or trading of all kinds Taioralehip without permission from the Directorate of Veterinary Medicine Lake In the case of controlling the movement of the car in which the bird is a fine driver, up to 500 pounds, with the execution of all the birds after sampling in the absence of proven integrity and provides resolutions to ban the transfer of conservative Sblp «remnants of birds» of farms that have been shown to act without authorization from the Directorate of veterinary medicine in return for collecting the amount of twenty pounds on the declaration in the case-control cars loaded Balsplp be executed without a permit means Sblp health and environmental sound, under the auspices of the Committee concerned with the collection of a fine set at 500 pounds seized from the vehicle with the ban on domestic poultry breeding in cities with the removal of all special education, which nest there in the balconies of the houses with a fine of 200 pounds on the contrary, and prohibits the sale of birds in the shops and the imposition of a fine 300 pounds or 15-day closure for the assignee violation.

For its part, the health ministry said that the total 64 cases that have been positive so far, since the disease appeared in Egypt in February 2006, 61 of them had been wounded because of the birds coming home with two of them was a result of their poultry farms, while only one case was of a girl was the result of a work stores that sell live birds, the ministry's statistics point out that 2007 was the fiercest in terms of numbers of bird flu infection, with the 25 people in 2006, followed by 18 cases in 2009 and then being injured 13 b while the 2008 is the last least in terms of numbers of cases where the affected recorded 8 cases only.

translated article
http://dostor.org/ar/content/b...

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by: cottontop @ Sat Apr 18, 2009 at 12:34:57 PM CDT

Mutation probability of the disease...

hattip treyfish who hattipped Sally ;-)

(suspect patient #65 was 33 weeks pregnant.-cottontop)

Saturday, April 18, 2009 - 16:10
Shaheen: Shaaban Abdel Rahim singing of bird flu was intended
Mutation probability of the disease and its transmission among humans in Egypt, great - Camera Essam El Shami

Written by Amira Abdel-Salam

The dawn of the 65 confirmed case of bird flu, a series of questions, especially as it was confirmed after the case of 64 a few hours, are we to a new outbreak of the disease at the end of the winter season? Or to the crisis in the ministry's plan to combat the disease? "Is Tamiflu is still effective in the treatment of infected cases? Or is it just a housing crisis erupted Pthor Verosha avian flu and its transmission among humans?.

Warned the Minister of Health. The woman in a clear message, from the negligence or inaction in dealing with avian influenza, mutate, and because the probability of transmission among humans in Egypt, a large, if there was any kind of complacency in dealing with the flu.

D students. Hatem mountain groups of the Egyptian society, especially groups that deal directly with live birds, the need for caution when dealing with the flu, saying: "We are not calling to prevent the breeding of domestic birds, because it is a source of income for the family, particularly in the areas rural, but following the instructions call for sound health in dealing with the flu. Although a tribute to all the international organizations in Egypt in the face of bird flu control, but that does not mean that we have eliminated the disease, the disease is still in its strength and fear it could mutate and spread from human to human person, and here occur delinquent that take the lives of millions of people and cause economic losses estimated Baltreionat of dollars.

D said. Amr Qandil head of infectious diseases, the Ministry of Health and a member of the National Committee to combat bird flu, said that there are a total of 3 million doses stocks, Ministry of Health strategic drug Tamiflu, the drug only to the processor after the emergence of avian flu symptoms to humans in the early stages, but if the patient's income in a stage of the second degree or late, thus this drug is ineffective, calling on all citizens to go to the nearest health unit or hospital to take the property even in cases of suspicion, which has a positive impact on the recovery situation in the event of confirmed infected with HIV, saying that the ministry is ready to viral mutations in the first stage, even if it turned into an epidemic transmissible between humans.

D said. Abdel-Rahman Shahin, official spokesman of the Ministry of Health and Population, the Ministry launched a national campaign by anti-virus bird flu prevention campaign, pointing out that this information campaign is a campaign to raise awareness of the dangers of the disease include the press, radio and television Vgina "Shaaban Abdel-Rahim," avian influenza not just a "bang" as they are to educate citizens in order to reach all groups, especially the most vulnerable to the disease.

This is in addition to the epidemiological surveillance of the disease by isolating the case until
6337 on suspicion of being infected with the disease, but it was all negative, province of Egypt
came first in the rankings in terms of the number of suspected cases, which amounted to 843 cases, followed by the province of
the West 802 the case, then Al-b 519 case Monoufia 512 and 486, Giza, Damietta and Alexandria, 449 and 403 and 353 Qaliubiya Dakahliya 322 and 294, Menya, Sohag and Qena, 284 and 215 Fayyoum 187 suspected and Beni Suef 172 and 152 lake and 129 East, then 82 and Aswan Asyut 40 case 30 case of Ismailia Luxor 17 and 13, Port Said, Suez and the valley 7 new Helwan, South Sinai, 6 and 4, the Red Sea, North Sinai and 3 cases is one case, the province on October 6, had not been recorded any cases of suspected bird flu, bringing the total positive cases, 65 cases so far.

http://www.youm7.com//News.asp...


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by: cottontop @ Sat Apr 18, 2009 at 16:00:08 PM CDT

From what I am reading....

They are not giving good news about her conditions.
(and I should say that she IS 33 weeks pregnant, not Was)

The Egyptian Ministry of Health Friday, injuring a woman with bird flu, bringing the total number of people infected since the first outbreak in Egypt in 2006 to 65 people.
18/Apr/09

The ministry said in a statement that called the gift Ms. Salah Rajab (25 years) from the prairie into a hospital Demerdash April 11, 2009, has been suffering from very high temperature and cough, and was given the drug Tamiflu, and then deteriorated health condition Friday, a result of shortness of breath and was placed on the a ventilator and her condition is unstable and critical.

Egyptian families are still in rural areas and still maintain the custom of raising poultry at home, leading to contact with children and women.

According to WHO statistics, bird flu has killed nearly 250 people in the world since 2003, mostly in South-East Asia.

translated
http://translate.google.com/tr...

(oh my! Sorry about that looong url)

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by: cottontop @ Sat Apr 18, 2009 at 16:07:50 PM CDT

[ Parent ]

No - the baby was miscarried

at 33 weeks as a result of Salah Rajab's confirmed H5N1 infection:

http://translate.google.com/tr...

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by: Pixie @ Sun Apr 19, 2009 at 21:07:22 PM CDT

[ Parent ]

Egypt - The Ministry of Health to confirm the incidence of the human No. 66 with avian influenza

CAIRO - Editor Masrawy - The Ministry of Health to confirm the incidence of the human No. 66 with avian influenza, a girl named Manar Ibrahim Saad, Zidane, aged a year and a half from the village of Chaabas Amir Kulain province of Kafr el-Sheikh.

And Dr. Abdul Rahman Shaheen said the official spokesman of the Ministry of Health that the onset of symptoms to the patient was on 15 April of this entered the hospital fevers of Kafr el-Sheikh with a high temperature and cough after exposure to dead birds suspected of being infected with bird flu, he said, pointing out that as soon as the suspicion of being infected with the disease were given the drug Tamiflu, a stable and satisfactory condition.

Source: Middle East News Agency

http://www.masrawy.com/News/Eg...

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by: UK - Bird @ Sun Apr 19, 2009 at 16:24:52 PM CDT

This is in the same area (Kafr El Sheik) as WHO confirmed case #64

Saadia Ahmed Abdel Latif Al-Hamid (33) (female).  

Saadia Ahmed Abdel Latif Al-Hamid (33)(WHO #64) had onset 4/7, was hospitalized in Kulain central on 4/8, was moved to Kafr el-Sheikh Fever Hospital 4/15.  Finally - "once suspected" - of having contracted H5N1 she received Tamiflu on 4/15 so there was a substantial delay in her treatment.  

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by: Pixie @ Sun Apr 19, 2009 at 21:26:13 PM CDT

[ Parent ]

Another H5N1 Human Infection case in less than 72 hours

From Zeinobia's blog:

Sunday, April 19, 2009
http://egyptianchronicles.blog...

This is not good.

The ministry of health has announced today that year and half Manar Ibrahim Zidan is No.66 in the H5N1 human infection roll in Egypt. This is so fast , it is less than 48 hours from the announcement of Case No.65 !!

Baby Manar is from a village in Kafr El-Sheikh ,Delta, there were several case from Kafr El-Sheikh this year, I recall case No.64 Mrs. Sadia is from Kafr El-Sheikh too. I hope someone will make a map like the one posted last year with the infections locations and compared it with last year's map. I think Al-Fayoum,Bahaira and Kafr El-Sheikh are the top governorates with the highest H5N1 infection rate.

It seems that we are going to back to babies with H5N1 after all. Anyhow Manar has entered the hospital on the 15th of April and she was given Tamflu and thank God her condition is stable .
_______________

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by: Pixie @ Sun Apr 19, 2009 at 21:05:03 PM CDT

Here's Dr. Niman's map

of the Egyptian cases:

http://tinyurl.com/chl4bs

http ://maps.google.com/maps/ms?=UTF8&hl=en&t=p&msa=0&msid=106484775090296685271.00045e1b92
7e68d58eab0&ll=31.061757,30.790558&spn=0.262332,0.499878&z=11

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by: Pixie @ Sun Apr 19, 2009 at 21:28:53 PM CDT

H5N1 Confirmed Kellin Cluster Causes Concern in Egypt

Commentary

Recombinomics Commentary 21:01
April 19, 2009
http://www.recombinomics.com/N...

The Directorate girl Manar Saad Ibrahim Zidan (18 months) from the village of Chaabas Amir Kulain confirmed the status of her disease
==================

The above translation describes the latest confirmed H5N1 case (#66) in Egypt, who like case #64 is in the Kellin district of Kafr El Sheik (see updated map) raising concerns that this case is related to the earlier case (33F), who developed symptoms on April 7, and possibly is her child (see zoomed Kellin map).

More information on the distance between the residences of these two confirmed H5N1 cases in the Kellin District, as well as any relationship, would be useful.
 

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by: Pixie @ Sun Apr 19, 2009 at 21:31:47 PM CDT

H5N1 Cairo Cluster Delays Raise Transmission Concerns

Commentary

Recombinomics Commentary 22:31
April 19, 2009
http://www.recombinomics.com/N...

Woman, age 25, 33 weeks pregnant, began experiencing symptoms of fever and cough on April 6. She was admitted to Ain Shams Hospital on April 11 and received Tamiflu April 16. Infection with avian influenza was confirmed April 17.
==============================

The above comments detail the gap between admission and the start of oseltamivir treatment for the 65th confirmed case (25F) in Egypt. This five day gap is unusual, because patients with bird flu symptoms and contact with poultry are immediately treated with Tamiflu, and a throat swab is collected for PCR analysis for H5N1.

The delay in treatment for this patient suggests she denied a poultry contact. The possibility is support by the delayed treatment of case #63 (6M), whose treatment was also delayed at the same hospital. Since she was confirmed and was in critical condition, the significance of the treatment should have been well known to the staff at Ain Shams Hospital, because case #63 was also treated there. These two cases appear to be a few miles apart (see updated map), raising concerns that this geographic cluster is signaling more efficient transmission of H5N1.

These concerns were increased by the confirmation of case #66 (2F) in Kafr El Sheik. This case followed a recent case (#64) in Kafr El Sheik in the same district (Kellin). Moreover the 8 day gap in disease onset dates raises concerns that these two cases are related, and case #64 infected case #66.

Such transmission was recent seen in Beheira where two cases from the same districts were subsequently described as next door neighbors and cousins (both 2M). Moreover the 4 day gap in disease onset dates strongly suggests that one cousin infected the other.

The presence of three distinct clusters in Egypt this month, as well as three confirmed cases in three days has raised concerns that H5N1 infections were much higher than the reported 66 cases. The latest case is the 11th toddler between the ages of 1 ½ or 2 ½ in Egypt this year, representing a significant increase in frequency and number of H5N1 confirmed toddlers. This concentration of so many cases in such as small age group (in contrast to 6 toddler cases in the three preceding years), raises concerns that many in older age groups has protective immunity due to a significant prior exposure to H5N1.

These results indicate that toddlers with bird flu symptoms, but no contact with poultry, should be tested for H5N1. Moreover, the 99% of suspect cases with poultry contact who test negative by PCR should be tested fro H5N1 antibodies.

Recent results have suggested that the 3 BP deletion (S129del) in a subset of cases produces similarities with H1N1, and phylogenetic analysis of the first two toddler cases in 2009 had this deletion, raising concerns that this change, which interacts with the receptor binding domain, has produce H5N1 which is more efficiently transmitted.
 

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by: Pixie @ Sun Apr 19, 2009 at 21:32:48 PM CDT

Clutsering H5N1 Clusters Raise Pandemic Concerns in Egypt

Commentary

Recombinomics Commentary 07:40
April 20, 2009
http://www.recombinomics.com/N...

The Directorate girl Manar Saad Ibrahim Zidan (18 months) from the village of Chaabas Amir Kulain confirmed the status of her disease
=========================

The above translation describes the 66th confirmed H5N1 case in Egypt, which is the third confirmed case in three days. However, more alarming than the frequency is the fact that all three cases are members of clusters and the six most recent confirmed cases form three distinct clusters.

The 66th case is a toddler from the Kellin district of Kafir el Sheik as is case #64 (33F). The village of Shabas Emier is only a few miles from the town of Kellin (see updated map), suggesting the two members of the Kellin cluster are from a small geographic area. The precise location of case #64 was not released, but it is possible that both cases are from Shabass Ameir and/or are related or have contact. Since the disease onset dates are 8 days apart, contact between the two cases would strong support transmission of H5N1 from case #64 to case #66.

Similarly, case #65 forms a Cairo cluster with case #63. Both were admitted to the Ain Shams hospital in Cairo and treatment was delayed for both suggesting they denied a poultry connection. These two cases also appear to be a few miles apart at the northern edge of Cairo (see updated map).

The third is the Beheira cluster created by two cousins in . The cousins were next door neighbors and developed symptoms four days apart, strong supporting the infection of one cousin by the other.

These three clusters involving the six most recent confirmed cases create a significant cause for concern. A recent report described a relationship between a subset of H5N1 isoaltes in Egypt and season flu, H1N1, which is efficiently transmitted to humans. This relationship was tightly linked to a 3 BP deletion, which creates S129del, which involves a position that interacts with the receptor binding domain. Moreover, this deletion was in siblings in the Qena cluster in 2007 and the sibling sequences were identical.

Recently a phyologenetic of the first two cases in 2009 in Egypt were released and the psoition of these isolates suggests they also have S129del. If these and other 2009 isolates have this deletion, including the six cases that form clusters in 2009, there would be a genetic explanation of the more efficient transmission represented by the clustering.

The release of the2009 sequences from Egypt is long overdue. NAMRU-3 has not relased any human or poultry from the 2008/2009 season.

In addition, the relationship between the two Kellin cluster members including the distance between residences would be useful.

The clustering of clusters demands more transparency and a much more aggressive testing of toddlers without poultry contact as well as antibody levels in the suspect cases that are PCR negative.

---

by: Pixie @ Mon Apr 20, 2009 at 04:15:21 AM CDT

Egyptian toddler hit by bird flu

08:30, April 20, 2009

The Egyptian Health Ministry said Sunday that a baby girl aged one year and a half has contracted bird flu virus, bringing the human cases of the fatal avian influenza to 66 in the populous country.

The girl, Ibrahim al-Manar who comes from Kafr El-Sheikh governorate north of Cairo, is now in critical condition despite taking the drug Tamiflu, the press center of the ministry said in a telephone interview.

Earlier on Friday, Hadiye Salah Ragab, a 25-year-old woman, who comes from a northern neighborhood of Cairo, was admitted to hospital after contracting the deadly virus.

Egypt is the most affected country by the deadly avian influenza outside Asia. It reported its first H5N1 virus in dead poultry in February 2006 and the first human case in March of the same year.

The death toll of the human cases of bird flu is 23 so far in Egypt.

According to the latest statistics of the World Health Organization on its website, some 418 people in 15 countries and regions have contracted the virus and 257 of them died of the disease.

Source: Xinhua

http://english.people.com.cn/9...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Mon Apr 20, 2009 at 04:44:27 AM CDT

WHO Sending Team to Egypt To Investigate H5N1 Clusters

Commentary

Recombinomics Commentary 18:01
April 20, 2009
http://www.recombinomics.com/N...

Ahram Al-Massai aware that a team of experts from the headquarters of the World Health Organization, Geneva, will arrive in Cairo on Thursday to assess the procedures and monitoring of the Egyptian reality of the situation after the high incidence of infection (66) after a confirmed human case of the Ministry of Health on Wednesday evening from a new infection in a girl from the village Chaabas status Kulain kaafirs Amir Sheikh claims Manar Saad Ibrahim Zidan (18 months)

According to Dr. Nasr's Assistant Minister of Health, and Dr. Amr Kandil Undersecretary for Preventive those tests are conducted for all the positive cases to ensure full identification of the type of infection and the virus and the genetic makeup of it. He said Dr. Abdel Rahman Shahin, official spokesman of the ministry that all the tests proved that there are no changes or mutations in the virus.
===========================

The translation above described a WHO investigation of H5N1 in Egypt scheduled to begin on Thursday. Egypt has reported mild H5N1 cases in toddlers this year. To date there have been 15 confirmed cases, including three in the last three days. So far none have died, although several of the older recent cases have been reported as being in critical condition and on ventilators. All three of the recent confirmed cases belong to geographic clusters, which increases concerns of more efficient H5N1 transmission to humans.

The absence of "mutations" referenced in the above translation merely refers to the lack of reassortment involving human flu genes (as reported to Egypt by Weybridge/Mill Hill, CDC, and NAMRU-3. However, such natural reassortment including H5N1 genes has not been reported anywhere, although there have been multiple descriptions of human to human transmission between close contacts. These examples of H2H2H or H2H transmissions did not involve H5N1 that had acquired human genes. However, for most clusters involving clade 2.2, which is present in Egypt, there have been changes in the receptor binding domain of H5N1 isolates from human clusters.

One such cluster in Egypt involved two siblings from Qena in the spring of 2007. Both sequences had a 3 BP deletion (S129del) and the sequences from the siblings were identical supporting human to human (H2H) transmission based on the 4 day gap in hospital admission dates. These cases well mild and the siblings quickly recovered. Symptomatic contacts tested negative. This 3 BP deletion has been reported in 13 public sequences from Egypt, including human and poultry in 2007 and 2008.

A recent paper on similarities between a subset of H5N1 isolates in Egypt, and H1N1 seasonal flu included the sequences with the 3 BP deletion. Moreover the two examples used in the table and figure in the paper used a human and chicken sequence with the deletion.
The association of position 129 with the receptor binding domain, raises concerns that this change could increase the efficiency of human H5N1 transmission. The WHO phylogenetic tree in the report of vaccine target for 2009 includes the first two HA sequences from Egypt in 2009. Both sequences were similar to each other and appeared to map to the same position as prior public sequences with the deletion. Although WHO has used prior examples of the deletion in reports in 2007 and 2008, no such public sequences were include in the 2009, which makes the assignment of the deletion to the 2009 cases less certain.

The lack of certainty would be removed however if the sequences were released. The WHO tracking system indicates NAMRU-3 has the samples from the 2009 cases, but no sequences have been made public from the 2008/2009 season (human or poultry). The presence of the deletion in some or all of the 2009 would raise significant concern.

These sequences should be made public immediately.

---

by: Pixie @ Mon Apr 20, 2009 at 10:48:02 AM CDT

Avian Flu Cases in Egypt Raise Alarms

By DONALD G. MCNEIL Jr.
Published: April 20, 2009
New York Times
http://www.nytimes.com/2009/04...

An unusual pattern of avian flu cases in Egypt - almost all are in toddlers, all of whom have survived - has led some flu-tracking Web sites to speculate that dozens of silent cases are circulating there.

That would be an alarming development, but other experts, including those at the World Health Organization, say such fears are exaggerated. Although thousands of Egyptians have rushed their children to hospitals this flu season, there is no evidence yet of asymptomatic avian flu cases or any significant mutation in the H5N1 virus.

"Right now, it's all hot air," said Dr. Robert G. Webster, a flu expert at St. Jude Children's Research Hospital in Memphis. "I hope to hell it's not happening, because it would mean the virus is adapting to humans. But there's not a shred of data."

Bird flu has faded from world headlines because it has not caused a pandemic. But the disease is still circulating in poultry in Egypt, Indonesia, China, Vietnam and along the India-Bangladesh border. It has mutated into at least 10 strains and occasionally infects humans.

An April 8 Reuters article from Cairo quoted a visiting W.H.O. expert saying his agency feared "something strange happening in Egypt" and would help the government test the blood of healthy people for antibodies this summer.

Antibodies to the flu would indicate they had recovered from silent infections.

But a W.H.O. spokesman said privately that the agency was just helping the Egyptians with a long-planned study and the article had "jumped the gun."

Translations of Egyptian media reports posted on flu-tracking sites say dozens of suspected cases have been hospitalized, but some seem to confuse avian flu with seasonal flu and even confirmed poultry cases. The Egyptian health ministry, which works closely with a United States Navy laboratory based in Cairo, has confirmed 15 human cases this year, with no deaths; almost all were in young children.

Dr. Nikki Shindo, a W.H.O. medical officer who works in Egypt, said the surge in toddler cases and survivals had a possible explanation. The government has loudly warned its citizens to avoid sick poultry and has trained doctors in remote clinics to give Tamiflu quickly and move cases to state hospitals, where treatment is free. In a country where chickens are both kept as pets and eaten, toddlers still touch dying birds but poultry workers would not.

Egypt's outbreak response contrasts sharply to Indonesia's, where the sick often take herbal medicine first and where rural clinics lack Tamiflu, she said.

Dr. Arnold S. Monto, a flu expert at the University of Michigan School of Public Health who also teaches in Egypt, said even geography helps. All cases are along the Nile and easily moved to Cairo, while travel among Indonesia's thousands of islands is slower.

Also, he said, the government has been more aggressive since it was criticized by opposition parties for not wiping out the poultry epidemic that began in 2006.

Henry L. Niman, a biochemist who tracks flu mutations, has speculated that a mild strain of H5N1 is more common in Egypt than has been found because nasal swabs for flu are inaccurate. He noted that mild cases were found in Qena, Egypt, in 2007, and has called for more testing and for releasing the genetic sequences of strains found in both poultry and people.

Dr. Tim Uyeki, a flu specialist at the Centers for Disease Control and Prevention in Atlanta, said there had been mild cases of H5N1 among children in several countries. There have also, he said, been studies in Indonesia, Thailand, Cambodia and Nigeria similar to the one proposed for Egypt in which the blood of cullers, poultry workers and relatives of sick people has been tested.

"Those are the ideal people to look at," he said. "And there was zero or extremely low prevalence of antibodies," meaning silent infections were very uncommon.

---

by: Pixie @ Mon Apr 20, 2009 at 17:19:17 PM CDT

Europe Supports WHO Investigation of Egyptian H5N1 Clusters

Commentary

Recombinomics Commentary 01:18
April 21, 2009
http://www.recombinomics.com/N...

There are no reports as yet of a change in the virological sequences and it is commendable that the Egyptian authorities have been sharing viruses with the global community as evidence from the WHO A(H5N1) Tracking Mechanism.(6)

However uncertainty remains and it will be important to investigate further. It is very welcome that the Egyptian authorities have invited WHO to send senior staff to Egypt next week to assess the current epidemiological situation.

It is especially reassuring that despite the low CFR and apart from two of the cases in the most recent report there have been no clusters in the cases suggesting more easy human to human transmission.

However it would be hoped that this would be investigated in Egypt with serological surveys to look for milder and asymptomatic cases and any suggestion of clustering since even though the seeming lack of significant change in the sequence of the virus is reassuring the changes can be subtle and its how the viruses behave that is most important.(7)

A good example of such investigations were recently published in the Weekly Epidemiological Report of joint National / WHO work done in Pakistan in 2007.
==============================

The above comments from the European Centre for Disease Prevention and Control report on the low case fatality rate in Egypt were published last week when there was only one cluster, the Beheira cousins in the Kom Hamada district. However, there were 3 subsequent cases in the past three days, which created two more clusters. One is in the Kellin district of Kafr el Shiekh where case #64 (33F) and #66 (1.5F) were confirmed over the weekend. The other is in northern Cairo, where case #65 (25F) and #63 (6M) are located. Both were admitted to the same hospital, where treatment was delayed in both cases, presumably because the patients denied a poultry contact. Thus, the above comment on hints of one cluster have already grown to three clusters.

Similarly, the WHO phylogenetic tree suggests that many of the new 2009 cases willl have the same genetic markers, S129del and the associated I152T, which was identified in escape mutants in the Webster lab. Both of these markers are in all thirteen public H5N1 sequences in this sub-clade, which included the Qena cluster (6F and 4M) from 2007, a liely in the first two human H5N1 isolates from 2009.

Although Egypt has provided samples of the cases to NAMRU-3, none have been released. The finding of S129del and I152T in the 2009 would provide a genetic signature for these cases and the similarities of the sequences with H1N1 is cause for concern.

This season the cases have not just been focused in children, but have been in toddler (11 of the 12 confirmed cases in childfren. This concentrayion in this narrow age group (1 ½ to 2 ½) raises additional concerns that the PCR testing of suspect cases in Egypt lacks sensitivity.

Such a lack of sensitivity was seen in the Paksitan cluster mentioned above. Although four brothers were symptomatic and had x-ray confirmed pneumonia, only one was PCR positive. One was not tested, but the other two were negative in spite of high H5 antibody levels (titers of 2560 and 320). Moreover, another brother who was asymptomatic and PCR negative also had an H5 titer of 320.

Thus, the Pakistan study demonstrated the limitations in PCR testing and raises concerns that many of the PCR negatives among the 99% of suspect hospitalized patients in Egypt are false negatives.

Therefore, antibody testing of these suspect cases, as well as toddlers that have symptoms but lack a poultry contact, are welcome and necessary and shoudl be addressed by the WHO investigation.

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by: Pixie @ Mon Apr 20, 2009 at 19:39:54 PM CDT

Increasing cases of suspected injury in Menoufia

hattip commonground/treyfish

Ibrahim Abdel-Latif writes

Detained hospital fevers Shebin housewife, on suspicion of being infected with bird flu virus after the emergence of symptoms of infection, and Dr. Hisham Al-Atta, Deputy Minister of Health Menoufia, the situation of a woman named Zainab Ibrahim Ahmed Zaghloul (23 years) resident district housewife "Ptbs" Shebin Center Kom, and suffer from cough, running nose and pain in the joints, was withdrawn from the blood sample for analysis mentioned central labs of the Ministry of Health in Cairo.

It is noticeable increase in cases of suspected infection Menofia, and already have a sample positive for the children, are Shoroq Saeed (two years) in Shebin and Mr. Habiba (a year and a half) LAID Mnov Center, and the uniform of healing, the spread of the first accused Jeddah garbage district Bcpin Western Kom causing HIV infection in her granddaughter.

translated article
http://74.125.91.132/translate...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Tue Apr 21, 2009 at 04:23:51 AM CDT

Data Supporting Enhanced Human H5N1 Transmission in Egypt

Commentary

Recombinomics Commentary 16:50
April 21, 2009
http://www.recombinomics.com/N...

That would be an alarming development, but other experts, including those at the World Health Organization, say such fears are exaggerated. Although thousands of Egyptians have rushed their children to hospitals this flu season, there is no evidence yet of asymptomatic avian flu cases or any significant mutation in the H5N1 virus.

"Right now, it's all hot air," said Dr. Robert G. Webster, a flu expert at St. Jude Children's Research Hospital in Memphis. "I hope to hell it's not happening, because it would mean the virus is adapting to humans. But there's not a shred of data."
===================================

The above comments from Donald McNeil's New York Times piece, "Avian Flu Cases in Egypt Raise Alarms," include the control data that provides more than a "shred of data" for enhanced H5N1 transmisison because the confirmed cases are focused in toddlers between the ages of 1 ½ and 2 ½. The other children "rushed" to hospitals this year have tested negative.  

There have been 15 confirmed H5N1 cases this year and 12 were children.  However, only one of the 12 was not a toddler.  Moreover, the 11 confirmed toddlers are almost double the 6 toddler confirmed in the past three years.  Thus, the frequency in each of the past three years was about 12%, while this year its 67% of confirmed cases. In addition, all have survived and most have had mild cases that did not produce pneumonia nor require ventilators.  Only one of the 11 toddlers had been in critical condition, and even when osletamivir treatment begins three to four days after the start of symptoms, as seen in the latest case, the case is still mild.

These mild cases raise concerns that they may represents a small tip of a very large iceberg.  In the spring of 2007 there were also mild cases, when 16/17 patients survived.  However, the demographic was different.  16/17 of the cases were children between the ages of 3-10.  Thus, the change in demographic from children in the spring of 2007 to toddlers in 2009 is significant and represents real data.

The concern of significant spread is also supported by the clustering of clusters.  The two cases (#61 and #62) identified at the beginning of this month were cousins and next door neighbors in Kom Hadash in Beheira.  The four day spread in disease onset date indicated the index case #61 infected his cousin, #62.  

That cluster was followed by the formation of a similar cluster (case #64 and #66) in Kafr el Sheikh in a small district, Kellin. It remains unclear if these two cases were related or neighbors, but the two cases had disease onset dates separated by 8 days, and the cluster signals for efficient transmission of H5N1 to humans.  

In addition, the other two cases this month (case #63 and #65) were from northern Cairo and admitted to the same hospital.  Treatment was delayed after admission, suggesting the patients denied poultry contact.

Thus, the six most recent confirmed cases form three geographic clusters, signaling more efficient transmission of H5N1 to patients.  Moreover, none of the patients have died, although three were initially in critical condition, but none were toddlers.  The three toddlers in these cluster have mild cases and only the most recent case is still hospitalized.

In addition to the epidemiological data, suggesting H5N1 infections are significantly higher than the confirmed cases, is the evidence for a genetic change.  Although there is no data supporting reassortment between human and avian flu genes, there is little reason to expect such data since there have been no prior reports, including dozens of H5N1 clusters signaling human to human transmission.

Instead there is evidence of a genetic change at position 129, which is in contact with the receptor binding domain.  Most clusters involving clade 2.2 have receptor binding domain changes.  The deletion of position 129, S129del, has been reported in 13 public H5N1 sequences in Egypt, including human and avian isolates in 2007 and 2008.  In 2007, the cluster from Qena had this change in H5N1 from two siblings.  The hospital admission dates for the siblings were four days apart, supporting the infection of one sibling (4M) by his sister (6F).  The deletion is also associated with a downstream change, A152T, found in H5N1 escape mutants isolated by the Webster lab.  This additional change signals the origin of the deletion.  
In addition, another change at position 129 (S129L) is associated with human H5N1 isolates in Asia, signaling a role for this position in the adaptation to humans.  Moreover, this change is also associated with changes that creates similarities between H5N1 and H1N1, human seasonal flu.

This genetic data is some obscured in the 2009 cases because NAMRU-3 has not released any H5N1 sequences from poultry or human isolates from the 2008/2009 season.  However the first two cases of 2009 (toddlers from Cairo and Suez) was included in a WHO phylogenetic tree on vaccine target for 2009.  Bother toddler sequences were similar, and the branch on the tree suggested that the 2009 isolates belonged to the sub-clade with S129del. In prior trees from 2007 and 2008 WHO reports on vaccine targets, at least one public sequence with S129del was included.  The absence of such a marker in the 2009 reports leaves some ambiguity, but it is likely that the two isolates from the toddlers has S129del.

Thus, the data on the genetic changes in H5N1 in 2009 in Egypt has been withheld by NAMRU-3, although WHO clearly has the data because it was required to contrauct the WHO tree.

Media reports indicate the WHO team is in route to Egypt to investigate the H5N1 cases and clusters.  

Release of the withheld sequence data is long overdue.

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by: Pixie @ Tue Apr 21, 2009 at 09:33:10 AM CDT

Egypt - Health announces the death of bird flu to 24 children from 67 inch to the injury of another Suhaj

CAIRO - Editor Masrawy - Dr. Abdel Rahman Shahin, official spokesman, media adviser to the Ministry of Health for the death of a child to the reputation of Muhammad Ali, aged 6 years of Shubra al-Khaimah government to, in respiratory failure.
Shaheen noted that the total number of deaths has reached 24 cases since the beginning of an outbreak of bird flu in Egypt in 2006 until the death of this situation, which is the first case this year.

The deceased child had developed symptoms on Sunday, March 22 last on their income, Ain Shams University Hospital on Saturday, 28 of the same month, immediately after the suspected cases of cholera have been given the drug (Tamiflu), and his condition was critical.

In a related development, said Shaheen, confirmed Tuesday that the incidence of human disease No. 67 of avian flu to a child named Kamaluddin Ahmed Ramadan, "4 years" Okhmim from the governorate of Sohag.

Sahin said that the onset of symptoms the child had been on 18 this month, and the impact of income on Saturday admitted to hospital in Sohag, which is suffering from high temperature and was nominated after being exposed to birds suspected of being infected with bird flu.

He pointed out that once the suspicion of being infected with the disease were given the drug Tamiflu and the condition is stable.

http://www.masrawy.com/News/Eg...

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by: UK - Bird @ Tue Apr 21, 2009 at 13:38:57 PM CDT

This boy was

WHO confirmed case #63.

He was treated late.  Onset of symptoms was 3/22, but he was not given Tamiflu until after his hospitalization on 3/28 when he was already critical because they at first apparently suspected he had cholera.

There was no poultry contact reported with this case.  

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by: Pixie @ Tue Apr 21, 2009 at 15:09:11 PM CDT

[ Parent ]

The new boy, WHO confirmed case #67

Was on the other hand treated promptly with Tamiflu and should do ok.  

Ahmed Ramadan Kamaludin Okhmim (4) from Sohag (southern Egypt) had exposure to poultry suspected of being infected with H5N1, but he was hospitalized the same day he became symptomatic (4/18) and was given Tamiflu immediately.  His condition is reported as being stable.  

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by: Pixie @ Tue Apr 21, 2009 at 15:26:01 PM CDT

[ Parent ]

Official report: 6549 in the case of suspected bird flu infection since the appearance of the virus in Egypt

Hat-tip Commonground at PIN:

The 5-yo sibling of Manar Saad Ibrahim Zidan (1.6) (WHO confirmed case #66) has also now been admitted to Kafr El Sheik Hospital in Kelin along with 7 additional other supsect cases.

21/04/2009
http://dostor.org/ar/content/v...

A report released by the Department of Preventive Medicine, Ministry of Health Ministry for 6549 to monitor the suspected case of avian flu since the disease outbreak in February 2006 and noted the report issued to the Cairo governorate over Egypt in the numbers of persons suspected of being infected with bird flu b 861 deaths, followed by Western b 823, then the case of Kafr El-Sheikh b 542 in the case bottom provinces of North and South Sinai and Marsa Matrouh on the end of the list the cases of injury, while each province has not seen any injuries on October 6,

This comes at a time when the Ministry of Health yesterday the first No. 66 on the incidence of the disease in a girl alleges Manar Saad - one and a half years - entered the province of Kafr el-Sheikh to hospital suffering fevers maintain a rise in temperature and coughing after exposure to dead birds suspected of being infected with the disease.

On the concerns made by the World Health Organization report on bird flu virus in Egypt, which leads to the spread between humans, Dr. Adel Khattab - Advisor to the Minister of Health to combat avian influenza - bird flu virus is still on its initial move from birds to humans only, not The best so far, no mutation of the virus leads to transmission between humans and each other, and it did not enter the stage of disease very harsh evidence that Egypt did not witness any of the 14 deaths among the disease this year, pointing out that the World Health Report does not contain any evidence that the virus will mutate or injured person without showing symptoms, noting that all cases of suspected infection were transferred to hospitals subject to the diets of the medical tests, indicating that successive infections in Egypt due to the education of household birds, despite awareness campaigns and laws enacted by the ministry for several years to combat the disease.

Said Dr. Susan Abbasi - Director of Kafr El-Sheikh hospital admitted: that the hospital had received 8 cases of suspected SARS patients, including children, Amr Ibrahim Zidan - 5 years - the brother of Ibrahim al-Manar, which the girl child infected with the disease have been confirmed.

The Director of the hospital cases were 5 children and 3 women.

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by: Pixie @ Tue Apr 21, 2009 at 15:37:24 PM CDT

Suspicion of infection in new cases of bird flu in Fayyoum

Hat-tip Commonground at PIN:

Tuesday, April 21, 2009 - 14:56
http://translate.google.com/tr...

Hospital doctors suspected fever in Fayoum was injured bird flu, has been taking samples of it to be sent to the central Ministry of Health laboratories for analysis.

Ramadan, the citizen Ahmed Darwish (55 years) live in the city of Fayoum Alskhanp, had entered the hospital diets Fayyoum, which suffered a sharp rise in temperature, and doctors suspected of being infected with bird flu, of which samples were taken for analysis labs Central Health Ministry and a statement of his illness or not.

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by: Pixie @ Tue Apr 21, 2009 at 16:50:35 PM CDT

Hospitalized Brother of Kellin Toddler Raises Concerns in Egypt

Commentary

Recombinomics Commentary 21:56
April 21, 2009
http://www.recombinomics.com/N...

Said Dr. Susan Abbasi - Director of Kafr El-Sheikh hospital admitted: that the hospital had received 8 cases of suspected SARS patients, including children, Amr Ibrahim Zidan - 5 years - the brother of Ibrahim al-Manar, which the girl child infected with the disease have been confirmed.

cases were 5 children and 3 women.
==========================================

The above translation describes the hospitalization of the brother of the 66th confirmed H5N1 case in Egypt.  The siblings live in the village of Shabas Emier, which is in the Kellin district (see updated map ).  The 64th confirmed cases also lives in the Kellin district, raising the possibility of direct contact between these two cases, which were admitted to the Kafr El Sheikh hospital 8 days apart.

However, the infections of two cases in the same small district signal a more efficient H5N1 transmission, increasing the likelihood that the brother is also infected.  Similarly, the clustering of suspect cases in the same hospital increases concerns that some or all of these cases will test positive, like 99% of the suspect cases in Egypt.

These suspect cases are in addition to the 67th confirmed case which was announced today.  That case was in Sohag, where there have been no confirmed H5N1 poultry cases announced this year,

The almost daily reports of confirmed H5N1 cases, as well as the potential expansion of the Kellin clusters, continue to increase concerns.

Many of these new cases are likely linked to the deletion of position 129, S129del.  

Release of the sequences from the human cases this season is long overdue.

---

by: Pixie @ Tue Apr 21, 2009 at 16:55:32 PM CDT

Egyptian 6-year-old Dies of Bird Flu; 4-Year-Old Gets Disease

By Alaa Shahine
Last Updated: April 21, 2009 14:45 EDT
http://www.bloomberg.com/apps/...

April 21 (Bloomberg) -- A 6-year-old boy died in Egypt after contracting avian influenza, becoming the country's 24th human casualty of the disease since 2006, the state-run Middle East News Agency reported today.

Egypt has the highest number of avian-flu cases outside Asia, according to the most recent data from the World Health Organization, a UN agency. With the newest reports, the number of infected people there has reached 67.

The boy, Ali Mohamed Ali, is the first fatality attributed to the virus in Egypt this year, the news agency quoted Abdel- Rahman Shahine, a spokesman for the Health Ministry, as saying. The boy had shown symptoms of the virus on March 22 after coming in contact with dead birds, Shahine said.

The Health Ministry reported the 67th infection earlier today, saying 4-year-old Ahmed Kamaleddin has contracted the virus. He was in the hospital in what was described as stable condition.

Kamaleddin was given Roche Holding AG's drug Tamiflu as a treatment, the news agency quoted Shahine as saying.

Roche, of Basel, Switzerland, says the antiviral medicine can reduce the severity and duration of flu symptoms if taken within 48 hours of the onset of disease. Early treatment for the H5N1 avian flu, the type that can be fatal in humans, may improve survival, some uncontrolled studies have shown.

Egypt has asked the World Health Organization to help investigate an outbreak of the so-called bird flu after a dozen non-fatal cases of the disease this year prompted speculation the virus may be becoming less virulent.

To contact the reporter on this story: Alaa Shahine in Cairo at asalha@bloomberg.net

---

by: Pixie @ Tue Apr 21, 2009 at 17:14:56 PM CDT

Viral time-bomb

.
Scientists fear the increasing number of bird flu cases among children may allow for the mutation of the pathogenic virus, reports Reem Leila

16 - 22 April 2009
Issue No. 943
http://weekly.ahram.org.eg/200...

As the number of reported bird flu cases in children continues to rise attention is increasingly being focussed on government efforts to control the disease. Although the virus is now causing fewer fatalities among those who contract it, scientists are worried about the changing profile of those who do develop symptoms. The World Health Organisation (WHO) fears the rise in infections among small children, without a similar increase in older people, could suggest adults are being infected but not falling ill, acting as symptom-free carriers of the disease.

A preparatory mission consisting of WHO, UNICEF, FAO and other UN agencies, will arrive in Egypt on 21 April.

"The mission will test blood and take swabs from people who contracted the virus and their families as well as those who are in direct or indirect contact with birds," says Ahmed Abdel-Latif, WHO representative in Egypt.

With three more cases reported last week, the WHO is concerned that the disease is now almost exclusively striking infants. There is also speculation that though symptoms are generally milder than in earlier cases, this could constitute a viral time-bomb. At the same time, Abdel-Latif strictly confirms that the virus has not yet mutated into a human-to-human strain.

Mohamed Sayed, plague and avian flu disease expert at the Research for Agricultural Guidance Centre, says that recent developments make it more likely the virus will spread.

"Ironically, its very virulence has provided an important safeguard. It did not get much chance to infect other people when it killed its victims swiftly, but now it has much more of a chance to mutate and be passed on. If the virus becomes less pathogenic it will become more transmissible."

The deadly strain of H5N1 usually kills half of those affected. Of this year's cases all were cured and discharged from hospital with the exception of the two most recent cases who remain hospitalised but whose condition is stable and who are, according to Abdel-Rahman Shahin, official spokesman to the Ministry of Health, expected to be discharged in the next few days.

Abdel-Latif argues that the higher rate of infection among children is a result of their weaker immunity systems and the fact that they "play with chickens in the streets".

"To control the deadly strain of H5N1 demands a convergence of biomedical, managerial and behavioural techniques," says Abdel-Latif. "So far Egypt is performing well on the biomedical front. Egypt's physicians can diagnose and medicate which is why the fatality rate is on the decrease." But what is needed, he argues, is a more holistic approach.

Combating the virus should be a national priority. Abdel-Latif advocates more awareness campaigns, particularly targeting children in rural areas.

"Existing campaigns are directed at adults. A change in the target audience is needed in order to avoid the spread of the disease."

He also believes the campaign should be directed through mosques and churches as well as the media. "People will respond more swiftly if they are advised by religious figures," he argues, adding that it remains essential for the owners of poultry farms to immediately report the presence of the virus.

Vaccine stocks only cover 30 per cent of the country's 300 million birds in rural farms, says Hamed Samaha, head of the General Authority for Veterinary Services (GAVS).

"The amount of vaccine is barely sufficient to cover the workforce that will distribute them and responsive farmers who are willing to inoculate their birds." Six million doses are needed to cover the entire poultry sector but, says Samaha, the authority can only afford to provide 120 million.

"Out of 13,000 registered veterinarians only 6,500 are available to work on vaccinations and 70 per cent of these are unsuited to field work being more than 50 years old. We end up with only 1,200 veterinarians while at least 34,000 are needed to cover targeted areas."

No new veterinarians have been appointed since 1994 because of a lack of funds. And while, says Samaha, Prime Minister Ahmed Nazif recently agreed on 1,500 new veterinarian appointments, "we are still massively understaffed."

Poultry farmers have also stopped reporting outbreaks for fear they will incur financial losses. The only way around the problem, Samaha argues, is to offer farmers compensation for any losses they might incur when revealing the real status of their farms.

Saber Abdel-Aziz, head of the epidemic and poultry department at GAVS, criticises the lack of human and financial resources without which veterinary services cannot play a more active role in combating the virus.

Currently there are 50 sites in Egypt that have tested positive for the virus. "Only two per cent of poultry farms apply bio-security measures," says Abdel-Aziz. Yet the veterinary authorities lack even vehicles to access many sites. While in 2006, he continues, the first avian flu campaign successfully vaccinated 90 million birds. "At first farmers were concerned so they cooperated with the authorities but now they are more confident and don't respond to our efforts."

---

by: Pixie @ Tue Apr 21, 2009 at 18:33:43 PM CDT

Found this on Google Translation

http://www.ahram.org.eg/
and
http://www.ahram.org.eg/Index....

http://translate.google.com/tr...

90% of victims in Egypt, women and children Avian influenza based on the nests!  Cultured cities in the disaster must be eliminated ..  The claim to increase allocations to vaccinate domestic birds in the countryside

With the end of last winter began to calm bird flu infections in poultry in Egypt, both in the farm or the rural sector in Egypt and raised hopes of curbing the disease this winter, but in the evil of the bird flu virus began to show teeth in some cases, although less severe, however, that most of the injuries for children less than 3 years, and statistics indicate that three-quarters of the deaths so far are female, and this is a serious indicator, as indicated by the World Health Organization reports that show that the number of cases discovered in Egypt so far, and declared the case of 66 23 died, including the case of

Egypt comes in third place worldwide among the five countries affected by the disease, where ten were reported worldwide in the case of 418 cases of which 257 died and the case fatality rate of more than 60%, but the ratio did not exceed 35% in Egypt. . have resulted in casualties among birds in the world of death and the execution of 150 million birds, at least.

And experts warn of the presence of poultry nest in cities are threatening the health of citizens, despite the fact that the ministerial decree prohibited all forms of poultry raising in the cities .. and despite the success of vaccination campaigns in poultry houses in the villages, however, some feared that the announcement of its existence, although it not precluded, and experts point to the importance of supporting immunization programs and outreach, and to examine the problem of raising pigs, which pose the most problems, where the cells of plants the virus will mutate to infect humans.

There is much more to this story...

---

by: Bronco Bill @ Wed Apr 22, 2009 at 08:10:07 AM CDT

Egyptian woman dies of bird flu - MENA

http://www.alertnet.org/thenew...

CAIRO, April 22 (Reuters) - A 25-year-old Egyptian woman has died of the H5N1 bird flu virus, the 25th human fatality of the disease in Egypt, state news agency MENA said on Wednesday.

The woman, from Cairo, died of respiratory failure, MENA reported.

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by: UK - Bird @ Wed Apr 22, 2009 at 15:47:56 PM CDT

Ministry of Health announced the death of the 25 avian influenza virus disease

http://www.masrawy.com/News/Eg...

CAIRO - Editor Masrawy - Dr. Abdel Rahman Shahin, official spokesman, media adviser to the Ministry of Health for the death of Salah Rajab, a gift of a 25-year-old from Cairo Governorate Lawn respiratory failure.

Shaheen said that the total number of deaths has reached to 25 cases since the beginning of the emergence of bird flu in Egypt in 2006 until the death of this situation, which is the second case during 2009.

Ms. deceased had developed symptoms on April 6 came on the impact of Ain Shams University Hospital on April 11 with a high temperature, difficulty breathing after exposure to dead birds suspected of being infected with bird flu .. and as soon as suspicion of being infected with the disease were given the drug Tamiflu and their health was critical.

The majority of injuries were recorded in Egypt is due to mixing with the poultry, especially that five million Egyptian families raise poultry in their homes.

The WHO is concerned at the possibility that some Egyptians were infected with the virus without showing symptoms.

---

by: UK - Bird @ Wed Apr 22, 2009 at 15:53:42 PM CDT

WHO Update #12 (old news)

http://www.who.int/csr/don/200...

21 April 2009 -- The Ministry of Health of Egypt has reported two new confirmed human cases of avian influenza.

The first case is a 25-year old pregnant female from El Marg District, Cairo Governorate. Her symptoms began on 6 April and she was hospitalized at Ain Shams University hospital on 11 April where she was started on oseltamivir on 16 April. She is in a critical condition. Investigations into the source of her infection indicated close contact with sick poultry prior to becoming ill.

The second case is 18-month old female from Kellin District, Kafr Elsheikh Governorate. Her symptoms began on 15 April and she was hospitalized at Kafr Elsheikh Fever Hospital on 18 April where she was started on oseltamivir on the same day of hospitalization. Her condition is stable. Investigations into the source of infection indicated close contact with dead and sick poultry prior to becoming ill.

For both cases, infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory and subsequently confirmed by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3).

Of the 66 cases confirmed to date in Egypt, 23 have been fatal.

---

by: AlohaOR @ Wed Apr 22, 2009 at 20:48:52 PM CDT

WHO Update #13 (old news -- case #67)

http://www.who.int/csr/don/200...

Avian influenza - situation in Egypt - update 13

23 April 2009 -- The Ministry of Health of Egypt has reported a new confirmed human case of avian influenza . The case is a 4 year old male from Akhmim District, Sohag Governorate. His symptoms began on 18 April and he was hospitalized at Sohag Fever Hospital on 18 April where he was started on oseltamivir. He is in a stable condition.

Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 21 April and subsequently confirmed by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3).

Investigations into the source of his infection indicate a history of close contact with dead and sick poultry prior to becoming ill.

Of the 67 cases confirmed to date in Egypt, 23 have been fatal.

---

by: AlohaOR @ Thu Apr 23, 2009 at 22:16:16 PM CDT

H5N1 Death No.26

Hat-tip Helblindi at PFI:

From Zenobia's blog:

25/Apr/09
http://egyptianchronicles.blog...

This is so depressing , my last three posts are about H5N1 !!!

The ministry of health has announced on Friday that 33 years old Sadia Mohamed Abdel Latif has died because of H5N1 , she is No.26 in our H5N1 death toll in Egypt. Late Mrs. Sadia from Kafr El-Sheikh was No.64 in our increasing H5N1 infection toll !!

In Alexandria the governor announced war on shops that are selling living poultry, this war or rather campaign to close these shops will continue for a week.

This is not good and what is worst is the reports coming from Mexico ,Taxes and California about the spread of swine flu. I know it is faraway from us but I can't stop thinking about those time bombs better known as pigs farms across the country that WHO warned from them over and over.

Now there is a sick governmental debate about where the government kindly shall remove them !!?? Is it in the new Helwan governorate or October governorate ?? or is it the desert ??

I have better suggestion why does not the government announce the war against living dirty pigs in the same way it announced the war on the living domestic poultry for precaution reasons !!??  

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by: Pixie @ Sat Apr 25, 2009 at 06:26:28 AM CDT

With all the excitement over the swine flu epidemic/pandemic we can't forget these cases

That mildish swine flu herald wave may well reach Egypt (and/or Indo, China, VietNam etc)in a few weeks and there recombine with H5N1 to turn into a killer pandemic. I think we should be including these new cases and deaths in our sights on the news diary as well. Just my opinion.

Always have a plan B.

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by: maryinhawaii @ Sat Apr 25, 2009 at 13:31:27 PM CDT

[ Parent ]

Well reminded MIH :-( n/t

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by: UK - Bird @ Sat Apr 25, 2009 at 13:33:12 PM CDT

[ Parent ]

30 Suspect Cases Bird Flu

Treyfish posted a translated article over at PFI which mentioned there being 30 suspect cases of bird flu H5N1.  Instead of posting the article I will simply provide a link to the thread so you can go and see for yourself if desired.

http://www.singtomeohmuse.com/...

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by: Okieman @ Tue Apr 28, 2009 at 22:04:30 PM CDT

could this be posted to news diary?

I know swine flu has taken over the story there, but H5N1 is every bit as much a threat as it was, if not more so, and I think we should be keeping up on its outbreaks as well. The close juxtaposition of the two outbreaks is important, IMHO.

Always have a plan B.

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by: maryinhawaii @ Wed Apr 29, 2009 at 01:40:21 AM CDT

[ Parent ]

Alleged 8 Egyptians infected with bird horses

8 Egyptians infected with equine influenza.

Hat-tip Helblindi at PFI:

29/Apr/09
http://www.alwafd.org/details....

Denied yesterday by Dr. Ibrahim BHANDARE director of preventive medicine General Authority for Veterinary Services of the Ministry of Agriculture reports about the presence of human cases of avian horses.

The professor, Dr. Muhammad Farooq diagnostic laboratory in the College of Veterinary Medicine, University of Assiut confirmed the presence of 8 human cases of horse flu in the province, the lake. And warned of what he described as a real disaster.

Dr. BHANDARE by operations room body veterinarian's best to follow the daily movement of the virus in the provinces. The sampling of the lake and the oases of Kafr el-Sheikh and Wadi Natrun show integrity and denied. BHANDARE was echoed by Dr. Mohamed Farouk the possibility of transmission of influenza virus cats to humans through bird. He said that possibility does not exist. And Dr Mohammad Farooq to the spread of equine influenza virus in Egypt by 20% between horses.

He also pointed to the spread of the disease governorates in Lower Egypt, more than Upper Egypt, especially in provinces: West Lake, Alexandria, Dakahlia The rates of death due to influenza horses per 3% only.  

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by: Pixie @ Wed Apr 29, 2009 at 07:26:20 AM CDT

expresses the fear of transmission of swine flu in Egypt because of the farms

Hat-tip Helblindi at PFI:

Al-Masry Al-Youm
http://www.almasry-alyoum.com/...

World Health Organization expressed concern on the transmission of swine flu infection in Egypt, because of the proximity of pig farms of the population, said the regional office of the organization - based in Cairo - Egypt is currently free of swine flu, but the problem is the presence of pigs near the humans.

"There is, consequently, fear of infection,"said Dr Hussein Gezairy, Regional Director of the World Health Organization at a press conference yesterday: "the problem must be eliminated, either dispose of or transfer of pig farms to places far from population centers"

[snip]

For his part, Dr. Hassan Al-Bushra, regional adviser for the World Health Organization, the Organization according to the epidemic, was expecting more than two years since the epidemic "swine flu," which occurs on average between six and 20 years.

[snip]

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by: Pixie @ Wed Apr 29, 2009 at 07:51:46 AM CDT

That should be

"WHO expresses the fear of transmission of swine flu in Egypt because of the farms"

---

by: Pixie @ Wed Apr 29, 2009 at 07:52:27 AM CDT

[ Parent ]

Egypt slaughtering all pigs to stop swine flu

Apr 29, 8:36 AM EDT
http://www.google.com/hostedne...

CAIRO (AP) -- The Egyptian government says it has begun slaughtering all pigs in the country as a precautionary measure against the possible spread of swine flu.

The Health Ministry says the slaughter of the country's 300,000 pigs will begin immediately.

The ministry has stated several times that there are no cases swine flu in the country, however neighboring Israel has reported two.

---

by: Pixie @ Wed Apr 29, 2009 at 08:04:18 AM CDT

Hat-tip Sand at PFI

for that story.

---

by: Pixie @ Wed Apr 29, 2009 at 08:07:25 AM CDT

[ Parent ]

I wonder if they know more about where the Mexican pigs came from than we do? n/t

---

by: UK - Bird @ Wed Apr 29, 2009 at 08:21:47 AM CDT

[ Parent ]

Egyptian Christians riot after swine flu cull

April 29, 2009
http://www.timesonline.co.uk/t...

Egyptian leaders ordered the slaughter of hundreds of thousands of pigs today to help protect against swine flu, prompting angry protests from the poor Christan farmers who feed their animals with a country's food scraps. The decision was also criticised as a "real mistake" by a senior UN food expert.

The Arab world's most populous nation has been been badly hit by the H5N1 bird flu virus in recent years and the move to cull up to 400,000 pigs - seen by Muslims as unclean animals - was designed to calm fears of an impending pandemic.

But it left Egypt's large Coptic Christian minority up in arms, especially the slum-dwelling "Zebaleen" rubbish collectors who rely on the hogs for their livelihood. Scores of them blocked the streets and stoned the vehicles of Health Ministry workers as they arrived to carry out the government's order at pig farms on the outskirts of Cario this afternoon.

"Our pigs are healthy. They are our capital and they have no diseases," said Adel Ishak, who feeds his pigs from the rubbish he collects in Manshiet Nasser, northeast of Cairo.

"We remind Hosni Mubarak that we are all Egyptians. Where does he want us to go?" added 46-year-old Gergis Faris, another pig farmer. "We are uneducated people, just living day by day and trying to make a living, and now if our pigs are taken from us without compensation, how are we supposed to live?"

The decison to cull the pigs was announced by Hatem al-Gabali, the Health Minister, after a meeting with President Mubarak. "It has been ordered to immediately begin the slaughter of all herds of pigs in Egypt," he told reporters.

Mr al-Gabali said slaughterhouses were to begin the culling process immediately at the fastest rate possible. Further precautionary measures such as the launch of an awareness campaign and increasing production of protective masks would also be taken, he said.

Magdy Rady, a Cabinet spokesman, put the number of pigs that could be culled at between 300,000 and 400,000. "If you see the conditions of the swine farms in Egypt, they are not healthy at all. They are hazards in themselves, even without the swine flu. That's why people are really getting afraid," he told the Reuters news agency, even before the decision was taken.

Officials said that the farmers would be offered compensation of 1,000 Egyptian pounds (£120) per pig but there seemed to be little confidence that the money would ever materialise.

Mr Ishak said that his community receives 6,000 tonnes of organic rubbish every day, but if the pigs die there will be nowhere to put the waste. "What is the use of compensation? It will feed us only for several months, what then?" he asked.

Egypt has not had any confirmed cases of swine flu yet but government experts fear a pandemic flu strain could spread quickly through the country because most of its roughly 80 million people live in the densely packed Nile Valley, many in crowded slums in and around Cairo.

The World Health Organisation has repeatedly said, however, that the newly mutated H1N1 virus is not found in pigs - although the animals can be the vessels for the "genetic reassortment" that produces new strains - and that pork meat is safe to eat.

Joseph Domenech, chief veterinary office with the UN Food and Agriculture Officer in Rome, said the Egyptian order was "a real mistake".

"There is no reason to do that. It's not a swine influenza, it's a human influenza," he said.

---

by: Pixie @ Wed Apr 29, 2009 at 12:36:37 PM CDT

Egypt to develop bird flu vaccine

Posted on Wednesday 6 May 2009 - 12:25
Merieme Addou, AfricaNews reporter in Rabat, Morocco
Egypt, the country worst affected by avian flu in the Middle East, and north Africa, is aiming to produce its own vaccine against avian flu. The Egyptian National Research Center director and the president of the Medical Products Society had signed a protocol to begin work on the vaccine against bird flu.

The vaccine is expected to be available on the Egyptian market within 18 months to two years.

The country also struggles to stem the spread of the virus by changing the habits of people living in rural areas, sometimes even in urban areas, where people are still keeping chickens, ducks, geese and pigeons in populated areas.

It is mostly young women who feed the fowl that contract the disease. Because of that many observers place the blame for the proliferation of the avian flu on people's ignorance of the lethal virus and their reluctance to give up their domestic poultry.

Egypt uses more then one billion doses of anti-bird flu vaccine each year, which have been imported either by the state or the private sector since February 17, 2006 and France donated more than 24.5 million doses in last January.

full story
http://www.africanews.com/site...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Wed May 06, 2009 at 09:30:21 AM CDT

Situation in Egypt:New H5N1 case

6 May 2009 -- The Ministry of Health of Egypt has reported a new confirmed human case of avian influenza . The case is a 34 year old female from Tanta District, Gharbia Governorate. Her symptoms began on 21 April and she was hospitalized at Tanta Fever Hospital on 21 April where she was started on oseltamivir. She is in a stable condition.

Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 23 April and subsequently confirmed by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3).

Investigations into the source of his infection indicate a history of close contact with dead and sick poultry prior to becoming ill.

Of the 68 cases confirmed to date in Egypt, 23 have been fatal.

http://www.who.int/csr/don/200...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

---

by: cottontop @ Wed May 06, 2009 at 22:39:38 PM CDT

Egypt: 10 new suspected H5N1

Kafr El-Sheikh - Egyptian Ahmed:
10 new suspected cases of avian influenza in Kafr Sheikh

Continue the series of cases of suspected bird flu patient in Kafr Sheikh to reach the number of cases retained more than 40 suspected bird flu patient, after the detention of 10 new cases on hospital fevers of Kafr el-Sheikh.

Susan Abu Abbas, the Director of the hospital: he was detained by the dear Hassan Mohamed (50 years), and Abeer Wardany ABDULAATI (23 years), and Islam Mohamed Attia (3 years), nymph and Abdel-Moneim (62 years), and hopes to Ahmad Lutfi (35 years ), and Susan Attia BASSIOUNI (20 years), and Mohamed Meghawri (15 years), and Saadia Usman (20 years), and Rania Abdo Barmawi (5 years), and Fawzia Abdel-Maksoud (28 years).

Denied the Directorate of Veterinary Medicine in Kafr Sheikh and there are no pigs in the province since 8 years; and when issued, Justice Ali Abd al-conservative former Shakour decision transported to Cairo, and the fold of one garbage dump next to the main Kafr El-Sheikh

http://www.ahram.org.eg/

google translate
http://tinyurl.com/dfr55u

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Thu May 07, 2009 at 19:22:38 PM CDT

40 suspect H5N1?

Kafr El-Sheikh - Egyptian Ahmed:

Continue the series of cases of suspected bird flu patient in Kafr Sheikh to reach the number of cases retained more than 40 suspected bird flu patient, after the detention of 10 new cases on hospital fevers of Kafr el-Sheikh.

Susan Abu Abbas, the Director of the hospital: he was detained by the dear Hassan Mohamed (50 years), and Abeer Wardany ABDULAATI (23 years), and Islam Mohamed Attia (3 years), nymph and Abdel-Moneim (62 years), and hopes to Ahmad Lutfi (35 years ), and Susan Attia BASSIOUNI (20 years), and Mohamed Meghawri (15 years), and Saadia Usman (20 years), and Rania Abdo Barmawi (5 years), and Fawzia Abdel-Maksoud (28 years).

Denied the Directorate of Veterinary Medicine in Kafr Sheikh and there are no pigs in the province since 8 years; and when issued, Justice Ali Abd al-conservative former Shakour decision transported to Cairo, and the fold of one garbage dump next to the main Kafr El-Sheikh

google translate
http://tinyurl.com/cvpr3t

orginal link
http://www.kfrelshikh.com/main...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Thu May 07, 2009 at 19:31:32 PM CDT

Shouldn't this significant outbreak be added to the News Diary? n/t

Always have a plan B.

---

by: maryinhawaii @ Thu May 07, 2009 at 19:59:16 PM CDT

[ Parent ]

Working on it. n/t

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Thu May 07, 2009 at 20:04:31 PM CDT

[ Parent ]

Swine flu suspect:8 Bhmyat students

8 Bhmyat students detained on suspicion of Suez in the swine flu

Thrusday, May 7, 2009 - 15:33
Hospitals receive cases of suspected influenza

Books Karim Hussein

8 injured students living in University City Branch of the Suez Canal University Bnzlat response resulted in severe injury of the high temperature, severe vomiting, due to strong mixing within the chambers, including the university city.

Immediately to Dr. Moses and Undersecretary of the Ministry of Health the Gulf of Suez, by transferring them to a hospital diets to detect them, and after making sure that cases are not beyond the cold, were taken to Suez General Hospital for treatment and left, four students were discharged from hospital upon recovery, while the other four remained in the hospital to complete the treatment. . Dr. Fahim Ahmed Khalifa, Vice-President of the University branch of Suez, that the minor injuries of students denied rumors that they were on over twenty students, where the suspect was caught a cold and is not suspected of bird flu or avian influenza as the most common pig.

google translate
http://tinyurl.com/d8z2j3

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Thu May 07, 2009 at 21:22:08 PM CDT

35 citizen of the West: suspect swine flu....

35 citizen of the West put under observation due to swine flu

Thursday, May 7, 2009 - 20:40

West - just India
Directorate of Health meeting Sunday attended by the development of 35 Egyptian citizens from abroad, from different countries under strict observation, and the fear of disease swine flu.

Was signed by a medical examination on 35% of citizens, as they are coming from France, Italy and the European Union countries and African countries, has been placed under constant observation and their families for fear that they are infected with the disease and put them under observation for a period of 10 days.

google translate
http://tinyurl.com/d2tyrn

United we stand: Divided we fall

http://cottontopssandbox.wordp...

---

by: cottontop @ Thu May 07, 2009 at 21:37:06 PM CDT

Just in case

.
Egypt may not have recorded a single case of swine flu but it is ready,

7 - 13 May 2009
Issue No. 946
http://weekly.ahram.org.eg/200...

The cull of Egypt's pig population, estimated at 350,000 animals, in response to growing concern of a swine flu pandemic, has already begun. The decision to slaughter was taken on Wednesday 29 April, at a meeting presided over by President Hosni Mubarak, though so far 1,100 pigs have been destroyed.

Hamed Samaha, head of the General Authority for Veterinary Services (GAVS), has said the cull could take up to a month.

Egypt has only two abattoirs licensed to slaughter pigs, one in Cairo and the other in Alexandria.

"The Cairo slaughterhouse's maximum capacity is 1,200 pigs a day, and in Alexandria it is just 450," says Samaha. "In order to increase capacity the government has begun work on three extra slaughter houses, one each in Cairo, Giza and Qalioubiya governorates."

More than 400 residents and pig farmers from Manshiet Nasser, a shantytown on Cairo's outskirts, blocked the road leading to their pig pens on Sunday, hurling stones, rocks and Molotov cocktails at police and veterinary officials. The police responded with a five-hour operation, surrounding the protesters with armoured cars and firing tear gas and rubber bullets to disperse the crowds. At least 14 people, including three policemen, were injured in the clashes.

Major General Ismail El-Shaer, assistant to the Minister of Interior, who was present at the scene, says a few people have been detained.

"Policemen were simply surrounding the neighbourhood to prevent residents from moving their animals and then hiding them from officials seeking to enforce the cull. We have been instructed to accompany the veterinary authorities to protect them from similar incidents and help them with their mission," said El-Shaer.

The government initially announced that it would not be offering pig breeders any compensation for slaughtered pigs since the meat could still be sold. It subsequently backtracked, announcing it would pay LE100 for each slaughtered pig and LE30 for those culled, a move that carries a total bill of LE30 million.

"We work and then they come and cut off our livelihood. The pigs don't have any disease. Take samples from the pigs and if they test positive we would happily see them culled," Manshiet Nasser pig breeder Marzouk Adli said after the clashes, complaining also that the compensation offered was inadequate.

Samaha defends the level of payments. "Receiving LE30 for a culled pig is better than nothing, and the LE100 payment is perfectly fair given farmers can keep the pig meat after it has been frozen in GAVS's refrigerators."

Though no case of the H1N1 virus has been reported in Egypt many people are alarmed at the possible appearance of the disease, and the government has been keen to stress that all necessary measures to tackle any outbreak are in place.

Ahmed Abdel-Latif, the World Health Organisation's (WHO) director in Egypt, believes the country is well-prepared given its experience in dealing with the avian flu virus, though he stresses that swine flu is potentially far more dangerous since it is capable of human to human transmission.

On Monday the WHO announced 1,003 confirmed swine flu cases in 20 countries, 568 of them in Mexico. The number of fatalities has increased to 22, one in the United States and the remainder in Mexico.

Last week the organisation raised its swine flu pandemic alert to phase five, one short of the maximum alert.

"Egypt is still free of the H1N1 virus to date. The WHO office is collaborating with the Ministry of Health and is providing them with updated and accurate technical information on a regular and continuous basis," says Abdel-Latif.

The Cabinet Decision Support Centre (IDSC) is fully prepared for any pandemic, says Mohamed Abdel-Rahman Fawzi, IDSC head of crisis management. He predicts that in the event of a major outbreak between 20 to 40 per cent of employees will be absent from work either because they are infected or too worried to leave their homes.

All ministries and public and private sector companies, says Fawzi, will be obliged to provide training where appropriate. They also need to develop telecommuting systems for their employees where feasible, determining the equipment, computer specifications, files, programmes and Internet access needed to enable people to work from home. Adequate infection control supplies, such as hand-hygiene products, tissues, and waste receptacles must also be procured by workplaces and factories. Fawzi also urges the public to make financial plans in the event of pandemic influenza and to factor in the financial consequences of fluctuations in the supply and demand for their products and services in the event the disease spreads.

In the meantime, Egypt has developed a new vaccine for H5N1 in its poultry population. A research team at the National Research Centre (NRC) says the vaccine will be more effective in dealing with the strain of virus found in Egypt. The NRC has signed a contract with the Holding Company for Biological Products and Vaccines (VACSERA) to start producing the vaccine which is expected to be available on the market within 18 months to two years.

NRC head Hani El-Nazer is optimistic about devising vaccines to combat possible mutations of the virus. "The NRC now has the technology to develop vaccines for the H5N1 virus, including any changes or mutations that may occur," he says.

Abdel-Latif praised Egypt's efforts in producing the new vaccine.

"We do not want the public to panic, but we urge vigilance and the practice of general preventive measures."

The WHO does not believe travel restriction will slow the spread of the virus. Instead, it says, the focus should be on protecting travellers. The WHO recommends delaying travel plans should individuals feel sick, and seeking immediate medical attention should they begin to feel ill following their arrival.

Minister of Health Hatem El-Gabali has already met with cabinet colleagues -- including officials from the ministries of education, higher education, civil aviation, transport and local development -- to ensure a coordinated response in case of a pandemic.

"I have agreed with the minister of education, Yosri El-Gamal, to use schools as treatment centres and for quarantine spots. University students will also be relocated to avoid unnecessary crowding," he said.

The Heliopolis mental hospital, close to Cairo International Airport, is now being used to quarantine any passengers showing symptoms of the disease. The hospital's 42 patients have been moved to Abbasiya hospital. El-Gabali also reports that 50 doctors, and the same number of nurses and health supervisors, are working round the clock at Cairo Airport to screen passengers, who will be checked before disembarking their aircraft. Doctors will also be available to check passengers arriving by sea.

El-Gabali travelled to Saudi Arabia on Tuesday to discuss with Saudi officials and other Arab health ministers the possibility of postponing the omra (lesser pilgrimage).

El-Gabali identifies Cairo, Giza, Alexandria, Mansoura and Assiut governorates as most vulnerable to the disease given the high density of their populations.

"In case of a pandemic schools, universities, cinemas, restaurants, cafés and other places where people gather will be closed," he explained. Patients will be treated at home and only those in a critical condition will be hospitalised.

He recommends that members of the public avoid close contact with anyone who appears unwell and urges them to wash their hands with soap and water regularly.

"Those who feel sick should seek immediate medical advice, stay at home and keep away from work, school and crowds. They must rest and take plenty of fluids, cover the mouth and nose with disposable masks or tissues, and wash their hands with soap and water especially after sneezing or coughing. Finally they should let people they have come in contact with know that they are ill."

Abdel-Rahman Shahin, official spokesman at the Ministry of Health, confirmed that strict quarantine measures are being applied at Egypt's 33 entry ports. Egypt is also stockpiling Tamiflu, with plans to double the current supply of 2.5 million doses, and up the number of protective masks available from 35 to 100 million.

"There are ample emergency supplies of essential items, from babies' milk to filters required for those on kidney dialysis," says Shahin.

Yet, however advanced the plans to contain any possible pandemic, employees of Egypt's embattled pork industry remain angry and afraid for their future. With the stock of fresh farm meat quickly drying up, some in the industry are bracing for layoffs and closures.

Hala Marcos, managing director of Maison Marcos, one of the largest pork-product manufacturers in Egypt, says the diminishing supply of meat will see sales grind to a halt.

"The decision to cull pigs will ruin our business. It will be total shutdown in no time," she says. Maison Marcos operates in Cairo, employing over 80 workers at four retail outlets, one processing factory and a pig farm.

In a joint statement, the UN Food and Agricultural Organisation, the WHO and the World Organisation for Animal Health said there is no evidence that influenza viruses can be passed to people through eating processed pork or other food products derived from pigs.

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by: Pixie @ Fri May 08, 2009 at 09:14:13 AM CDT

AGE-SPECIFIC RATES

http://www.promedmail.org/pls/...

Age-specific infection and death rates for human A(H5N1) avian
influenza in Egypt. By J. P. Dudley, Science Applications
International Corporation, Modeling and Analysis Division, Rockville,
Maryland, United States
-----------------------------------------------
The age-specific infection and death profiles among confirmed human
cases of influenza A(H5N1) infection in Egypt differ markedly from
those recorded in other countries. The case fatality rate among human
H5N1 cases in Egypt is 34 percent, versus an average of 66 percent in
other countries. In Egypt, children younger than 10 years comprise 48
percent of reported cases, nearly twice the global average of
approximately 25 percent, and no H5N1 fatalities have been confirmed
among individuals in this age group as of 23 Apr 2009. Females
outnumber males among confirmed H5N1 cases by a factor of nearly 2:1,
and 90 percent of reported fatalities in Egypt have been females. The
evident age and sex biases in morbidity and mortality among H5N1
cases in Egypt are phenomena that warrant further investigation and analysis.

Introduction:
The 1st cases of human infection with avian influenza type A(H5N1)
were reported from Egypt in March 2006, and a cumulative total of 67
confirmed cases including 23 fatalities have been reported as of 23
Apr 2009 [1]. There are evident anomalies in the age distribution and
sex ratio of human mortality from influenza A(H5N1) in Egypt relative
to those reported from other countries that warrant detailed
investigation and analysis.

Methods:
Published information on human H5N1 cases in Egypt was analysed to
develop a 1st order comparative analysis of age-specific and
sex-specific infection and mortality patterns between human H5N1
cases in Egypt and those in other areas of the world. The age and
case history data of patients with confirmed influenza A(H5N1)
infection in Egypt used in this analysis were derived from reports
published by the United States Naval Medical Research Unit No. 3 in
Cairo, Egypt [2] and the World Health Organization (WHO), available
as of 23 Apr 2009 [1].

Results:
Human H5N1 cases in Egypt are most frequently reported among children
younger than 10 years, and approximately 80 percent of all reported
cases have occurred among individuals under the age of 30 years. In
Egypt, children under the age of 10 years comprise 48 percent of all
reported cases, nearly double the current global average of
approximately 25 percent [3]. A median age of 8 years has been
reported for human H5N1 cases in Egypt between March 2006 and March
2009 [2], versus a median age of 18 years for WHO-confirmed human
cases globally between November 2003 and November 2006 [4].

The age-specific infection and death profiles among confirmed human
A(H5N1) cases in Egypt differ markedly from those recorded in Asia
and Indonesia when compared to cumulative data for countries
worldwide other than Egypt, Nigeria, and Turkey [These data are
illustrated by 2 figures in the original text.]. The case fatality
rate from human H5N1 cases in Egypt confirmed as of 23 Apr 2009 is
only 34 percent (23 of 67), versus an average of 66 percent among
WHO-confirmed cases from all countries other than Egypt (234 of 354
cases as of 23 Apr 2009) [5].

Human mortality from H5N1 in Egypt is highly biased towards females
(90 percent: 21 females, 2 males), with confirmed mortality only
reported among individuals older than 9 years. Although the sex ratio
of cases in most countries is approximately 1:1, females outnumber
males among confirmed cases in Egypt by a factor of nearly 2:1 (43
females: 24 males). Although the average case fatality rate from H5N1
among children aged 0-9 years from all countries other than Egypt and
Turkey is 59 percent, no confirmed fatalities among 33 children in
this age cohort have been reported from Egypt as of 23 Apr 2009. A
similar pattern is evident for H5N1 cases in Turkey during January
2006; although 11 of 21 confirmed H5N1 cases in Turkey were children
in the age group 0-9 years, no confirmed fatalities were reported in
this age cohort [6].

Discussion:
There is increasing concern that undetected H5N1 cases may be
occurring in Egypt, given the evident anomalies in observed age-
specific and sex-specific case incidence and fatality rates. Although
there appears to be no compelling evidence for human-to-human
transmission of H5N1 in Egypt, family clusters have been observed in
Egypt, and H5N1 clusters involving highly probable human-to-human
transmission have been documented in China, Thailand, Viet Nam,
Indonesia, and Pakistan [7].

The most characteristic presentation of humans with fatal H5N1 virus
infections is severe lower respiratory disease accompanied by
hypercytokinaemia of the alveolar tissues. The pathology of most
fatal H5N1 cases resembles those of fatal human severe acute
respiratory syndrome (SARS) infections, and a suspected SARS case in
China during November 2003 was subsequently confirmed as a fatal H5N1 case [8].

The existing anomalies with regard to age and sex may be attributable
in part to the existence of undetected fatal or non-fatal atypical or
asymptomatic human H5N1 infections. Although human infections with
the H5N1 virus are typically associated with respiratory symptoms,
the clinical spectrum of H5N1 infections in humans is extremely
broad, and H5N1 virus has been recovered from lung, brain, large
intestine, small intestine, cerebrospinal fluid, kidney, spleen,
liver, pharynx, blood, and placental tissues [9]. Fatal atypical
human H5N1 infections involving only gastrointestinal and
neurological symptoms have been documented from patients in Viet Nam
and Thailand [10]. Asymptomatic human infections with H5N1 have been
reported from China, Viet Nam, Japan, Thailand, and Korea [11].

Clinically mild illness from highly pathogenic avian influenza (HPAI)
H5N1 virus infection has been reported from children in most
countries, but the early detection and treatment of possible cases
may be a factor in the overall lower case fatality rate reported for
H5N1 cases in Egypt. Although a median time of 4 days from symptom
onset to hospitalization has been reported for H5N1 cases worldwide
[4], nearly 50 percent of confirmed cases in Egypt are admitted to
hospitals within 24 hours after the 1st onset of symptoms, and
approximately 70 percent are hospitalized within 72 hours after
symptom onset [2].

Conclusions:
The evident age and sex biases in the incidence of infection and
mortality among H5N1 cases from Egypt are phenomena that have not
been fully explained and merit further in-depth investigation and
analysis. Further research is needed to understand the immediate and
long-term health risks of avian influenzas for human populations and
to identify those members of exposed populations who are at greatest
risk of infection and serious disease from avian influenza viruses.
Although most cases in Egypt can be linked to contact with diseased
poultry, increasing numbers of confirmed human H5N1 cases with no
evident history of direct exposure to diseased poultry or birds are
being reported from China and Indonesia. Efforts need to be made to
evaluate potential background rates of asymptomatic and mild cases of
human avian influenza in communities where human H5N1 clusters have
been documented and to evaluate potential instances of human-to-human
transmission of H5N1 in Egypt.
[CONTINUES]

To calm the wife buy cases of chocolate, to calm the husband buy cases of booze, and to calm the children...... heck the booze and chocolate should work.

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by: Oremus @ Sat May 09, 2009 at 13:05:35 PM CDT

14 students detained in Suez

5-8 / 2009

Yesterday saw the detention of a number of people in several provinces on suspicion of having bird flu in pigs, Chest Hospital, where he was detained in Suez 14 industrial education students suspected of being infected by the disease.

The source of medical official - who declined to be named that the two students injured in the suspected infected samples were taken and sent them to the central laboratories of the ministry's statement on whether they were carriers of the virus or not, explaining that he had been detained 12 other students to stay the same room the students in detention, but Dr. Ahmed Shadi, Director of SuezSadr hospital, denied the existence of any suspected cases of the hospital, the detention of students to justify their cold normal.

In the West, a Andz hospital yesterday afternoon fevers Tanta citizen returning from Argentina, Ibrahim Mustafa Oboumndor, under tight security after a rise in temperature is great suspicion of being infected with swine flu, the Department of the hospital and took blood and swab samples were sent to labs central Ministry of Health with the extent of his illness or not.

And the Directorate of Health meeting Sunday attended by the highest degree of preparation after the reported detention of an Egyptian citizen, coming from Al Israel two days ago allegedly Roushdi Hadi Suleiman, a driver working with the international forces, and to enter Israel and Palestine for the delivery of food aid.  The Directorate has decided to put a citizen under 35 health surveillance for 10 days after returning from European and African countries, fear of illness.

google translated
http://tinyurl.com/q8xulb

orginal article
http://tinyurl.com/q6d4b4

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sat May 09, 2009 at 19:33:15 PM CDT

More out of Egypt

Hat tip Helblindi @ PFI

Comment: 14 new suspected cases today, some of them probably the same as yesterday (those from Kafr El-Sheikh, for one), as this is a different source; the ones in Minya, Dakhalia and Port Said are new:

Detained, hospital fever, yesterday, in the West, Port Said, Minya Dakahliya, 14 suspected cases of bird flu symptoms. Detained in the West «fevers Mahala» Nada Abdullah Ghazi, 6 years, from the village of Kafr El-Khamis, Mohammed Sameh and Norhan Azim, 3 and a half years, from the village of Saraj and dead Hussam Abdullah Abdullah Shahawi, «two», from the village of Jabriya, and Nasser Ramadan Antar, 6 and a half years, and Sameh Ala'edeen «years» received «Tanta fevers» Fayza Mustafa Zeinhom, 3 years, and Fawzi Huwaida SNOUSSI, plant Ayari, housewife, 30 years, Abeer Hassan El-Shafei, 3 years, Miriam Yahya Hamad Awad, 10 months, from the village of Shin Center Qtor fevers in Kafr El-Sheikh was detained as a hospital admitted the names of Kafr Al-Safa and Mr. Abdul Hamid, two samples were taken for analysis.

In Port Said, said just to leave, and Under-Secretary, Ministry of Health in the county, the hospital admitted Port detained Radwan Radwan Abdul Sattar, to the Department of Civil Protection fire on suspicion of having bird flu, a hospital in Sadr Dakahliya detained in Mansoura Hanan Ahmed Hussein, 37 years from the village of Mit Assem were taking a sample to be sent to the Ministry of Health laboratories, bringing the number of cases, the hospital retained the 10 cases.

In Minya Minya detained hospital fevers Shehata, Hosni Mubarak, 22 years, the city of Minya has been sampled.

The detention of 14 suspected cases of b «avian flu» in 4 provinces And the closure of «two farms» Menoufia
08/May/09

Detained, hospital fever, yesterday, in the West, Port Said, Minya Dakahliya, 14 suspected cases of bird flu symptoms. Detained in the West «fevers Mahala» Nada Abdullah Ghazi, 6 years, from the village of Kafr El-Khamis, Mohammed Sameh and Norhan Azim, 3 and a half years, from the village of Saraj and dead Hussam Abdullah Abdullah Shahawi, «two», from the village of Jabriya, and Nasser Ramadan Antar, 6 and a half years, and Sameh Ala'edeen «years» received «Tanta fevers» Fayza Mustafa Zeinhom, 3 years, and Fawzi Huwaida SNOUSSI, plant Ayari, housewife, 30 years, Abeer Hassan El-Shafei, 3 years, Miriam Yahya Hamad Awad, 10 months, from the village of Shin Center Qtor fevers in Kafr El-Sheikh was detained as a hospital admitted the names of Kafr Al-Safa and Mr. Abdul Hamid, two samples were taken for analysis.

Samples were tested for b «Eman Mohamed Mohamed cane», 26 years of Kafr El-Khader, Center Besion Farid Mohammed and Fatima Ibrahim, 5 years, Kafr Hegazy, Mahala Center, was taken out of the negative after the hospital trust them.

In Port Said, said just to leave, and Under-Secretary, Ministry of Health in the county, the hospital admitted Port detained Radwan Radwan Abdul Sattar, to the Department of Civil Protection fire on suspicion of having bird flu, a hospital in Sadr Dakahliya detained in Mansoura Hanan Ahmed Hussein, 37 years from the village of Mit Assem were taking a sample to be sent to the Ministry of Health laboratories, bringing the number of cases, the hospital retained the 10 cases.

In Minya Minya detained hospital fevers Shehata, Hosni Mubarak, 22 years, the city of Minya has been sampled.

In the governor decided Monoufia Engineer Sami Amara closure of poultry farms for a period of 3 months to manage without a license and failure to take samples to be tested against bird flu in addition to the requirements and procedures followed to prevent the disease.

orginal article
http://www.almasry-alyoum.com/


United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sat May 09, 2009 at 19:46:05 PM CDT

Is it possible for you to do a summary of all the recent suspect cases?

The entry just above this was regarding suspect cases of swine flu, and this article is about suspect cases of bird flu. I also have heard from other sources that there are upwards of about 100 suspect bf cases in egypt over the past week or so.

The possibility of SF mixing and reassorting with BF is the nightmare scenario which we all dread. Right now, these reports make it seem like the scene is being set for exactly that, but without having all the suspect cases of each type of infection charted as to location and onset, it is really hard to follow.

I know this is asking alot of you, and that you are very very busy, but if it is at all possible for you to kind of put this together and post it on the news diary I think it would be invaluable.

Thanks for all you do.

Always have a plan B.

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by: maryinhawaii @ Sun May 10, 2009 at 01:56:37 AM CDT

[ Parent ]

Mary, a summary is a great idea.

Unfortunately cottontop has way too much on her plate right now.  She has both Egypt and Indonesia sites to search so she will not be able to do this summary.  Also I don't have any newshounds that I could ask to do this right now, because there is so much news to search.  If you would like to put something together, we would really appreciate it.

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

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by: History Lover @ Sun May 10, 2009 at 20:40:28 PM CDT

[ Parent ]

Egyptian girl contracts bird flu, 69th case

http://www.alertnet.org/thenew...

CAIRO, May 10 (Reuters) - A five-year-old Egyptian girl has contracted the highly pathogenic bird flu virus after coming into contact with infected birds, the state news agency MENA reported on Sunday.

The case brings to 69 the number of people confirmed to have contracted the H5N1 avian influenza virus in Egypt, which has been hit harder than any another country outside Asia.

While the avian influenza virus rarely infects people, experts say they fear it could mutate into a form people could easily pass to one another, sparking a pandemic that could kill millions.

MENA, citing the Health Ministry, said the girl from Sohag province was admitted to hospital on Saturday. It said she was being treated with the anti-viral drug Tamiflu and was in a stable condition.

cont.

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by: UK - Bird @ Sun May 10, 2009 at 15:51:02 PM CDT

Ministry of Health officially announced the 3 suspected cases of swine flu

5/10/2009 8:18:00 PM 5/10/2009 8:18:00 PM

CAIRO - Editor Masrawy - the Health Ministry said Sunday that he was detained on Saturday, 3 cases of a disease suspected of being infected by swine flu "virus 1 to 1."

And Dr. Abdul Rahman Shahin, official spokesman of the Ministry of Health had been detained by armed carpenter Helwan governorate named Reza indispensable Boshra birth at the age of 23 years Bhmyat Helwan, as well as old Fatma Samir Ramadan Qaliubiya County Hospital issued July 23, in addition to a veterinarian, Najib Iskandar Jiryes 57 year of the Governorate of Cairo were detained Bhmyat Abbasiyah.

Shaheen said that the results of laboratory tests were all negative for the virus, the global epidemic, "said the 1 H 1," pointing out that there is a difference between the statement and a  case of suspicion, which followed a series of measures to ensure the safety of the person or animal disease and the existence of cases already In light of this confirms that there has been no case of swine flu in Egypt until the day that what happened is just a suspicion in some cases have been confirmed free of disease after the disclosure.

The spokesman added that the official hotline 105 may come from the first of May until the evening of Saturday, 24,894 of communication between the queries and complaints and reports of breeding in the deaths of birds and pigs, with reported cases rose to the emergency room of preventive ministry on the 3877 flu and swine flu and flu-like symptoms.

The official spokesman of the Ministry of Health to stringent quarantine measures in all outlets and ports, and ongoing coordination and periodic follow-up of the
Ministry of Health and all relevant ministries, ports, airports and border crossings to ensure the safety of all arrivals to Egypt as well as follow-up from the affected States for the duration of their presence in Egypt and to take all preventive measures to all land ports, sea and air, and the application of quarantine measures at all coming from infected countries.

To continue efforts to reduce the spread of the disease and raise the high state of alert in all the facilities and begin to emphasize the rehabilitation of workers in all areas of the implementation of the activities of the ministry to  hold the front 29 a symposium on pandemic flu in the world of health departments in all governorates, attended by officials from all departments of all ministries and other public facilities in provinces and the work of 264 health departments in the symposium and 4600 at the level of villages and health units.

It also held training sessions to educate the crews of the aircraft company Egypt Air and the Ministry of civil aviation workers and employees in all areas of airports and ports, in addition to the work of a training program for 450 doctors in all provinces and a symposium on the global epidemic of health officials and doctors working with banks and tourist facilities.

Shaheen said that the confirmed cases so Alakhadd - also announced the World Health Organization - are in 29 countries around the world with total 4379, of whom 45 died in Mexico and 2 in the United States of America and the state and one in both Canada and Costa Rica, bringing the total death toll to 49 deaths case .

With the continued cases of suspected bird flu on Saturday only to the high state of 52 provinces of Cairo, Alexandria, Fayoum and Minya, Sohag, Qena and Aswan, Damietta, and the lake Qalubia Monoufia, East and West, Dakahlia, Kafr El-Sheikh, the New Valley, bringing the total of suspected cases of the disease since the  entry of Egypt in 2006 to 72331 confirmed cases and depends on the situation of 68 of whom 26 died and 42 recovered cases.

http://tinyurl.com/qz5pmw

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sun May 10, 2009 at 20:46:54 PM CDT

Thousands of Egyptians abandon Umrah plans amid flu fears

RIA Novosti

09/05/2009 12:25 CAIRO, May 9

(RIA Novosti) - Thousands of Muslims in Egypt have cancelled their plans to conduct a pilgrimage to the Islamic holy cities of Mecca and Medina this year due to the threat of A/N1H1 virus, Egyptian newspaper Al-Masri al-Yaum said on Saturday.

Over 3 million Muslims, including dozens of thousands of Egyptians, travel to Saudi Arabia to perform the Umrah or the "minor pilgrimage" every year. However, about 60% of Egyptian pilgrims decided against performing this ritual, following the warning from the Egyptian Health Ministry, the paper said.

Egypt so far has not been affected by the so-called "swine flu," but the authorities are taking emergency steps to prevent the possible spread of the deadly virus in the country.

by: mojo @ Sun May 10, 2009 at 21:01:07 PM CDT
http://www.globalsecurity.org/...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sun May 10, 2009 at 21:24:12 PM CDT

42 suspected bird flu in one day

Sunday, May 10, 2009

Egypt-42 suspected bird flu in one day

Distributed to 12 County

The number of cases confirmed since 2006 arrived in the case of 68
Written by Amira Abdel-Salam

.
Ministry of Health announced in a statement on Sunday that suspected cases of bird flu in Egypt and the case reached the 42 on Saturday, at a rate of 6 cases of the Governorate of Cairo and Alexandria, and 8 cases, 5 cases in each of the Monoufia and 3 cases of the West and the eastern region, Damietta, two Rawash Qalubia and one each in Fayoum, Menya, the lake and Dakahliya.

.
This brings the number of suspected cases of bird flu in humans since the disease in Egypt in 2006 to the 7179 case, the confirmed infection of 68, and 26 cases died of disease, while 42 corresponded to the situation of recovering.

hat tip treyfish-Pandemic Information News
http://tinyurl.com/omabaj


United we stand: Divided we fall

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by: cottontop @ Sun May 10, 2009 at 22:09:44 PM CDT

H5N1 in Egypt Raises Pandemic Concerns

Commentary

Recombinomics Commentary 14:58
May 12, 2009
http://www.recombinomics.com/N...

A five-year-old Egyptian girl has contracted the highly pathogenic bird flu virus after coming into contact with infected birds, the state news agency MENA reported on Sunday.

The case brings to 69 the number of people confirmed to have contracted the H5N1 avian influenza virus in Egypt, which has been hit harder than any another country outside Asia.
====================

The above comments describe the most recent confirmed H5N1 case in Egypt. Although the pace of confirmed cases has slowed in Egypt, local media reports continue to detail the hospitalization of suspect cases, although less than 1% of hospitalized cases are PCR confirmed for H5N1.

The low confirmation rate, coupled with mild symptoms, has raised concerns of silent spread of H5N1. The recent outbreak of swine H1N1 worldwide may allow the issue of H5N1 in asymptomatic cases, or those with lower viral loads, may allow this issue to be resolved.

In Egypt, H5N1 testing is limited to cases claiming poultry contact. However, if a swine contact was required for H1N1 swine testing, the initial positives in the United States would have gone undetected because none of the confirmed cases has a swine contact.

The H1N1 has led to enhance surveillance, although much of the testing has been limited to travelers originating in North America. However, the heightened awareness of H1N1 may lead to broader testing. Seasonal H1N1 and H3N2, as well as swine H1N1 and avian H5N1 will all give a positive on an influenza A test. Swine H1N1 and avian H5N1 however, will not sub-type with standard reagents, which are directed against human seasonal flu.

These swine H1N1 isolates are confirmed with additional tests that are specific for swine H1N1. However, H5N1 will also test negative on the swine H1N1 test, which will signal another serotype (or evolution of the swine H1N1) and require additional testing.

Such testing may lead to the discovery of widespread H1N1 in local populations in Egypt.

Release further analysis of non-typable influenza A positive samples in Egypt would be useful.

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by: Pixie @ Tue May 12, 2009 at 10:59:46 AM CDT

H5N1 suspect in Luxor

Detention of suspected case of influenza in Luxor
Monday, May 11, 2009 - 18:50

Shorter hospital fevers detained a suspected case of bird flu, the hospital had received shorter fevers Hefnys Mohammad Mahjoub (17 years) from the village of Almdamod west of Luxor, with a high fever and symptoms similar to bird flu and the hospital administration decided to detention and sampling, and sent to the central factor Cairo to the illness or not.

In a related context Luxor International Hospital granted exit permits for the Japanese tourists and an Egyptian tour guide was a free of swine flu, a Japanese tourist Iitap Luxor Hotel inmate has been informed of the management of the hotel Bchke in the illness after an outbreak of swine flu symptoms, and of which the high temperature was transferred to Luxor International Hospital with a tour guide, who was accompanied by were subjected to medical examinations and tests and found free of the disease, the authorities refused to give out the names of the tourist guide and tourism.

goggle translated
http://tinyurl.com/qpxvnn

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Tue May 12, 2009 at 20:08:02 PM CDT

Can we get a new Egypt diary please? n/t

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Tue May 12, 2009 at 20:11:43 PM CDT

new Egypt diary up...

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by: DemFromCT @ Tue May 12, 2009 at 21:04:42 PM CDT

[ Parent ]