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New Cases in Egypt II

by: MaMa

Fri Nov 24, 2006 at 03:25:24 AM EST


This Diary is for reports and discussion on the cases in Egypt.

The posts from the thread at the old forum have been transferred to this Diary and will be continued from here.
New data has been added for the current situation (Dec 06).

Notes and pic by Theresa42

MaMa :: New Cases in Egypt II
Link to New Cluster in Egypt I

My apologies for the formatting (or lack thereof:-). I'll see to it ASAP- I just ran short of time.

  22 November 2006
AnnieB – at 00:00

Last few postings from previous thread

anonymous – at 10:45 That Egyption govt site now says all tests negative, but they don’t enumerate.

http://birdflu.sis.g...

DennisC – at 10:46

Egypt

Some household poultry in the northern Egyptian city of Alexandria have been tested positive for the H5N1 virus, a government statement said Monday. The Egyptian Ministry of Health sent teams to cull the infected domestic fowls along with veterinary services and Alexandria police, Egypt’s official news agency MENA quoted the Health ministry statement as saying. The medical tests of people who have been in direct contact with the infected poultry are ongoing in the Egyptian Ministry of Health, the statement added. It also said that there were two suspected human bird flu cases from Cairo and Giza, west of Cairo, admitted to hospitals but tested negative.

http://tinyurl.com/y...

RBD – at 11:39

anonymous, A cache of the link you provided indicates the statement on no current human cases was made on or before November 12.

The four suspect cases listed in the first post on this thread were admitted 3–4 days AFTER that statement.

Ruth – at 15:08

So we are still waiting on those test results.. It shouldn’t take that long. The wiki world is waiting.

Snowhound1 – at 15:35

Well, also keep in mind that throughout the months of trying to track cases in various parts of the world, there have been many “suspected” cases that “we” have been waiting to hear the results of, and nothing is ever said about them again. They simply “disappear”. It will be disappointing, but this could very well be what happens in these four suspected cases in Egypt. We can only hope that the reason nothing is reported is that the tests are negative.

RBD – at 19:35

Snowhound1, Since two of the four were unconscious, and they form a tight cluster, it is harder for them to just go away.

Theresa42 – at 22:14

anonymous – at 10:45 — That Egyption govt site now says all tests negative, but they don’t enumerate.

http://birdflu.sis.g...

This report was posted on the Egyptian government’s website on Nov 2 — pre-dating the 4 suspected cases from Sohag, as RBD suggests. If you go to their Press Release main page, you’ll see the Nov 2nd date (it’s the one at the top): http://birdflu.sis.g...

Theresa42 – at 22:21

Snowhound1 – at 15:35 — Well, also keep in mind that throughout the months of trying to track cases in various parts of the world, there have been many “suspected” cases that “we” have been waiting to hear the results of, and nothing is ever said about them again. They simply “disappear”. It will be disappointing, but this could very well be what happens in these four suspected cases in Egypt. We can only hope that the reason nothing is reported is that the tests are negative.

Well put, Snowhound! To put things in perspective — there were at least 150–200 suspected cases back in March at the height of the outbreak in Egypt — and we pretty much didn’t hear anything about most of them. I suppose we just must presume they all tested neg. ??

I would guess, too, that there’s been at least a hundred or more suspected cases since then — we just rarely hear about them. The Egyptian gov’t pretty much only mentions positives (occasionally they mention poultry workers who tested neg — but they never say if these people had symptoms or were just tested ‘cause they were working with/culling H5N1 pos chickens) — we rely on the papers (mostly “Al Wafd”) for any hints about others.

Walrus – at 22:56

I don’t believ the Egyptian Government maintains a free press. After all, they have a Tourist industry to protect.

AnnieB – at 00:05

Previous thread is here

Theresa42 – at 10:26

Sounds like the 4 cases in Sohag have tested neg…

Google-translated from Arabic:

New hotbeds of avian influenza in Menoufia, Port Said

Nov 22, 2006

Sana, Mustafa wrote: Announced yesterday that the National Committee to confront disease avian flu headed by Dr. Hatim al-Jabali, minister of health and population infected with the emergence of new hotbeds of avian influenza in the Governorates of Menoufia, Alexandria indicate the emergence of the virus in birds in the household Alordian Alexandria between pen Obat deceased was a lady inside her house. Dr Rahman Shahin, spokesman of the Ministry of Health and added that the discovery of a new positive Menoufiya Governorate of chickens infected ÈÇäÝáæäÒÇ Obat domestic birds in the new facility status Albajor and teams from the Ministry of Health and veterinary services and the police to execute all birds in infected hot WittTahir places Educational birds and checking Almkhalten were sent samples of dead birds around the central labs to the Health Ministry spokesman also announced that the 7 »« suspected human cases in the presence of avian flu was negative outcome, the cases have been booked in hospitals Sohag, Giza and Port Said.

http://www.alwafd.or...

cottontop – at 10:38

If these suspected cases are testing negative, I wonder what they are testing positive for? What other diseases are still causing a nightmare there?

Okieman – at 10:39

Theresa42 – at 10:26

“negative outcome” sounds like they died to me, not a negative test. Machine translations are tough to interpret.

gharris – at 10:57

Could the testing procedures could be giving false negatives!

Mary in Hawaii – at 11:17

gharris at 10:57 This is from the WHO working group report of Sept 22 regarding research into H5N1. I don’t have the link handy, but you can find it on the WHO website. Title

“Influenza Research at the Human and Animal Interface”

I. Detection and diagnosis of human H5N1 infections Serological methods. A presentation from the US Centers for Disease Control and Prevention (CDC) described the state-of-the-art in diagnostic testing, including laboratory confirmation of H5N1 infections based on serological tests.

Such testing becomes important when poor sampling technique, poor specimen quality, or other problems rule out isolation of the virus or preclude the use of PCR-based tests. For example, two cases from the 1997 outbreak in Hong Kong were confirmed on the basis of serological results alone. Serological tests are also used in studies aimed at screening for mild or asymptomatic illness in population groups with high potential exposures to the virus, including family members and contacts of patients, poultry workers and cullers, and workers in live animal markets.

Serodiagnosis depends on the use of paired sera collected at specified dates during the course of a patient’s illness, as dictated by the kinetics of the antibody response. Antibody can usually be detected 10 days post-infection; detection of antibody 9 days post-infection is rare. When the collection of paired sera is not possible, diagnosis can be made using results from a single serum sample evaluated together with clinical and epidemiological data.

It sounded to me from this research paper that false negatives were a real problem in a lot of cases.

Little Kahuna – at 11:39

Yes, false negatives are a really big problem especially if they are masked by a patient who is currently taking Tamiflu.

Theresa42 – at 14:02

Okieman – at 10:39 — “negative outcome” sounds like they died to me, not a negative test. Machine translations are tough to interpret.

Yes, indeed — dying would be a negative outcome! In my experience, though, when the Arabic machine-translator says “negative outcome”, that means neg test results.

Gonna verify the whole article with another (better) machine-translator though — just in case.

Theresa42 – at 14:20

Same article as in post “Theresa42 – at 10:26″ — better machine-translation … I’m just assuming that the 4 suspects from Sohag (Suhaj) are included in this “7″ that have tested neg, although that’s not actually spelled out here ….

New foci to the bird flu in Monofiya and Port Said

She wrote - Sanaa Mostafa:

Yesterday the national committee for the confrontation of the bird flu disease with the presidency of doctor Hatem declared the mountain the Minister of Health and the citizens are the appearance of new foci injured by the bird flu in the governorates of Monofiya and Alexandria they become clear the appearance of virus in house birds in the rosy region in Alexandria between chicken and ducks one of the women raise them inside its [her] house.

He stated that doctor Abdul Rahman Shahin the spokesman to the Ministry of Health and he added that the discovery of a positive new site took place in Monoufia Governate to chicken and house ducks injured by the bird flu in the new facility in a district El Bajour and groups from the Ministry of Health, the veterinary services and the police have executed of all of the present birds in the injured foci and cleansing the places of Al Tew upbringing and he examined the contacts and sending samples took place from the associates by the dead birds to the central laboratories in the Ministry of Health as the spokesman declared that the “7″ the humanity conditions suspect of their injury by the bird flu disease their results came a negative and was the conditions have been reserved in the hospitals of Suhaj governorates, Giza and Port Said.

http://www.alwafd.or...

ANON-YYZ – at 14:48

Theresa42 – at 14:20

“foci” reads like “cluster”

Conclusion seems to be:

“suspected cluster of 7 in Suhaj tests negative”

RBD – at 14:59

Yes, it sounds like results were negative, but no indication is given on why the four were hospitalized the same day, or why 2 were unconscious.

The three unconscious patients in Turkey at the beginning of 2006 also tested negative initially, and were not positive until they died and samples were collected from their lungs.

Theresa42 – at 21:42

ANON-YYZ ¨C at 14:48 — Conclusion seems to be: ¡°suspected cluster of 7 in Suhaj tests negative¡±

No. The article says (from the second translation): “the ¡°7¡å the humanity conditions suspect of their injury by the bird flu disease their results came a negative and was the conditions have been reserved in the hospitals of Suhaj governorates, Giza and Port Said.”

So, there were 7 patients in 3 hospitals in Suhaj, Giza and Port Said. If we suppose that the article is talking about the 4 suspected cases in Suhaj, then there ought to be 3 between Giza and Port Said (unless there was a fifth person in Suhaj we haven’t heard of).

23 November 2006
RBD – at 09:35

Speaking of another patient at Suhaj:

Egypt reported a suspected new human case in the central city of Sohag, the Al-Ghomhuria newspaper reported today, without saying where it got the information. A 25-year-old woman was transferred to the hospital for treatment, the newspaper said.

Last Updated: November 23, 2006 08:14 EST

http://www.bloomberg...

anon_22 – at 10:03

anon_22 – at 12:00

And the Hajj is just round the corner.

Do people go to get healed of sickness? Or for someone else who is sick?

NS1 – at 17:27

The Hajj can be physically demanding and outbreaks of illness have occurred.

I’m not certain if it is considered a time of physical healing, perhaps more a time of of physical denial?

Theresa42 – at 22:22

RBD – at 09:35 — Speaking of another patient at Suhaj:

Egypt reported a suspected new human case in the central city of Sohag, the Al-Ghomhuria newspaper reported today, without saying where it got the information. A 25-year-old woman was transferred to the hospital for treatment, the newspaper said.

The story from Al-Ghomhuria…

Machine-translated from Arabic:

The bird flu is tribal and marine - Suspicion condition in Suhaj and a positive site in the lake

Nov 23, 2006

A new suspicion condition appeared by the bird flu disease in Suhaj .. Its name house lord Wafaa Abdul Salam was injured by it “25 years” from Salamon village Tema district and transferred Suhaj adenoids .. And in El-Behera Governorate the discovery of a positive site took place to house birds injured by the bird flu the confirmation of its positivity took place in the central laboratory in the Ministry of Health .. The site is in Al Fakharani’s village Delingat district and there are no symptoms on the contacts.

http://212.103.160.2...

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Three suspected human H5N1 cases

News thread has post to story on Yahoo that there are three suspected H5N1 cases in Egypt. May want to track here.



The First paragraph of the article

Thu Nov 30, 3:10 PM ET

CAIRO (AFP) - A woman and her two children are suspected of contracting the deadly H5N1 strain of bird flu in Upper Egypt, a veterinary official reportedly said.

The 25-year-old mother, her 12-year-old son and daughter, 10, from a village in Sohag governorate, were hospitalized after showing the first symptoms of the sickness, the province's veterinary services chief Mohammed al-Masri told the official MENA news agency.

They are currently undergoing tests to determine whether they are suffering from H5N1 which has killed seven people in Egypt this year, he added.

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead


[ Parent ]
25 year-old woman
I wonder if this 25 year-old mother of two from Sohag (Suhaj) is the same 25 year-old woman from Sohag reported the other day (on the 23rd, I think)?

Proud FAF-er.

[ Parent ]
25 year old woman - is this a duplicate?
I wonder if this 25 year-old mother of two from Sohag (Suhaj) is the same 25 year-old woman from Sohag reported the other day (on the 23rd, I think)?
by: Theresa42 @ Thu Nov 30, 2006 at 23:50:41 PM EST

-------------------------------------------------------

Do we have total of 2 suspected clusters or 3?

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.


[ Parent ]
Not sure
Haven't found anymore details yet (just so ya'll know -- I check the Egyptian papers 'Al Wafd' & 'Al Gomhuria' everyday).

Proud FAF-er.

[ Parent ]
a short timeline
I just ran a quick timeline of the Egypt events over the past two weeks.  16 Nov, 3-4 new cases of suspect human H5N1 admitted to hospital in Sohag, 2 unconscious. 22 Nov: poultry found positive for H5N1 in Alexandria, poultry hotbeds for H5N1 declared to be in Menoufia, Port Said and Alexandria.  2 suspect cases of human H5N1 in cairo test negative, the 4 suspect cases in Sohag test negative, report of possibly as many as 7 potential bird flu patients in 3 hospitals in Suhaj, Giza and Port Said.
Nov 23: another patient in Sohag with suspected bird flu
Nov 30: 3 more suspect bird flu cases, all from same family, in Sohag. 

Anyone see a pattern emerging here?
Can we post a map of Egypt and trace these cases?
Some questions that desperately need answering are:
Are there any known links between any of them (in addition to today's three family members)? Do any of the Sohag cases come from the same neighborhoods, use the same water source, shop at the same markets, etc etc?
Is Egypt doing any follow up testing on all those "negative" cases they reported over the past week, and is there any data on how these purportedly negative cases are doing these days?

As you recall, the genetic data Niman has traced proves that Egyptian H5N1 now has the necessary mutations to go H2H.  So, is it?

Always have a plan B.


Thank you for laying it out like that. We do need to track this. n/t




[ Parent ]
scientific pickyness
Mary, with all due respect, your statement

As you recall, the genetic data Niman has traced proves that Egyptian H5N1 now has the necessary mutations to go H2H.  So, is it?

really ought to have been stated as

As you recall, Niman's hypothesis based on the genetic features he has traced predicts that Egyptian H5N1 should now have the necessary mutations to go H2H.  So, is it?


medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.

[ Parent ]
didn't the Egypt gene sequence match the Nature prediction?
Lisa the GP: I realize you are being very precise, and I appreciate that. But I thought we had more than Niman's hypothesis to go on here. As I recall (and I could be remembering wrong) the Nature article gave a rather precise prediction of the genetic mutations that would be necessary for H5N1 to become transmissable enough H2H to become a pandemic, based on extensive laboratory research. Directly following that Nature mag prediction, Niman uncovered the fact that, based upon recent releases of genetic sequences from Egypt and - I believe - Dijbouti (sp?) these mutations had already occured.  Thus I didn't think he was predicting that the Egyptian H5N1 "should" have these mutations that could lead to a pandemic, but that these exact mutations predicted by the researchers from the Nature article had in fact occured, based on genetic sequences released by WHO. It's a slightly different spin.

Always have a plan B.

[ Parent ]
no the Nature paper did not make any such prediction
MIH: the Nature article gave a rather precise prediction of the genetic mutations that would be necessary for H5N1 to become transmissable enough H2H to become a pandemic, based on extensive laboratory research.

The Nature paper found that some strains of H5N1, in in vitro experiments using glycan array, was able to bind to sugars with alpha2,6 linked terminals, thought to be related to ability to bind to receptors on human respiratory lining.  Analyzing these samples, they identified several mutations that they thought was responsible for this binding ability.  Then they said that sequences from a couple of patients from Azerbaijan and one from Iraq had some of these mutations.

In interpreting this, one must be very careful.  First the receptor binding theory is far from proven, at least not in such a straight forward fashion.  Even assuming it is proven, it is only one element in a complex process of pathogenesis and transmission.  That is, it is likely that receptor binding may be necessary but not sufficient for h2h to occur and for the virus to be able to establish itself in a new species.

Secondly, assuming that the receptor binding theory in the simplified form (ie 2,6 binding = human binding = virus jumping species) is valid, there are still many pitfalls.  I already mentioned that this was a laboratory test on glass slides, which by no means mimic the complex biological conditions that the virus has to deal with.  We don't know that binding on glass slides is the same thing as binding on human cells.

The next issue is how unusual is it to find a positive test?  Now, H5N1 has to date infected 200+ patients.  Apart from one other paper published last year by Stevens and Taubenberger, where they used one sample from Vietnam, there has been no 'extensive research' on this at all.  If we can hypothetically get all 200+ samples and do the same tests, to the extent that the virus was able to infect these people, surely there must be some samples where this test will turn out positive?  Do you believe that from 2003 up till recently (aka when we know a pandemic did not happen) ALL samples should have been negative for 2.6 binding? 

I would suggest, and this is all hypothetical, that it is likely that there were some that were positive.  We just don't know how many.

In other words, we do not have a baseline (eg what is the overal percentage of samples that tested positive say from 2003 to 2005) with which to compare the test results. 

So the finding of in vitro 2,6 binding is important, we need to pay attention, we need to do more of these tests, but in no way can we conclude that we are anywhere close to discovering the definitive mutation(s) needed for the virus to go pandemic.  All that the researchers have achieved is to identify some changes that (read this language carefully) in laboratory conditions appear to facilitate binding to 2,6 terminal linked sugars on glass slides aka the glycan array tests.

There are still far too many dots floating around, most of which we have not identified yet, let along be able to connect them, IMHO.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Re. the 7 negs from Egypt
Mary in Hawaii:  report of possibly as many as 7 potential bird flu patients in 3 hospitals in Suhaj, Giza and Port Said.

The 7 suspected bf patients in 3 hospitals in Suhaj (Sohag), Giza and Port Said reportedly tested neg.  I thought that perhaps the 4 suspected cases from Suhaj (3 kids & neighbor/worker) were amongst these 7 that tested neg, although their identities were never actually spelled out in the news reports.

Machine-translated from Arabic:

New foci to the bird flu in Monofiya and Port Said
Nov 22, 2006

She wrote - Sanaa Mostafa:

Yesterday the national committee for the confrontation of the bird flu disease with the presidency of doctor Hatem declared the mountain the Minister of Health and the citizens are the appearance of new foci injured by the bird flu in the governorates of Monofiya and Alexandria they become clear the appearance of virus in house birds in the rosy region in Alexandria between chicken and ducks one of the women raise them inside its [her] house.

He stated that doctor Abdul Rahman Shahin the spokesman to the Ministry of Health and he added that the discovery of a positive new site took place in Monoufia Governate to chicken and house ducks injured by the bird flu in the new facility in a district El Bajour and groups from the Ministry of Health, the veterinary services and the police have executed of all of the present birds in the injured foci and cleansing the places of Al Tew upbringing and he examined the contacts and sending samples took place from the associates by the dead birds to the central laboratories in the Ministry of Health as the spokesman declared that the "7" the humanity conditions suspect of their injury by the bird flu disease their results came a negative and was the conditions have been reserved in the hospitals of Suhaj governorates, Giza and Port Said.

http://www.alwafd.or...

Proud FAF-er.


So this is old news then n/t


You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
Sorta old news
Just the news about the 7 suspected cases who tested neg.  I was just trying to clarify Mary's timeline.

The suspected cases of the 25 year-old woman and her 2 children appear to be new (although I'm wondering if the 25 year-old woman was reported in the news the other day -- see my comment above).

Just checking the Egyptian papers now....

Proud FAF-er.


[ Parent ]
you're the best
in the business, Theresa42!

[ Parent ]
re my post Nov 30 in relation to 3 new cases
I wasn't trying to  mislead by putting up that brief timeline, I was merely going through the thread picking up the recent events that other fluwickians had posted and reviewing them in a very scant outline. I believe I did say that all these other earlier cases had been declared negative (some rather rapidly) I was merely trying to make the point that nothing about them had been said since. Has anyone heard anything to indicate they have all fully recovered? What illness they did have that made Egyptian health authorities suspect bird flu? Have they been retested? (Since it is well known that PCR tests are often flawed, and that it takes a minimum of 9-10 days for antibodies to show up?) Ever since that rumor thread, I pick up that the attitude has become rather testy toward me, (as well as any of Niman's information) so I shall just go back to lurking and leave you all to sort things out without any further input from me.

Always have a plan B.

blaming the messenger
Mary, you were perfectly clear in your post that started the rumor that it was a *rumor* and you were essentially making a request for information to either verify or discard it.  You didn't do anything wrong and there's no reason for people to snark at you.

Niman, however should know better.  He and the others who ran with the rumor without verification should be ashamed of themselves.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
Please stay with us!
MIH, your input is valued by so many who aren't taking the time to pick nits about wording of other's posts.  Please don't let a few people, who seem to have a bit of extra time that might be better spent actually looking for news or information, run you off.

Folks, I've got a bad feeling about the way we're slowly starting to unravel.  Please, lets go back to real news and constructive thoughts about solutions to problems.  If your post is not constructive, think about not posting it.  If we don't do this, we're going to run people off of this board and miss some important contributions.


[ Parent ]
Addendum
By the way, my frustration with the tenor of the board is not specifically with comments on this thread.  It's an overall feeling I'm getting, and I didn't mean to direct this to any specific individuals.

I'll go back to my hole now...


[ Parent ]
picking nits on wording
Ree, I think I've been pretty supportive of MaryinHawaii on this rumor thing.  Mary if you felt picked on by me regarding the 'Niman theory' thing, I didn't mean it that way, I'm just a stickler for remaining evidence-based.  Honestly I'd already decided what the comment would be based on the content and noticed that you were the poster only in the process of copying the quote; my comment was content, not personality, based.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.

[ Parent ]
People have so much invested in BF
That it gets a little obsesive round here every now and then. A lack of actual news is making people react too strongly to anything posted. I swear some people seem to want a pandemic to happen so they'll be proved right.

I wouldn't blame you for going back to lurking (we've all been tempted at one time or another) but the site needs as many posters as possible.


[ Parent ]
UK--yes I want a pandemic to happen...
Yes, I would like to order a flu pandemic for this flu season, and I'd like it to be an H5N1 strain with a lethality on order of that observed in the 1968 pandemic or less, so that any nastier strain that may try to come along later finds a population so chock full of H5 and N1 antibodies as to be hardly palatable at all.

Hows that? :D

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
LOL me too
I also want to win the lotto

[ Parent ]
I want a pandemic to happen
Doc, did you have a sandwich on wry for lunch today? :P

It is better to look ahead and prepare than to look back and regret.

[ Parent ]
To hell with 'em Mary

Not testy here. You made it clear that it was a rumor. You did nothing wrong. But it does sometimes take thick, thick skin to withstand reactions that range from nitpicky to hypercritical to outright hostile reactions of some posters.

If you need to take a breather for your mental health, go for it. It is good sometimes. But don't let the dogs get you down. And don't forget to come back.



[ Parent ]
Hear! Hear! n/t



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Hang in there Mary
I appreciate all your contributions to NFW and I stand by you on the Quebec rumor.  It was advertised as rumor quite appropriately.  It was just unfortunate the way some people took it.

Meteorologist in Florida!?!  Now we're talkin'!!!

[ Parent ]
Egypt timeline
MIH - thanks for the timline.  It helps to see it listed out that way.  I've been troubled by the 7 negatives - it would be nice to hear what the outcome is/was (was it just a bad seasonal flu?  Dengue? Something else?)  Did they survivie? Pass on??

I thought I saw some discussion here (or elsewhere) that the H5N1 tests often came back with false-negatives, especially the quick-tests.


snowdog - This may be the article you were thinking of re: false negatives
[ Parent ]
egypt timeline
Thank you Mary in HI, i was actually hoping someone would do a timeline on that for us.  BTW, thank you also for posting the Canadian 'rumour', most news and facts begin as rumours...

Ditto!
T42 :)

Proud FAF-er.

[ Parent ]
Official Recognition of False Negatives - Conflicting Standards for Labels?
Given the increasing acknowledgment of false negatives, I wonder if we are going to see some contradictory labeling being done by the scientific types on one hand(potentially withholding judgement/labeling until a greater number and different type of tests are run) and the labeling done by the political/economic types on the other hand (that will trumpet the first sign of negatives even though it may not be conclusive). 

Given the recent studies detailing the false negatives and the incidents of positives being identified after 8 or 9 negatives, it seems likely that there will be some different standards applied  - which may also reflect the biases and interests of the spokesperson/organization.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 


Just an observation
In perusing the English speaking Egyptian bird flu site...

http://birdflu.sis.g...

I had remembered reading that Egypt was testing up to 100 people a day. I imagine some of the more "likely" suspect cases make the news, the others do not. It certainly seems they are actively looking for human cases at any rate.

This is the last sentence found in "Bird flu statistics"
http://birdflu.sis.g... 

- Ministry of Health is daily analyzing up to 100 human specimens for free all over Egypt.

If all of these "suspected" cases made the news, there is no way you could keep track of them all. My best sense is that we will have to wait on a confirmed cluster and see where that takes us, wherever that may be. JMHO

 


Egypt testing up to 100 people a day
Whenever there is a bf outbreak in poultry, Egypt seems to test anyone who may have had contact with that poultry (good policy) -- that's my impression anyway given what I have seen in the Egyptian papers and from the government's bf site like you say.

I think when bf suspected cases hit the news, then those people are definitely showing flu-like symptoms and/or have been hospitalized.

Proud FAF-er.


[ Parent ]
Regarding testing of "suspect cases"
Hey Theresa42-

This is exactly in-line with the boundaries  that the WHO has published for testing of "suspect" cases. We shouldn't be surprised at the sheer number of "tested" cases. They should be frequent and numerous. The new guidelines would almost mean that if you had flu symptoms you would also be tested for H5N1.

I don't necessarily believe that this type of testing is occurring, but the more they test the better, as far as I'm concerned. The costs of doing this however, may turn out to be more than most countries can afford, and I'm more concerned about when NO testing is carried out, and suspected cases are just ignored due to cost restraints. This is when things can really snowball. I keep reading about how much money it is going to cost to keep abreast of the situation, and in light that it is still a "hypothetical" occurrence, I imagine the money will dry up long before the virus will lay dormant. Every news piece I read tends to lend a feeling of "we have it under control."

Every individual, state and country is going to place limits on what they feel is an appropriate amount of money to spend..if the need exceeds the demand, then there will be a lot of unknowns out there.


[ Parent ]
As an example...
On the same site, (Hard to discern the date of the entry because they don't date them individually), which had to have been entered since the last death on October 30th, as there is mention of that specific case.  I have never seen this suspect case in any "news" story, although more detail was supplied than is normal.

Yesterday, Engineer Ahmed Mohammed Abdul-Qadir, 63 years old, on pension, living in the Oguizzi area in Tanta Governorate was kept in the hospital for being suspected bird flu infected. He was primarily given a dose of the Tamiflu medication until the final analysis be released.

http://birdflu.sis.g...

I have no idea when "yesterday" was, but I certainly haven't seen a release of the final analysis. I have a feeling we won't be seeing the results of the "suspect" cases, unless they are really bad. This must have taken place in early November, just a guess, because I found the site within the last three weeks and it hasn't been updated since that time. 


Report is from Nov 2
If you go to the main press release page on the Egyptian government's bf site, you'll see that this press release is dated Nov 2 (it's the one at the top).

http://birdflu.sis.g...

I'm pretty sure that is the correct date of this press release since someone (hat-tip, Dutchie!) also posted it on Nov 2 on CE:
http://www.curevents...

Proud FAF-er.


[ Parent ]
Theresa42-Thanks for illuminating my point! n/t


[ Parent ]
recombination data
First, thank you very much for your kind words: It is easy under these circumstances to be somewhat on edge and testy. I don't think the situation we are in can be overstated: those who see what is at stake, the potential outcome, cannot even look it squarely. I know I can't: I glance at the possibilities sideways and squinting, a view head on is just too much to absorb and allow.

That said, I would like to say something about Niman's recombination theories, since that seems to be an ongoing subject of debate among many here. I am fairly new to this site, so I don't know what went down that made him the subject of so much controversy. When I read his postings on his website I don't see anything but the relating of data that he has gathered and put into an orderly form which seems to track the ongoing evolution of the H5N1 virus over the past 3 years or so.  As regards the theoretical role that recombination plays in such viral change, I would like to cite a reference. Raven & Johnson 4th Edition "Biology" textbook, c 1996 is the College Board's recommended text for AP high school biology courses. I taught AP biology in California, which is why I have a copy. On page 657 there is an essay on Flu Viruses. Here is a quote directly from that textbook:
"A change in one of the amino acids of the spike protein occurs as a result of point mutation in 1 of 100,000 viruses during the course of each generation. Such changes rarely alter the shape of the spike protein enough for it to escape the surveillance of the human immune system. The problem in combating flu viruses arises through recombination. Viral genes are readily reassorted and recombined, even among fundamentally different viruses. Such reassortment can produce major shifts in the amino acids that make up the spikes. When such shifts occur, worldwide epidemics may result....(snip) Viral recombination of this kind seems to have been responsible for the three major flu epidemics that have occurred in this century, the "killer flu" of 1918, the Asian flu of 1957 and the Hong Kong flu of 1968. (snip) Flu virus researcher Robert G. Webster of St. Jude Children's Research Hospital in Memphis, Tennessee believes that the Hong Kong flu virus originated when the genetic material of a human flu virus recombined with another virus from a duck."

Of course, many of you wikians are pHds, MDs etc and are quite well aware of this already; which is why I can't see what all the argumentation is over Niman's basic hypothesis, which is that it is primarily recombination that causes the genetic shifts in flu viruses which lead to pandemics. Isn't that exactly what Webster says? I would appreciate it if someone would explain to me if there has been a fundamental shift away from this viewpoint in the last ten years since the book was published that has made what was once accepted now controversial? Or is it something else?


Always have a plan B.


there is an unfortunate confusion in terminology here
The word recombination is used in several different ways.  This is one of the most important things to know before you can make sense of this controversy.

First of all, it is loosely used, as in this book that you quoted, to mean any exchange of genetic material between 2 different strains.  In this context, it may be used synonymously as reassortment (the exchange of a whole gene segment), or it may imply that reassortment is one form of recombination.

Secondly, it is used in a more technical sense to mean the exchange of portions of one gene as opposed to a whole gene segment (aka reassortment).  That is the meaning that Niman uses it for, and that is the meaning that the debate is about.

Thirdly, it is used in laboratory language to describe any process or product (recombinant) that involves exchanging or combining genetic material from different sources.  This use and the processes involved are not part of the debate.

There are several mechanisms by which a pandemic influenza virus can arise.  The vast majority of scientists accept reassortment and gradual adaptation by mutation as the major mechanisms.  What is controversial is whether recombination (in the sense of exchange of portions of one gene or even a single nucleotide) is a significant process of evolution for flu viruses.  Most scientists think not, while Niman thinks so.

I hope this clarifies some of the confusion for you.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Recombination in DNA not RNA
Recombination is validated as occurring in DNA-based organisms and microbes.  The mechanism for DNA recombination makes use of the base-pairing of the double helix.  RNA, while it can form transient pairings, does not have this stable base-pairing proclivity, and so would have to recombine by some other mechanism.

Niman has no explanation as to how or why the RNA strands would be in proximity to recombine, and has refused the assistance of a molecular biologist to try to figure out such a mechanism that might make his hypothesis more tenable.  Also, much of the data he presents in support of his arguments has alternate explanations that do not rely on any previously unnoticed natural phenomenon.

That does not mean he is wrong.  It does explain why people who are in science are skeptical.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
there is evidence of recombination in some RNA viruses
but it is considered very rare in what is called 'negative-sense' RNA viruses, to which influenza belongs.

This is an excerpt from my previous post on the subject:

"I have written on this topic before. This is the link to a summary of a review paper on recombination in negative sense RNA viruses, which IMO is the most complete review of recombination for this particular group of viruses, which includes influenza A.

"The original paper can be found here Phylogenetic analysis reveals a low rate of homologous recombination in negative-sense RNA viruses, Chare et al, Oxford UK"


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
thanks susanC
Looks like I know what I'll be reading on my laptop tomorrow.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.

[ Parent ]
Ditto!
Definitely helps clarify...and I'll be reading your referenced material tomorrow too. Thanks for making it available. Aloha!

Always have a plan B.

[ Parent ]
Learning Recombination: Links to articles, etc...
There is a thread with links to that article and many others, on CurEvents:

There is also some discussion of those articles including some comments on them from Niman:

http://www.curevents...


[ Parent ]
RNA doesn't have stable base-paring proclivity ?
How does RNAi work again ?  I though it was with double-stranded RNA...

[ Parent ]
Let's just say...
there were some differences of opinion between Niman and others and things also got personal.  It's a shame as I value all ideas in trying to figure this whole thing out.  While I'm well educated I am definitely NOT a scientist.  I find that when I am reading differing opinions I can see both sides of the arguement (or in this case it may be multi-sided).  Truth be told no one knows for certain otherwise we wouldn't be where we are now - lots of unanswered questions and a great deal to be fearful of.  Thank you for your post and welcome aboard!

[ Parent ]
A couple more useful articles...
"Evolutionary aspects of recombination in RNA viruses"
http://vir.sgmjourna...

"RNA Recombination in Animal and Plant Viruses"
http://mmbr.asm.org/...

Proud FAF-er.


[ Parent ]
Mary, this is the internet, you can be anything you want to be
Mary, just pick an anonymous name and put as many MDs, PhDs, DDScs- honorary anythings you want after it. You can even be a Nobel Prize winner here. I am a 5 star General. Never be intimidated by an anonymous person on the internet. They could really be a 13 years old for all you know; or Prince Charles.

  * EdD - Doctor of Education
  * DBA - Doctor of Business Administration
  * DProf - Doctor of Professional Studies
  * DClinPsych - Doctor of Clinical Psychology
  * EdPsychD - Doctor of Educational Psychology
  * DNursSci - Doctor of Nursing Science
  * HScD - Doctor of Health Science
  * EngD - Engineering Doctorate
  * SocSciD - Doctor of Social Science
  * DMin - Doctor of Ministry
  * ThD - Doctor of Theology
  * MD or DM - Doctor of Medicine
  * PhD - Doctor of Philosophy (most universities)
  * DPhil - Doctor of Philosophy (University of Oxford, University of Sussex and a few others)

[edit] Higher Doctorates

  * DD - Doctor of Divinity
  * DCL - Doctor of Civil Law especially at Oxford
  * LLD - Doctor of Laws
  * DM or MD - Doctor of Medicine not to be confused with the American MD
  * DSc or ScD - Doctor of Science
  * DLitt or LittD - Doctor of Letters
  * DLit - Doctor of Literature
  * DMus or MusD - Doctor of Music
  * DDS - Doctor of Dental Surgery
  * DUniv - Doctor of the University


[ Parent ]
well, maybe that is how you got *your* 'credentials'...
I got mine at a US accredited medical school and a US accredited residency program.

You can claim anything you want but if you don't have the knowledge base, it starts to show after awhile.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
the above comment is not particularly useful
clark likes to be deliberately provocative at times for reasons known only to him.

Ah, well. Everyone has to have a hobby.

I suggest everyone ignore the bait.


[ Parent ]
See niman's recombination site for latest posts on Egypt
forgot to add that to last post ;0p

Always have a plan B.

how many tested for it
I don't have my notes with me right now because I'm not at home, but if I recall, the state of California has tested about 70 suspect bird flu cases, all of which proved negative.  These were people over the last year or so who had a flu-like illness after returning from countries where there was an outbreak.  No mention was made of any deaths, so presumably they all recovered.

Testing is only an indicaton that TPTB are taking the matter seriously.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


There is discussion re new Egypt cases
on the News Diaries - 24th and 25th December if you want to "keep up"

Eat pudding first - who know's what might happen next! - Anon

Egypt Case Data updated
Egypt Case Summary - Updated as of 26 Dec 06
WHO Case Age Sex Symptoms Hospital Death Region Assoc other Cases Comments
1 30yrs F Mar 06 16 Mar 17 Mar  Qaliubiya No  Monitored others, no signs
2 30yrs F 12 Mar  16 Mar  27 Mar  Qaliubiya No Noted from same region as Case 1
3 32yrs M 16 Mar 16 Mar Recovered  No details No  Farm worker, poultry recently culled
4 17yrs M 18 Mar 19 Mar Recovered  Gharbiya, Nile Delta No  Father runs poultry farm
5 18yrs F Mar 25 Mar Recovered  Kafr El-Sheikh No  Same region as cases 6 and 7
6 6yrs F April No detail Recovered  Kafr El-Sheikh Sister case 7  Reported recovered later
7 1.5yrs F April No detail Recovered  Kafr El-Sheikh Sister case  6  Reported recovered later
8 31yrs M late Mar 30 Mar Recovered  Fayoum** No  Diagnosed in Jordan
9 1.3yrs F late Mar? 4 Apr Recovered  Sohaj No  No other details
10 6yrs M late Mar? 6 Apr Recovered  Qaliubiya No  No other detail
11 18yrs F 29 Mar 5 Apr 6 Apr  Minufiyah No  Nil
12 18yrs F 5 Apr 11 Apr 14 Apr  Minufiyah No  Nil
13 27yrs F late Apr? 1 May 4 May  lived in Cairo No  Infection occurred in Minufiyah
14 75yrs F 11 May no data 18 May  Al Minya No  Exposed to infected poultry
15 39yrs F 30 Sep 4 Oct 30 Oct  Gharbiya, Nile Delta No  Exposed through home slaughter
16* 30yrs F mid Dec? 17 Dec 24 Dec  Gharbiya Cousin of cases 17 & 18  Extended family living in single dwelling
17* 15yrs F mid Dec? 20 Dec 25 Dec  Gharbiya Sister case 18  Cousin of case 16
18* 26yrs M mid Dec? 20 Dec no status  Gharbiya Brother case 17  Cousin of case 16

* WHO have not posted updates to their website yet
** Assumed to be source of infection (Egypt National living in Jordan)



Eat pudding first - who know's what might happen next! - Anon


Further detail from Theresa42
From my notes...
7 previous deaths (now 9 counting the two recent deaths from Al Gharbiyah):

30 yo woman WHO Mar 20, 2006 -- Amal Mohammed Ismail, d. March 17, 2006
30 yo woman WHO Mar 29, 2006 -- Fatima Mohammed Yussef, d. March 27, 2006
18 yo girl WHO Apr 13, 2006 #4 -- Irnan Mohamed Abduld Gawaad, d. April 6, 2006
18 yo girl WHO Apr 21, 2006 #5 -- (from Al Minufiyah), d. April 14, 2006
27 yo woman WHO May 4, 2006 #6 -- (from Al Minufiyah), d. May 4, 2006
75 yo woman WHO May 18, 2006 #8 -- Zeinab Mahmoud Mohamed, d. May 18, 2006
Hanan Aboul Magd (39F), d. Oct 30, 2006

8 recovered individuals:

32 yo man WHO Mar 29, 2006 -- Mohammed Bahaaeddin Abdel-Menem, recovered
17 yo boy WHO Mar 29, 2006 -- Mohamed Mahmoud Ghobashi, recovered
18 yo girl WHO Mar 29, 2006 -- Shaimaa Khairi el-Desogi, recovered
31 yo man ProMed 20060406.1034 -- Abdul Fattah Asaad Mabrouk (in Jordan), recovered
18 month old girl WHO Apr 3, 2006 #2 -- (from Kafr El-Sheikh), recovered
6 yo girl WHO Apr 3, 2006 #2 -- (from Kafr El-Sheikh), recovered
8 yo boy ProMed 20060406.1034 -- (from Al Qaliubiya), recovered
16 month girl ProMed 20060405.1021 -- (from Sohaj), recovered

(This is also posted on today's News Diary (25 Dec)

Eat pudding first - who know's what might happen next! - Anon


More new information from Theresa42
More on Intisar & Shafika Farid 
Intisar Farid (30) was the mother of 4 children.  Shafika (15/16) was supposed to get married next week....
Machine-translated from Arabic:

The disbelief of the kiblah shop it says goodbye to the eighth victim to the bird flu epidemic [now there is also a ninth]
The specter of death threatens its brother with the hospital of the Abbasid chest
The village peoples got rid of the birds for fear of moving the epidemic to them
Dec 26, 2006

A follow-up:  Hani Atef in a late hour from an evening - the day before yesterday - the village of the dead of the tribalism shop belonging to my wedding procession center said goodbye to "Farid Badawi's victory" [Intisar Farid] the second victim to by the western [Al Gharbiyah governorate] and that took the last breaths inside Al Sadr's hospital by the Abbasid after their transfer to them from my wedding procession fevers hospital she, their [her] brother [Reda Farid] and their nephew [cousin - Shafika Farid - now dead] is till now if the analyses of the central laboratories in the Ministry of Health proved their injury by the disease and their [Intisar's]  condition deteriorated and have been buried in their family graves in the village amid the weeping and the wail of the women and its [her] four children and its [her] seven brothers.

"The delegation" lived hard moments inside the house of "a victory" [Intisar] family formed of a single room in them the poverty and the disease met so that it transfers the life of family formed of two parents and 8 brothers to a hell after a death "a victory" [Intisar]  and lying its brother Reda - 26 years - a worker in bricks factory in a serious condition in Al Sadr's hospital by the Abbasid for his injury by a same and an invitation is to dismiss about it the specter of death because it became the only breadwinner to the family.

Farid Abdul Halim - 80 years - "victory" [Intisar's] father says that his daughter was married from Ramadan Al Sharqawi - 35 years - daily wage worker in bricks factory and it [they] has four sons they are Dina - 12 years - a student by the primary sixth grade, and an upper - 5 years - and Mohamed - 3 years - and a satisfaction a year and half of the years and the disease symptoms have appeared on them [Intisar & Reda] after their carrying out of the participation in the slaughter of a number of the ducks and the poultry that carried out their purchase from a market the village is in "Shafika Farid"'s preparation for its nephew [cousin] wedding party - 16 years - and that was injured also by the same disease [Shafika is now dead, too], and have been reserved in the hospital of the Abbasid Chest and was whose wedding is scheduled last week and passed without its completion of the death of one of village sons [wonder what that person died from?] so that it postpones to this week.  And he added:  the joy turned into a funeral and the father joined a severe weeping and its condition deteriorated and could not complete the talk with us.

And Mr. Abd Al-Halim a brother says I fabricate with severe rise in the temperature she, its [their] brother and its nephew [their cousin] and have been transferred to the hospital receiving the necessary treatment and remained they by it for 5 days their dimension they deteriorated their condition and at the appearance of the analyses results that confirmed their injury by the disease was transferred to Cairo, and after it we heard death news "a victory" [Intisar] that fell on our ears as the thunderbolt, and it directs their husband and a number of the village sons to the receipt of their body and have been transferred to the village to it is buried in the family graves.

And in a distant corner its old mother Shafika Mohamed Rizk - 63 years - that laments her flesh and blood sat "a victory" [Intisar] that died because of the poverty and the failure of government in the provision of a pain to the bird flu and its cries rose "your joy turned into a funeral O Safiyya" they went to its calming down and started they say its deceased daughter was bend the family individuals and she was carrying out the response of all its needs especially after they became crippled the bed after their injury by the paralysis since a many years and we were getting ready for the wedding nevertheless it turned to a funeral and a great sadness till now the death of its dear daughter and Refaat its hands to the sky suppliant Allah is to write the rescue to its son "Reda" and its granddaughter [niece] "Shafika" who lies in the hospital between life and death.

And village mayor Mohamed Fouad the head confirmed that it just after the assurance from the three conditions injury by the disease attended to the village emergency teams, and have aided the condition a security cordon around the family house as far as a kilometer from all of the trends, the execution of poultry and the house birds that the families were hiding it inside bedrooms in addition to the holding of cleansing operations of streets, the village houses and the burial of poultry that have been executed in the health cemetery and taking samples from all the injured family individuals and with their number reaching 33 persons for its analysis to make sure of its being free from the disease.

And the village peoples confirmed that they hurried just after their knowledge of the death of their village daughter into getting rid of the poultry, the ducks and all of the birds for fear of moving the disease to them or to their boys and pointed out that their birds did not fortify before the veterinary medicine.  And the death of "a victory" [Intisar] has revealed the procrastination of the veterinary medicine systems by the western [Al Gharbiyah] about carrying out of the first with the fortification of the birds of the biggest farms by an evidence is that most injured conditions are from the villages citizens and any real injury did not happen in the farms which the failure of measures that the Health Department took with the preservation confirms and prepares an indication that "a victory" [Intisar] will not be the last victim to the disease.

http://www.alwafd.or...

by: Theresa42

Eat pudding first - who know's what might happen next! - Anon


Thanks, AnnieB!
:)

Proud FAF-er.

[ Parent ]
A little more on Shafika...
From the Kuwaiti News Agency...

Machine-translated from Arabic:

The Egyptian Ministry of Health ..A ninth human death condition by the bird flu virus

Cairo - 25-12 (an universe) - The Egyptian Ministry of Health declared that an Egyptian girl was dead today after its injury by the bird flu virus (H5N1) so that the number of the persons who spent at [died from] this disease in Egypt to nine persons since the emergence of the epidemic in last February come.

And the ministry in a press statement explained that the girl that aged 15 years she was dead in one of Cairo hospitals explaining that it at the appearance of the disease symptoms on the girl her detention and their giving took place the necessary treatment including a drug (Tamiflu).

And she pointed out that the samples that were taken from the girl proved their [her] injury by the disease and have been put thereafter on the respirator last Saturday [Dec 23] until the death came to her today due to the stop of heart.

And the Egyptian Ministry of Health has declared yesterday an eighth human death condition to a woman that reaches 31 years due to Idabtha [exposure?] by the same virus during the slaughter and the cleaning of domestic birds.

And the Egyptian government showed the great interest with the confrontation of this disease since Prime Minister doctor Ahmed Nazif held a the meeting of the month the past for understanding of the last readiness on the national level for fighting bird flu and coordination to the crisis administration.

And the Ministry of Health and Population provided large amounts of the medicine of Tamiflu the anti-disease that reached its number two millions doses as two Egyptian companies started the production of this medicine locally.

http://www.kuna.net....

Proud FAF-er.


Thanks Theresa
You really put a human face on these cases.

One thing that comes through is that they clearly understand the link between AI in poultry and human infection.  Even if they disregard it and choose to hide their birds, they understand it. 

There is no mention, however, about any concern that one human may have caught the virus from another human, or that it could be transmitted person to person.  The 1KM quarantine indicated is, of course, the customary, for poultry.  People seem to be able to move about freely, and there is no word on any restrictions of the movement of the rest of these victims' families. 

The good news is that its been 8 days since the 30-year-old woman entered the first hospital, and 5 days since the second victim (15) and her brother (26) also entered the hospital.  Presumably less than ideal precautions were taken on the part of the HCW's at these local facilities before their patients tested positive and were swiftly transfered to Cairo.

It seemed to take 5 to 7 days for these cases to become ill enough to enter the hospital.  As far as additional cases go, we are still in this window.  The next two days should indicate whether this was a very limited family cluster event or not.  That no additional cases have been mentioned so far is good news, but the strain that these three family members contracted seems to be particularly virulent.  Let's hope the worn adage (hope?) that the virus won't evince such virulence if/when it becomes transmissible is operational here.  I'd hate to see it run through this family and this hospital with its present virulence. 


[ Parent ]
Is a local market the origin?
From T42's post, "ducks and the poultry that carried out their purchase from a market". Now this sentence had me up in a shot, here's why:

So the family was busy getting ready for a wedding.

1. Did they buy live ducks/poultry in the market to supplement their own little flock in anticipation of the wedding, putting the just bought new birds with the existing ones, with the view of culling and cooking the birds just before the wedding ceremony that was to take 2. place a week later?

2. Since they were so poor, could the birds have been gotten at a very low price for being perhpas not in the most pristine health?

3. Did they buy ducks/poultry to replace a little flock that had just died suddenly?

4. Or, since they were so poor, did they ever have a flock at all, and did they just buy the ducks/poultry with the intention of feeding them up till a day or so of the wedding and then culling and cooking them?

Is there something I misunderstood?

Let me be blind to wicked text, deaf to wicked words, mute to wicked comments.


I am asking those same questions
FrenchieGirl.  To cull birds 2 weeks before the wedding does not make sense, so how were all 3 of the infected people who died become exposed?  Did the birds even die or appear ill?  These individuals became ill 2 weeks before the wedding, so the argument that they were culling birds for the wedding doesn't fly with me.  You cannot refrigerate poultry for 2 weeks, so they would have to be frozen.  If these are poor individuals, they may not have those options (refrigeration/freezing)available to them.

[ Parent ]
chicken meat is best preserved alive...
they did not need any frigde, they keep their birds alive until dinner time..

regular in most part of world. The reason why they bought the birds two weeks prior is probably because of awailible transport that day, other shopping etc... Is it fare from a marked this place? Maybe a local map could tell.


[ Parent ]
7 suspected cases in Bani Suwayf & Al Gharbiyah governorates
Four more suspected cases -- 2 in Al Gharbiyah governorate and 2 in Bani Suwayf governorate.  This makes seven total suspected cases, apparently -- 4 in Mahalla and 3 in Tanta...

Google-translated from Arabic:

Four suspected human cases of avian influenza in Beni Suef [Bani Suwayf] and Western [Al Gharbiyah]
Dec 27, 2006

Mohsen Karim, Hani Atef emerged:  Pathological cases suspected of being infected with a new avian influenza in Beni Suef and Western .  Doctors at the hospital were surprised pathogenesis of Beni Suef appearance of the symptoms of the disease known Hoda Abdel-Hamid of the village of Blvia Amal Mohammad Omar from the village of Riyadh Pasha was accorded some medicines and drugs.  As has been withdrawn samples and sent them to labs to make sure that catching the same disease.  In Western were yesterday detained two new hospital pathogenesis of Mahalla on suspicion injuries allegedly reported the disease, namely Ibrahim morning Fakhrani us from the village of Abu Sair, of the Center for Child and Smnod Mohamed Farhat Captain of the same village.  The medical devices to withdraw samples of the two cases and sent to the Health Ministry's central labs.  This brings the number of suspected cases of avian influenza in the bee Bank to 7 cases including 4 in the pathogenesis of hospital Mahala and 3 Hospital pathogenesis of Tanta.

http://www.alwafd.or...

Bani Suwayf governorate is ca. 100 km south of Cairo:
http://en.wikipedia....

Proud FAF-er.


Theresa42, thankyou so much for
your efforts in getting these translations for us .. as saddening/alarn=ming as they are, we would be lost without people like you doing this.

Is there anything I/we/others can do to help you with this?

Eat pudding first - who know's what might happen next! - Anon


[ Parent ]
No problem!
There's some tips for searching/machine-translating bf-news from Egypt here...

http://www.newfluwik...

...for anyone who wants to join in the machine-translating, hair-pulling fun. :p

Proud FAF-er.


[ Parent ]
Al Gharbiyah officials under criticism...
Google-translated from Arabic:

Western [Al Gharbiyah] attacking local officials neglect in the face of bird flu pandemic
Decisions banning the circulation of live birds "ink on paper" .. The official statements alleging safety procedures
Dec 27, 2006

Tanta Atef Khamaisa, Hani Atef:  In a hot attacked members of the local council of the Western Province [Al Gharbiyah] executive organs responsible for the face of bird flu pandemic conservatism.  The chairman of the board of health, veterinary medicine and agriculture failed to implement the Security Council to ban the circulation of live birds in markets and said that the birds are sold in markets, and this poses a threat to the public health of citizens and thus maintain efforts to contain the disease and prevent its spread.

A number of members had asked to Undersecretary of the Ministry of Health and Agriculture and the Director of Veterinary Medicine on the measures taken by their agencies to confront the disease avian flu and foot-and-mouth disease, the causes that led to the failure to eliminate them so far and safe disposal of medical waste, which pose a threat to the integrity of the environment.

Mr. al-Husseini, Undersecretary of the Ministry of Health Directorate is the vehicle and the early detection of disease and avian influenza that so far 98 cases of suspected monitoring and sampling result proved the safety of all cases of the disease only two exceptions. [??]

He added that:  Automatic "Altamiflo" counter of the disease is available in all hospitals and in large quantities, in addition to other antibiotics, pointing out that all hospitals dealt with according to a specific mechanism for the disposal of medical waste security and to ensure there is the possibility of using some of expendable supplies and preserve the surrounding environment from pollution.

The director general of Veterinary Medicine Directorate had preventive actions to contain the foot-and-mouth disease have been vaccinated all beef cattle preservation.

Council members stressed that the executives talk does not correspond with reality, especially with regard to the avian flu disease -- not a day passes without the discovery of new hotbeds of disease of birds, where the birds infected with the epidemic, as well as cases of suspicion among citizens Almkhalten of these birds.

Although health conditions agitated Nabil Manassah President of the Council directed his talk to the Undersecretary of the Ministry of Health, asking him to speed the implementation of the ban the circulation of live birds and the closure of all shops, which still sells bird markets, which poses a threat to the health of citizens and abort all attempts to maintain control of the disease.  The Undersecretary of the Ministry of Health help the rest of the organs responsible for the closure of these stores, the Governor sought to confront the pandemic.

The session concluded that the implementation of conservation and the Supreme Committee to confront the disease does not appear until the new cases infected with avian influenza.

http://www.alwafd.or...

Proud FAF-er.


not a day passes ...
Council members stressed that the executives talk does not correspond with reality, especially with regard to the avian flu disease -- not a day passes without the discovery of new hotbeds of disease of birds, where the birds infected with the epidemic, as well as cases of suspicion among citizens Almkhalten of these birds.

Did anyone else notice that small phrase?


yep, I noticed that too.

Not good. looks like we may have another Indonesia on our hands....

Click here for a curious observation.

[ Parent ]
and..
....as well as cases of suspicion among citizens......

Click here for a curious observation.

[ Parent ]
Niman says.....
As usuall, Niman is on it.....
  http://www.recombino...

Commentary

Additional H5N1 Suspect Cases in Northern Egypt
Recombinomics Commentary
December 26, 2006

Pathological cases suspected of being infected with a new avian influenza in Beni Suef and Western [Al Gharbiyah]. Doctors at the hospital were surprised pathogenesis of Beni Suef appearance of the symptoms of the disease known Hoda Abdel-Hamid of the village of Blvia Amal Mohammad Omar from the village of Riyadh Pasha was accorded some medicines and drugs.

This brings the number of suspected cases of avian influenza in the bee Bank to 7 cases including 4 in the pathogenesis of hospital Mahala and 3 Hospital pathogenesis of Tanta.

The above translation describes four new suspect bird flu cases in two Egyptian governates, increase the total to seven.  These cases are in addition to the four confirmed cases in Egypt this season.  All four were withing 15 miles of Tanta, the capital of Gharbiyah, which is were three of the seven suspect cases are hospitalized.

These additional hospitalizations increase concerns.  Three of the first four confirmed patients have died and the sequence of HA from the first case had acquired a number of polymorphisms found in other Qinghai isolates in the area.  In addition, the first sequence has M230I, which is found in all three human influenza strains, H1N1, H3N2, and influenza B.

Additional information on these new suspect cases would be useful.



Click here for a curious observation.


As Dr. Niman always says:
"Additional information on these new suspect cases would be useful."

It certainly would be.

And, come on, NAMRU-2, how about those sequences? 



[ Parent ]
iirc NAMRU-3 is in Egypt
NAMRU-2 is in Indonesia

[ Parent ]
Thanks Dem,
I stand corrected, and have the opportunity to say:

Ok, NAMRU-3, what about those sequences? 


[ Parent ]
Not that I have been trying to keep up, but...
Has Egypt already released the sequence of the first case in Egypt that died?  OR maybe I should ask... Is this from the 30 yo female that died the other day?  That is how I read this passage...

and the sequence of HA from the first case had acquired a number of polymorphisms found in other Qinghai isolates in the area.  In addition, the first sequence has M230I, which is found in all three human influenza strains, H1N1, H3N2, and influenza B.

or have I just totally skipped some important information somehow.  Which, I might add, is entirely possible.

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead


[ Parent ]
Egypt Sequences
"Has Egypt already released the sequence of the first case in Egypt that died?  OR maybe I should ask... Is this from the 30 yo female that died the other day?"

No - At at least two human sequences from earlier this year have been released.

(A/Egypt/12374-NAMRU3/2006(H5N1))

(A/Egypt/2782-NAMRU3/2006(H5N1))


[ Parent ]
Thank You, Laidback Al...
I was sure I had to be reading that wrong.  I did not think it was possible to sequence the virus and get it released to the public in that short amount of time.

This analysis is really based on the earlier deaths in Egypt and is not something new. It would be interesting to see how these new sequences relate to each other and to the ones in Indonesia.

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead


[ Parent ]
The earlier Egyptian sequences
(I believe from October) were completed and released before the patient died, I believe, which was very fast indeed. 

[ Parent ]
Wow, I would say that was fast....
I must have not noticed. In Oct, I was totally wrapped up with work...

Thanks Pixie...

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead


[ Parent ]
Niman had it
Niman always has it - I don't think much gets by him. 

From Dr. Niman's recent Commentary (12/25):

This season the first case was hospitalized on Sept 30.  She was H5N1 confirmed on October 11 and US NAMRU-3 deposited the HA sequences at Genbank on October 13....[snip]...Most alarming was the acquisition of M230I..[snip]...US NAMRU-3's rapid release of the sequence from the first cases is to be commended.  Similar timely releases from the current cluster would be useful. 


[ Parent ]
thank you, NAMRU-3 ! n/t


[ Parent ]
Bird Flu Continues Spreading to Humans in Egypt
not exactly news but notice:
"Local news media reports suggest that there have been about 20 suspected human cases in the northern part of Egypt..
Local reports said the authorities had declared an emergency and were trying to kill all the birds for a quarter-mile around the compound, but were frustrated by residents who hid birds under beds. Slaughtered birds were buried at a cemetery, streets were cleaned, and all 33 family members were tested..
http://www.nytimes.c...

Be Prepared

We look at this
hiding of the birds askance, but what if this were happening here, the supposed vectors were our beloved dogs, and someone was coming to cull them for our own good?  We'd hide them under the bed too, and we don't even depend on them for nutritional or financial survival.

[ Parent ]
I find it easier to understand hiding a pet
than hiding livestock.  People have emotional investment in a pet.  Livestock are all interchangeable except for the financial impact.

A wyandotte is a wyandotte is a wyandotte, if they're livestock. (spelling?)  If they're pets, then the individual matters.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
Well, that's our cultural bias.
Many people in places where they are hiding these chickens would think that our attachment to our pets is sentimental and silly, particluarly if the critters have no nutritive or financial value.  They are very likely to see our domesticated animals as just regular livestock, and  more as a source of protein than a family member. 

Let me put it this way.  My daughter has a pet crayfish -  in New Orleans, that is lunch!  It all depends on one's perspective.

We are just very lucky we have the luxury of being attached to our pets, instead of our productive livestock. 


[ Parent ]
Totally agree Pixie
We should all walk a mile in their shoes ....

Eat pudding first - who know's what might happen next! - Anon

[ Parent ]
but if financial compensation is offered...
If you offer money to reimburse for killed livestock, then a farmer is likely to take it.

I think most pet owners would not take money to kill their pets unless the sums were pretty high.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
Here is a good reference map site
You can zoom in and out and see all the areas in Egypt
http://encarta.msn.c...

Eat pudding first - who know's what might happen next! - Anon

What I find troubling
is the revelation from the WHO that viruses from the Karo cluster were found to be antigenically closer to the Qinghai subclade that is currently causing disease in Egypt than the other Indonesian samples. 

I don't know what that means, but it can't be a good thing, that the virus in Egypt might have whatever characteristics that the Karo one had, in addition to whatever changes there are from Qinghai, such as E627K.

A brief description of the various clades and subclades can be found here http://www.newfluwik...

In addition, some populations in the Middle East have a very high rate of first cousin marriages, http://www.consang.n...  up to 50% for some places in Egypt.  In theory, if there were rare genetic traits that predispose a person to certain diseases including viral infections, high consanguinity rate could cause an unusually high concentration of some rare specific traits such as HLA types, which are known to be associated with differences in immune response to influenza viruses as well as influenza vaccines..

For example, there are indications that cytotoxic T-lymphocyte responses to influenza A virus may be modulated by HLA type http://www.pubmedcen...  while this study by Fouchier/Osterhaus http://cat.inist.fr/... shows preferential usage of different HLA alleles with different influenza viruses.

I must stress this is speculation on my part.  I write it up in the hope of someone with information telling us more about it.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


Mixing?
Is the Hajj where some mixing of viral sequences in humans has/can/will occur?  Here is an excerpt from an Indonesian article concerning Hajj participants and where they get some of their food.  Does Egypt export poultry to Saudi Arabia?  I bet they do.

[snip]

"A total of 205,000 Indonesians are due to perform the hajj pilgrimage this year."

[snip]

"The presence of the food stalls are useful and helpful for Indonesian hajj pilgrims who have to buy their own daily food as there are no catering companies serving them."

http://www.antara.co...


Hajj
I heard that there will be people coming in from all over the area.  Indonesia, as well as all around the middle east.  Not a good situation as far as I can tell.

[ Parent ]
Hajj
Millions of Muslims are gathering in the Saudi Arabian city of Mecca for the annual Hajj pilgrimage which begins on Thursday amid enhanced security.
http://news.bbc.co.u...

[ Parent ]
Hajj
The key question is whether an infected local who hasn't shown symptoms yet also joins the Hajj from the start.  As I understand it, the ritual takes about a week.  If the answer is yes, then we will see lots of sick during that week but not going home yet. Then it will be a situation that calls for shutting down the Hajj and stopping air travel from the affected areas (very hard to do though). If the answer is no, then the Hajj is just like any other large and close gathering of people as far as pandemic is concerned.

The probability of an infected person from Indonesia going through the Hajj and infecting the crowds is no higher than that same person infecting other people at any airport. Pandemic would start from the earliest airport infection, not from the Hajj.

As for people going home from the Hajj, they would have hung around the Middle East for the week, and so other travelers would likely be bringing home the pandemic earlier.

Sure the Hajj is a problem due to large number of international travelers, but not completely different from international travel hubs or any large convention.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.


[ Parent ]
more details on 10th death in Egypt
Inky posted this breaking news on the news page.  Here are some more details.  Little is made of the familial connection here.

Egypt reports 10th bird flu death

December 27, 2006 / Middle East Times / http://www.metimes.c...

CAIRO -- A 26-year-old Egyptian man died Wednesday from the H5N1 strain of bird flu, the health ministry in Cairo said.

Reda Abdel Halim Farid, from the central Nile Delta region of Zifta, is the 10th person to have died in Egypt after contracting the deadly strain, the ministry said. In a statement carried by the Egyptian news agency MENA, the health ministry said Farid died in a Cairo hospital. He had previously been admitted to a hospital in Zifta, in the Gharbiya governorate.

He was tested in the Cairo hospital after having been treated with the drug Tamiflu, but the results still showed signs of the deadly bird flu strain. Farid is the third person from Zifta to have died from the virus.

On Monday, a 15-year-old girl died from the disease, and on Sunday a 30-year-old woman also died.

The ministry said it had conducted tests with persons close to Farid and there were no signs of the virus in any of them. [snip]


Onset date for Farid
More information on Reda Abdel Halim Farid (26):

Egyptian man dies of bird flu, 10th death

Reuters/Yahoo /  1 hour, 42 minutes ago  /  http://news.yahoo.co...
[snip]

The man showed symptoms of the disease on December 14 and was admitted to a rural hospital three days later. He started receiving Tamiflu treatment on December 20 after a second case appeared in his family and the medical staff learned that he may have come into contact with poultry, Bushra said.  [snip]


[ Parent ]
Egypt needs to get her act together
http://www.newfluwik...

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
more on the family and suspected cases
Repeat from News page

The number of suspected human cases infected with avian influenza in the seven new cases in the Western and Eastern yesterday. Said Mr. Husseini, the Undersecretary of the Ministry of Health enough : We reported three patients to the hospital in Tanta They regimens : Nura Saleh Abdel-Moneim «25» housewife from the village of Tanta Sptas status,
And hopes of the possibility of Ismail «28 years homemaker», ma'am Ahmed Fatuh sponsor «51 years homemaker» from Shubra Waqqas, the status Alsentah, sampling and sent to the labs Central, has also been taking samples from 33 members of a family victory Farid Abdul Hamid of the village of Kafr Hanoun Center Main, who died yesterday, and buried her brother «Reza» 26 years, and his son, brother «Shafih saying» 16 years in the hospital issued Abbasiya.

Dr. Mohamed Al-Rajabi hospital director pathogenesis of Mahala on the detention of two suspected avian influenza Fayasapthma are : Suna Mohammad Najjar »« 55 years of the village of Soft soil, and the release of Mr. Mohamed »« 52 years of the village of Shubra Babylon, and sending samples of their central labs.

And so many of the citizens of Kafr Hanoun «» «victory» body yesterday, amid the grief of her family, which was preparing for a wedding ceremony in his ailing brother «satisfactory». Also, Dr. Attiya Aziz, Director of the Directorate of veterinary medicine in the eastern hope Hassan Fawzi transfer from the position of Mansoura She, and her daughter, Fathiya Said «» to the hospital pathogenesis of Zagazig.

In Western governor decided Shafie Aldkruri continued closure of shops selling live chickens and ban circulated in the markets. Declared several provinces alert to cope with avian flu.

Source : Egypt Today

  http://translate.goo...

So these are the other suspected cases?

Nura Saleh Abdel-Moneim «25» housewife from the village of Tanta Sptas status,

Ismail «28 years homemaker»,

ma'am Ahmed Fatuh sponsor «51 years homemaker» from Shubra Waqqas,

avian influenza Fayasapthma are : Suna Mohammad Najjar »« 55 years of the village of Soft soil,

and the release of Mr. Mohamed »« 52 years of the village of Shubra Babylon,



Thanks for cross-posting UK-Bird. n/t




[ Parent ]
Another translation of this article...
Here's another translation of the article that UK-Bird posted above.  Thx, UK-Bird!

Sounds from this article that there are 7 suspected cases from Al Gharbiyah and Ash Sharqiyah governorates.  An earlier article mentioned Bani Suwayf governorate ... so that sounds as though there may be 3 governorates with suspected cases.  Not 100% sure, yet, though.

The 3 new suspected cases from Al Gharbiyah are not from the same village as the family with the 3 confirmed cases/deaths -- don't know how near or far away they are, though.

There are also 2 suspected cases from Mahala -- don't know where that is (also Al Gharbiyah governorate?).  And, there are 2 suspected cases (a mother and daughter) from in/around Zagazig in Ash Sharqiyah governorate.

Machine-translated from Arabic:

An injury & 7 new human cases by symptoms similar to the bird flu in the western [Al Gharbiyah governorate] and eastern [Ash Sharqiyah governorate]
Dec 26, 2006

The number of human cases rose the suspect in their injury by the bird flu to 7 new cases in the western [Al Gharbiyah governorate] and eastern [Ash Sharqiyah] yesterday.  Doctor Al Sayed Al Hussein said the Ministry of Health deputy by the western [Al Gharbiyah]:  we transferred three patients to the hospital of Tanta fevers and they [are]:  (1) Nura Saleh Abdul Moneim 25 years - housewife from Sbtas village in Tanta district; and (2) Moselhi Ismail's hopes 28 years, homemaker; and (3) Hanem Ahmed Fattouh the sponsor 51 years, homemaker from Shubra Waqqas, in Al-Santa district, for taking samples and its sending to the central laboratories, Also taking samples took place 33 individuals from Farid Abdul Hamid's victory family from "a tender hamlet village" [Kafr Hanoun/Hanut], "my wedding procession" [Center Main] district, the one that was dead the day before yesterday, and its brother lies "Reza" 26 years, and its nephew "Shfia Abdul Halim" 16 years in the hospital of the Abbasid chest.

And doctor Mohamed Al Rgbi hospital manager of the Mahala fevers declared the detention of two conditions for the suspicion fisabthma by the bird flu they [are]:  (4) Souna Mohamed Al Nagar [Suna Mohammad Najjar] 55 years from village "Saft the dust" ("Soft soil"); and (5) the release of Mr. Mohamed 52 years from a village a span Babylon (Shubra Babylon), and sending samples from them to the central laboratories.

And the citizens of "tender hamlet" [Kafr Hanoun] bid farewell to the body of "a victory" the day before yesterday, amid their family sadness, that were getting ready for the establishment of its nephew wedding party the patient "curative".  Also doctor Atiya Abdul Aziz declared, the Veterinary Medicine Department manager in the eastern [Ash Sharqiyah governorate] about (6) Amal Hassan Fawzi's transfer from the region of "the triumphant station" [Mansoura She] in Zagazig, and (7) its [her] daughter "Fathiya Said" to the hospital of Zagazig fevers.

And in the western [Al Gharbiyah] the governor Al Shafie Al Dakrouri decided the continuation of the closure of the shops of the alive poultry selling and the ban of their circulation in the markets.  And several governorates declared state of alert for the confrontation of bird flu.

http://www.07770500....

Proud FAF-er.


[ Parent ]
Niman's Commentary
Commentary

Third H5N1 Fatality in Gharbiya Cluster in Nile Delta

Recombinomics Commentary
December 27, 2006  /  http://www.recombino...

Brick factory worker Rida Farid Abdel Halim was the third member of an extended family in the Nile Delta province of Gharbiyah to die of the disease, said Hassan el-Bushra, WHO regional adviser for communicable diseases surveillance.

The above comments indicate the case fatality rate in Egypt's Gharbiyah governate remains at 100%.  There have been four confirmed cases, who lived within 12 miles of each other, and all four have died.  The first case was hospitalized on September 30 and the sequence of the HA H5N1 was deposited at Genbank on October 13.  In addition to polymorphisms in H5N1 from Egyptian isolates from earlier cases, the isolate had a number of additional polymorphisms, acquired via recombination with other Qinghai isolates migrating through the region.

In addition, the isolate had M230I, which is found in all three human influenza strains, H1N1, H3N2, and influenza B.  The acquisition creates a region of identity in the receptor binding domain of influenza, QSGRI (positions 226-230).  This identity match with influenza B indicates that H5N1 need not change positions 226 and 228 to generate a receptor binding domain match with a human influenza strain that is efficiently transmitted human-to-human, since influenza B has that property with Q (glutamine) and G (glycine) at positions 226 and 228, respectively.

The presence of this change, or the conservation of the additional acquisitions would be of interest.  Release of the sequences from H5N1 from the current cluster of three fatal cases in the Gharbiyah governate would be useful.
 


If you read Niman and nothing else, you would think it was 100% fatality due to some recombination that he predicted.
As more information comes to light, we now know there were 8 cases of recovery. While we can't rule out H2H yet, we can't confirm it either.  They were treated too late. What is important is that it hasn't gone H2H2H or H2H2H2H etc despite what looks like an ineffective public health system.

There will be many false alarms before we see the real one. We need to be diligent but let's not exhaust our mental and emotional energy before then.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.


[ Parent ]
I don't think that anyone here
reads only Niman.  ;-)

[ Parent ]
Niman is good at...
finding information and sequence analysis, but if you believe in his intepretation of that information and analysis then you'd be repeatedly ducking and covering daily for the past two years.

If he keeps calling TEOTWAWKI on a daily basis, eventually he'll be right.  Meanwhile he's mostly wrong on that parameter.

medical information provided is for discussion purposes only and should not be construed as medical advice. if you believe you have a medical problem, consult your practitioner.


[ Parent ]
I give Niman credit where it's due
He works hard on getting news out early. Use him as a news hound, even super news hound. Be very careful with his assessments and conclusions. Thank you.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
Whether it goes H2H2H...
Won't have much to do with the effectiveness or lack thereof of the health care system. That'll be up to the virus.

The best we can hope for from any health care system is early detection and maaaaybe a brief stay before things rip loose.



[ Parent ]
8 recovered cases
As more information comes to light, we now know there were 8 cases of recovery.

Just to clarify, the 8 recovered cases you're referring to do not represent new information.  These are the 8 persons that recovered back in March & April:

http://www.newfluwik...

Proud FAF-er.


[ Parent ]
Thanks for clearing that up.
It must be hard to get proper translation out of Egyptian news.  And thanks for qualifying the translations where you felt they were not very accurate e.g. Google.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
10 sus cases in Egypt?
Ok.  Here's a better translation of this article...

http://www.newfluwik...

...that was posted yesterday.

After cross-checking the names from the article posted by UK-Bird (& me) above...

http://www.newfluwik...

...I now count 10 suspected cases.  Please, folks -- double-check my count....

Machine translated from Arabic:

The suspicion of 4 cases of human bird flu case in Bani Suwayf and the western
Dec 27, 2006

Mohsen Abdul Karim and Hani Atef:  New sick cases suspected in their injury by the bird flu in Bani Suwayf and the western [Al Gharbiyah]  ones appeared.  The doctors of the hospital of Bani Suwayf fevers were surprised with the appearance of disease symptoms on (8) Maarouf Abdul Hamid's guidance from Blfia village and (9) Amaal Omar Mohamed from the village of pasha kindergartens and their giving some of the medicines and the drugs took place.  The withdrawal of samples took place from them and their sending to the laboratories to make sure of their injury truth by the disease.  And in the western [Al Gharbiyah] yesterday [Dec 26][/I] the detention of two new conditions took place in the hospital of El-Mahalla El-Kubra fevers for the suspicion of their injury by the disease and they (10) Sabah Ibrahim Al Fakharani from a village by us Abu Seer belonging to Samanoud center and (11) child Mohamed Farahat the head from the same village.  The medical institutions have drawn the samples from both conditions and sent them to the central laboratories in the Ministry of Health.  And hence the number of the cases suspect of their injury by the bird flu rise in the western of to 7 case from them 4 in the district fevers hospital and 3 in the hospital of Tanta fevers.

http://www.alwafd.or...

Proud FAF-er.


I mean 11...
...can't type right anymore!

Proud FAF-er.

[ Parent ]
Theresa42, I count 11, 10 if you remove Mr. Mohamed who was released
I made a spreadsheet and have 14 different names from your translated articles. If you remove the three deceased and the one released I show 10 different names taken from all the articles posted here in the last few days. Thank you for all your hard work also.

[ Parent ]
Influentia2 - if you want some help?
I appreciate you are working hard on the Indonesia Diary and all the tracking there so if you would like me to help out with the Egypt spreadsheet maintenance, please let me know.

Also, if Okieman can let me know how he made his Indonesia map, I could do the same for Egypt?

Eat pudding first - who know's what might happen next! - Anon


[ Parent ]
Thank you AnnieB
I would share the sheet I made if I knew how to post it on here. I haven't taken the time to learn any of that yet. I only have about 12 Indonesian links that are working due to the undersea cables that were damaged by the earthquake, so I may need help with this one if it keeps up. A spreadsheet really helps me follow everything better than trying to remember every article I read. I think a map like Indonesia's would also be a good tool to follow this situation.

[ Parent ]
If you email spreadsheet to DemFromCT, he can forward it
to me - he has my contact details.  I can then create a summary table like Michelle's one for Indonesia and update it as needed ...

Optionally, you could put the spreadsheet in singtomeohmuse and I can update it in situ there.  You choose.

Cheers

Eat pudding first - who know's what might happen next! - Anon


[ Parent ]
AnnieB I will email it to Dem and he can forward it to you
I have no idea how to get it to singtomeohmuse. The spreadsheet is nothing fancy like the Indonesian one, I was trying to keep it simple. You may want to tweak it a bit, but all the basics are there. I put a filter on it also because I like to see what areas have cases and to refer back  to areas as I add new ones like on the Indo sheet. Thanks I will email it in a few minutes.

[ Parent ]
It is late, and I don't really want to add to the confusion, but...
Late last night I found an interesting article from the New York Times (posted on 12/26/ newa thread) It reads in part:

The Egyptian Health Ministry offered sketchy details on the deaths.

It sometimes takes the World Health Organization several days to confirm cases.

Local news media reports suggest that there have been about 20 suspected human cases in northern Egypt.

At least three were among 33 members of an extended family that lived in a compound in Hanut in Gharbiya Province. The woman, who died last weekend; her brother; and a niece were said to have fallen ill after slaughtering ducks for a cousin’s wedding.

http://www.nytimes.c...

If there are 20 suspect cases reported by the local media, then we must be missing some of the news articles describing the others.

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead


[ Parent ]
I should add....
There was no "fault" implied by the last sentence I wrote; only an "observation seeking solutions".  I think you guys work miracles when searching for news items.

Back to my warm bed...

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead


[ Parent ]
Egypt map
I have a map of all the current confirmed & suspected cases in Egypt if there's somewhere/somehow I can post it.

Proud FAF-er.

[ Parent ]
if you send it to me I will post
demfromct@earthlink.net

[ Parent ]
Map sent
Thanks!

Proud FAF-er.

[ Parent ]
map and notes posted in new diary n/t


[ Parent ]
email it to DemFromCT and he will
tell you how to get it on the site ;-)

(I so love delegating tasks to him - hee hee)

Eat pudding first - who know's what might happen next! - Anon


[ Parent ]
Mr. Mohamed
Thanks, Influentia2!

Mr. Mohamed may not actually have been discharged from the hospital -- could be that that's a 'goofy machine-translation' of his name -- i.e. his full name maybe gets translated literally as "the release of Mr. Mohamed".

Then again, he may have been released.  Difficult to tell.

For now I'm keeping him on the list.

Proud FAF-er.


[ Parent ]
I kept them all on the list too, can always revise the list as needed n/t


[ Parent ]
Denver and chickens
The Hajj can't be anymore a danger than the Denver airport was a week ago -- and I understand another big storm is headed to Denver soon.  In truth, any large gathering with the single "wrong" infected person is going to move us to launch.  It rather bothers me that there is "oh, no, the Hajj is coming" kind of worrying.  What about Times Square on New Year's Eve?

We've kept chickens for several years and I learned that there are everyday chickens and then there are some special birds -- we had a little red hen that was very personable, smart and a terrific mother.  She was one of two dozen chicks that  we had ordered and the rest of the bunch wasn't anything special.  This little bird we had reminded me of "Along Came a Dog" by  the same writer who gave us "The Wheel on the School" -- both are terrific, insightful reads.  Anyway, someone who is close to their flock may geniunely be hesitant to do away with their gems (particularly if their governtment says the goofy stuff that governments tend to say -- remember "Duck and Cover" to protect yourself from a nuclear attack?  I do.  Reefer Madness was another FUBAR). 

Anyway, I'm at the point where I think another family cluster could pop up anywhere, even with the most fabulous of public health work.


Denying contact with poultry.
If the government doesn't pay enough compensation, you would expect some citizens hide their poultry under the bed.  In the case of the three victims in Egypt, is that a possible reason for patients, who don't believe they can be infected, deny contact with poultry for fear of having the entire flock (the extended family fortune?) culled?


You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
Hadj and panflu
It is true that any large gathering or travel can spread an infectious disease, but there is one additional thing about the Hadj. It is very auspicious (according to an anthropologist who studies Indonesia) for someone to die on the Hadj, so many sick people go on purpose, not just because they have the chance and have the tickets. Many others might not travel (say) through Denver if they are sick. There are also many live animals brought to Saudi Arabia to feed the millions of pilgrims. This presents an unusually "good" chance for flu strains to mix and match, so the Hadj conditions are of special concern and warrent close attention. People from Indonesia, Egypt, Turkey, Iran and Nigeria will all be there and these are places that have or have had bird flu.

You have a good point.
Can any thing be done by any one to address your point?

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
just like any other large convention????
Anon yyz: Here's a quote from a recent news article re the hajj:

"Between two and three million pilgrims are expected to take part this year.

The Hajj gets under way when all the pilgrims leave Mecca in a massive convoy to make their way to nearby Mina. It is due to end on Monday."

Two to three million gathered together in a massive convoy for 6 days is not "like any other large convention"..who are you trying to kid? I just hope people will google the facts for themselves and make up their own minds. Egypt and Indonesia are predominantly muslim countries, and the hajj is a big big deal, a "must go" at least once. There'll be lots of them there, that's for certain. Whether any will be sick or not, who knows? What are the odds, eh?


Always have a plan B.


The main issue is whether a bird flu infected local person joins the Hajj convoy,
presumably at the start of the 6 day ritual. I would expect most on the convoy would not travel home until the event is over. The risks of propagation are therefore similar to any travel pattern for large conventions. I saw part of the ritual on TV and yes there were countless people shoving. There was a stampede in a previous year that killed many.  The point though is one sick person can only contact so many other people on the convoy during the 6 days.  Even with a 50000 person convention, there will be too many people for one infected person to infect, so it becomes moot when you count into the millions. 

If this local person is asymptomatic for longer than the 6 days, and if the virus has turned efficient H2H, and since close contacts to this person are at risk, then we can expected undetected infected people traveling to other countries.  Otherwise, this person becomes sick during the week and checks into a hospital. The question then is whether the surveillance practices are in place, which based on the recent 3 deaths the answer is no unless they learn from that experience.  If the case is detected before the Hajj is over, then the problem is some what contained in Saudi Arabia.

One could argue the problem could be far worse if the index case is a waiter in an airport restaurant any where.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.


[ Parent ]
Hajj: my earlier post is here:
http://www.newfluwik...

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
the main issue is whether an infected person meets another 'right' host
IMO the main issue is whether an infected person meets someone with similar susceptibility to the virus but lives in a different part of the world. 

The way I conceive of this is that there are probably genetic constraints on both virus and host, and it's a combination of these 2 aspects that create the conditions for disease.  Right now, clusters mainly occur between family members.  There aren't even that many that are purely between neighbours, for example.  This could be purely coincidental, due to lack of reporting, or a real reflection of some genetically governed immune constraint.

Assuming that is the case, what does the virus need to continue expansion in the human race?  It needs to meet the right hosts that it can infect, probably someone with similar genetic predisposition, under this hypothesis, but who are genetically different enough that it can expand its range of adaptation to an increasingly diverse range of humans with different immune environments.

Until it gets to a point where it can infect just about any human being.

My guess is it's not there yet.  The trouble is we don't know how many other steps it needs to get there, and whether the conditions for such steps are easy to find or rare.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Let's all hope and pray you're right. n/t


Always have a plan B.

[ Parent ]
Hajj
And, how many of the faithful are from the USA,England,or France?
  I think that they come from the entire world.

There is no pleasure in having nothing to do; the fun is in having lots to do and not doing it." -Mary Wilson Little

“Last year, about 15,000 went from the U.S.

22 December 2006

American Muslims Go on Hajj

Larger numbers of pilgrims expected from United States in 2006 than in 2005

By Lea Terhune
USINFO Staff Writer

An adult and child listen to a sermon at the Islamic Center of the Capital District in Albany, New York. (File photo © AP Images) {Odd: I am (was) from the capital district in Albany}

Washington -- More American Muslims are expected to perform the hajj in 2006 than in previous years, according to Muslim organizations. The annual pilgrimage to Mecca in Saudi Arabia is a religious obligation for all Muslims who are able to make the journey.

“It is very special. There are 8 million Muslims in America, and if you get to make it, it is really very special,” Sa’ad, a State Department employee about to leave for the hajj, told USINFO. Preparation is essential. He said American mosques offer instructions for the hajj, using PowerPoint presentations to explain the ritual steps of the pilgrimage and the requirements for making a good hajj.

Tarik al-Lagany, information officer at the Embassy of Saudi Arabia in Washington, told USINFO that the number of American pilgrims has been increasing. “Last year, about 15,000 went from the U.S.,” he said. He attributes this to the growth of Islam in the United States. He said about 2.5 million people from around the world attend the hajj each year.

“Logistically, it is a huge challenge to be able to accommodate all these people,” he said. “As the number of Muslims in the world continues to grow exponentially, we will have to keep expanding those facilities.” In pre-oil days the hajj was a major source of income for Saudi Arabia, but today, he said, “we see it as an obligation of ours to host all these people and we try to bring as many as we can over, provide them with airfare and everything.”

Travel agencies offer hajj tour packages, but a pilgrim cannot just get a visa and go. To keep the vast numbers manageable, a quota is set for each country by the Organization of the Islamic Conference (OIC), an independent international organization concerned with Muslim issues.

More here:  http://usinfo.state....

I am not like other birds of prey....


[ Parent ]
gee, thanks for reminding me...
as if all the vacation and business and visiting-relatives travel New England is taking right now wasn't enough... and kids will go back to school after new year; still no local household pandemic preparedness...

[ Parent ]
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