Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009 - April 9, 2009

[Giuseppe]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Since human to human transmission cannot be discounted a priori, without an in depth field investigation, we should keep an open mind approach.

However, the widespread poultry presence into egyptians' houses and probable environmental contamination could also be one of the main causes of this year higher incidence of avian influenza infections in young children.

A WHO update on this new development in Egypt epidemiological behaviour of H5N1 virus in humans is long overdue.

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Since human to human transmission cannot be discounted a priori, without an in depth field investigation, we should keep an open mind approach.

However, the widespread poultry presence into egyptians' houses and probable environmental contamination could also be one of the main causes of this year higher incidence of avian influenza infections in young children.

A WHO update on this new development in Egypt epidemiological behaviour of H5N1 virus in humans is long overdue.

Actually, there isn't much evidence that much has changed in Egypt. There has always been a close relationship between backyard flocks and residents. If anything, the numbers would be lower now than in the past. Moreover, there has been an aggressive vaccination program, which appears to have lowered the frequency of H5N1 in commercial holdings, but outbreaks in backyard holdings are still common.

The big change has really been demographic, which has produced mild cases in toddlers at a rate that is much higher than the prior three years. The incidence in other groups, such as children, teenagers, or young adults has declined. There has been little evidence that the change in demographics is due to changes in behavior (especially in toddlers) or increases in backyard flocks that are H5N1 positive.

[sharon sanders]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

The actual mechanism of infection is really not relevant.

I think the mechanism of infection is extremely important.

In a country where H5N1 is endemic, many poultry to human cases could be possible.

The danger is the development of efficient and sustained human to human transmission.

Since the update states that the symptoms of the Al Beheira toddlers began 4 days apart instead of 2 days, this is inside the window for possible human to human transmission between them.

Why are not any of the relatives ill? Toddlers need attention when they are sick and some of the adults must have held and had close contact with these sick children prior to diagnosis.

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

I think the mechanism of infection is extremely important.

In a country where H5N1 is endemic, many poultry to human cases could be possible.

The danger is the development of efficient and sustained human to human transmission.

Since the update states that the symptoms of the Al Beheira toddlers began 4 days apart instead of 2 days, this is inside the window for possible human to human transmission between them.

Why are not any of the relatives ill? Toddlers need attention when they are sick and some of the adults must have held and had close contact with these sick children prior to diagnosis.

The change in demographics is pretty striking. Why are not more adults, teenagers, or children ill?

When I commented on mechanism, I was refering to a crawling toddler as opposed to other age groups. The point was that even though most cases are toddlers (who might be more likely to contacted H5N1 in feces or birds), toddler cases are still VERY rare, so getting two independent infections in neighboring houses over a four day period is not likely.

However, even if these two cases were two independent infections, it would indicated an increased transmision rate to humans (or at least to toddlers), because the two cases were so close in time and space.

[Treyfish]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

A suspected case of avian influenza Rawash
الأثنين، 6 أبريل 2009 - 19:21
Monday, April 6, 2009 - 19:21

The discovery of new infections of bird flu Rawash
W
ا Detained hospital fevers QENA woman on suspicion of being infected with bird flu, which entered the El-Shafei Bkhittp (48 years old), a housewife from the village of Qena, the status of solar modules, in a very weak condition, suffering from high fever and cough continued and similar symptoms of the disease and was shown to contact with birds she died a number of them.


Were sampled, and was sent to the central Ministry of Health laboratories for analysis.


http://tinyurl.com/cl68vr

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

I'll add my comment on the discussion of the source of infection for the two kids in Beheira. These children are very very young, that is why they are called toddlers. What we can not determine from translated news articles is whether they are doing more toddling with sick neighbor kids or more toddling with sick chickens. So is it human to human transmission or multiple cases of animal to human infection? I am not willing to guess.

It is also worth noting that there was canvessing of the neighborhood, but the number of confirmed H5N1 outbreaks in poultry in March or April in Kom Hamada is ZERO:

RECENT CASES:




Date of sampling: 3 April 2009
Date of result: 3 April 2009

Governorate: Kafr el Sheikh
District: Seidi Salem
Village: Saafan Village
Type of rearing: Backyard
Species: Chicken
Number of birds: 4

Vaccine status: Not available
Purpose of sampling: Notified case


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



Date of sampling: 31 March 2009
Date of result: 1 April 2009

Governorate: Sixth of October
District: Oseim
City: Oseim
Type of rearing: Backyard
Species: Mixed
Number of birds: 46

Vaccine status: Not available
Purpose of sampling: Notified case


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





Date of sampling: 31 March 2009
Date of result: 1 April 2009


Governorate: Sixth of October
District: Al Badrachin
Village: 1-Manshiet Dahshour-Ezbet el Sakran.
Type of rearing: Backyard
Species: Mixed
Number of birds: 77

Vaccine status: Not available
Purpose of sampling: Notified case


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





Date of sampling: 31 March 2009
Date of result: 1 April 2009


Governorate: Alexandria
District: Khorshid
Village: Hay Khorshid
Type of rearing: Backyard
Species: Mixed
Number of birds: 42

Vaccine status: Not available
Purpose of sampling: Notified case


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





Date of sampling: 31 March 2009
Date of result: 1 April 2009


Governorate: Alexandria
District: Al Kabari
Village: Hay al Kabari
Type of rearing: Backyard
Species: Chicken
Number of birds: 42

Vaccine status: Not available
Purpose of sampling: Notified case


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





Date of sampling: 31 March 2009
Date of result: 1 April 2009


Governorate: Minya
District: Minya
City: Minya
Type of rearing: Backyard
Species: Mixed
Number of birds: 26

Vaccine status: Unvaccinated
Purpose of sampling: Notified case


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


Date of sampling: 27 March 2009
Date of result: 29 March 2009

Governorate: Kafr el Sheikh
District: Al Hamoul
Village: Ezbet Shehata – Abo Sekin
Type of rearing: Backyard
Species: Mixed
Number of birds: 12

Vaccine status: Not available
Purpose of sampling: Active surveillance


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





Date of sampling: 18 March 2009
Date of result: 19 March 2009

Governorate: Gharbiya
District: Tanta
Village: Sanadid
Type of rearing: Backyard
Species: Mixed
Number of birds: 53

Vaccine status: Not available
Purpose of sampling: Notified case


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




Date of sampling: 18 March 2009
Date of result: 19 March 2009

Governorate: Beheira
District: Hosh Eisa
Village: Al Kordor-Al Maghazi
Type of rearing: Backyard
Species: Mixed
Number of birds: Not available

Vaccine status: Not available
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit


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



Date of sampling: 17 March 2009
Date of result: 18 March 2009

Governorate: Gharbiya
District: Kotor
Village: Sagein al Kom
Type of rearing: Backyard
Species: Mixed
Number of birds: 42

Vaccine status: Not available
Purpose of sampling: Notified case


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



Date of sampling: 16 March 2009
Date of result: 18 March 2009

Governorate: Beheira
District: Kafr el Dawar
Village: Manshiya Amer Barawla
Type of rearing: Backyard
Species: Mixed
Number of birds: 38

Vaccine status: Not available
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit


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



Date of sampling: 13 March 2009
Date of result: 13 March 2009

Governorate: Beheira
District: Kafr el Dawar
Village: Al Akreisha
Type of rearing: Backyard
Species: Mixed
Number of birds: 12

Vaccine status: Vaccinated 8 December 2008
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit


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



Date of sampling: 12 March 2009
Date of result: 13 March 2009

Governorate: Qalyoubiya*
District: Not available
Village: Not available
Type of rearing: Not indicated
*A truck from Sharkiya Governorate carrying 520 layer hens was stopped by authorities in Qalyoubiya Governorate
Species: Chicken
Number of birds: 520

Vaccine status: Unknown
Purpose of sampling: Passive surveillance


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



Date of sampling: 11 March 2009
Date of result: 13 March 2009

Governorate: Sharkiya
District: El Kenayat
Village: Ezbet Abu Hasona
Type of rearing: Backyard
Species: Mixed
Number of birds: Not available

Vaccine status: Unknown
Purpose of sampling: Notified case


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



Date of sampling: 11 March 2009
Date of result: 13 March 2009

Governorate: Sixth of October
District: Kerdasa
Village: Kerdasa
Type of rearing: Backyard
Species: Unknown
Number of birds: Not available

Vaccine status: Not vaccinated
Purpose of sampling: Notified case


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



Date of sampling: 11 March 2009
Date of result: 12 March 2009

Governorate: Gharbiya
District: Tanta
Village: Ezbet Shaban, Berma village
Type of rearing: Backyard
Species: Chicken
Number of birds: 8

Vaccine status: Unavailable
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit


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



Date of sampling: 11 March 2009
Date of result: 11 March 2009

Governorate: Assiut
District: Assiut
Village: Al Walideia
Type of rearing: Backyard
Species: Mixed
Number of birds: 45

Vaccine status: Vaccinated
Purpose of sampling: Notified case


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



Date of sampling: 10 March 2009
Date of result: 11 March 2009

Governorate: Minya
District: Samalout
Village: Gaber al Ghaber al Keblia
Type of rearing: Backyard
Species: Mixed
Number of birds: 8

Vaccine status: Vaccinated against H5N2 on 25 December 2008
Purpose of sampling: Notified case


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




Date of sampling: 8 March 2009
Date of result: 9 March 2009

Governorate: Alexandria
District: Al King / Al Ameria
Village: Abo el Reish
Type of rearing: Backyard
Species: Chicken, duck
Number of birds: 50 total

Vaccine status: Unavailable
Purpose of sampling: Notified case


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



Date of sampling: 6 March 2009
Date of result: 10 March 2009

Governorate: Beheira
District: Damanhour
Village: Nediba
Type of rearing: Backyard
Species: Mixed
Number of birds: Unavailable

Vaccine status: Unavailable
Purpose of sampling: Notification




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



Date of sampling: 6 March 2009
Date of result: 7 March 2009

Governorate: Beheira
District: Kafr el Dawar
Village: Owan
Type of rearing: Backyard
Species: Chicken
Number of birds: 20

Vaccine status: Unavailable
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit


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



Date of report: 2 March 2009
Date of result: 3 March 2009

Governorate: Suez
District: Al Ganain
Village: Abo Saial
Type of rearing: Backyard
Species: Chicken
Number of birds: 15

Vaccine status: Unvaccinated
Purpose of sampling: Notified case


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


Date of report: 1 March 2009
Date of result: 2 March 2009

Governorate: Beheira
District: Hosh Eisa
Village: Seriut
Type of rearing: Backyard
Species: Chicken
Number of birds: 2

Vaccine status: Unvaccinated
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit


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


Date of report: 1 March 2009
Date of result: 2 March 2009

Governorate: Beheira
District: Kafr el Dawar
Village: Al Malaka
Type of rearing: Backyard
<TABLE width=310 border=0><TBODY><TR><TD class=textcontainers width=72>Type of birds </TD><TD class=textcontainers width=44>

chickens

</TD><TD class=textcontainers width=39>ducks
</TD><TD class=textcontainers width=42>geese

</TD></TR><TR><TD class=textcontainers>Number of birds </TD><TD class=textcontainers>

22

</TD><TD class=textcontainers>

45

</TD><TD class=textcontainers>

10

</TD></TR></TBODY></TABLE>
Vaccine status: Unvaccinated
Purpose of sampling: Active surveillance: Participatory Disease Surveillance (PDS) visit

[AlaskaDenise]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Commentary

http://www.recombinomics.com/News/04060901/H5N1_Egypt_Delays.html

Commentary


H5N1 Confirmation Delays in Egypt Raise Concerns

Recombinomics Commentary 13:04
April 6, 2009

A 6-year-old Egyptian boy has contracted the highly pathogenic bird flu virus, the sixth case in a month in the most populous Arab country, state news agency MENA said on Sunday.

MENA named the boy as Ali Mahmoud Ali Somaa, from the Nile Delta province of Qalyubia.

Health Ministry spokesman Abdel Rahman Shahine said Somaa started suffering symptoms two weeks ago and was admitted to hospital a week later, where he was treated with the antiviral drug tamiflu, according to MENA.

Somaa is in a critical condition and is breathing with an artificial respirator,

The above comments describe the latest confirmed case (6M) in Egypt (#63 since 2006). Unlike the vast majority of cases in 2009, who are toddlers with mild courses, the latest case is in critical condition and on a respirator (see updated map). Only one other case in 2009 was described as critical, and since that case was hospitalized March, 1, the patient has probably recovered, because all 12 confirmed cases this year have survived.

The severity of the above case may be associated with the delay in hospitalization and the delay in diagnosis. These delays may be linked to an absence of a poultry connection. Over 6000 Egyptians have been hospitalized with suspected bird flu, but less than 1% test positive for H5N1. However, these cases begin treatment shortly after admission, based on symptoms and a poultry connection. The above case developed symptoms on March 22 and was hospitalized on March 28, but was reported confirmed yesterday, which was well after confirmation of case 61 who was hospitalized on March 31, and case 62, who was hospitalized on April 2. The delay in confirmation of case 63 is likely linked to a delay in testing and treatment. Since descriptions of case 63 have not mentioned a poultry source, it is likely that the lack of a source contributed to the admission and treatment delays.

However, these delays raise concerns that many milder cases would go untreated and/or unreported, because of resolution in the absence of treatment, or treatment based on an assumption of seasonal flu. Since patients without poultry links are not tested for H5N1, recovery of such patients would lead to a serious undercount of H5N1 infections. Moreover, a lack of such testing would also lead to a serious undercount of clusters, such as cases 61 and 62.

These two cases are toddlers from Beheira who were confirmed this month. They are next door neighbors, but case 61 was diagnosed in Menoufiya, where he developed symptoms and was hospitalized. Case 61 had a poultry connection, but it remains unclear if that connection was in Beheira, or in association with his visit to grandparents in Menoufiya. Case 62 was confirmed a few days after case 61, but no poultry connection was described for case 62, suggesting an absence of poultry deaths in the Beheira neighborhood where cases 61 and 62 lived.

This type of detail and associations are usually clarified in WHO updates, which are lagging cases. The last WHO update was on patient 60, who was confirmed last month. Moreover, there is also confusion regarding a 45 day old infant who died March 27 after being hospitalized March 26. Although samples were collected from the patient and family, and Tamiflu was given, the test results on this patient have not been announced, even though hospitalization and death were prior to confirmed cases 61-63.

The delays in clarification of these cases are causes for concern. Similarly, sequences from poultry and human cases in 2009 have not been released.

Clarifications and release of sequences would be useful.

.

[AlaskaDenise]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Commentary

http://www.recombinomics.com/News/04060902/H5N1_Beheira_H2H.html

Commentary


Human Transmission in H5N1 Toddler Cluster in Beheira Egypt

Recombinomics Commentary 17:56
April 6, 2009

Date of report: 2 April 2009
Governorate: Beheira
District: Kom Hamada

Event summary: Boy, age 2, began experiencing fever, cough and runny nose on March 31. He was admitted to Damanhour Fever Hospital on April 1 and received Tamiflu the same day. Infection with avian influenza was confirmed April 2. He reported contact with a dead or sick poultry. He was reported in good general condition on April 6. The MOHP reported this was the 62rd case of highly pathogenic avian influenza in Egypt.

Source of report: Amr Kandeel, Undersecretary for preventative affairs, MOHP
Samir Refaie, Head of Epidemiology and Surveillance Unit, MOHP

---------------------------------------
Date of report: 1 April 2009
Governorate: Beheira
District: Kom Hamada

Event summary: Boy, age 2, began experiencing fever and cough symptoms on March 27. He was admitted to Naaora Fever Hospital on March 30 and received Tamiflu the same day. Infection with avian influenza was confirmed April 1. He was reported contact with dead and sick poultry. He was reported in good general condition on April 6. The MOHP reported this was the 61st case of highly pathogenic avian influenza in Egypt.

Source of report: Amr Kandeel, Undersecretary for preventative affairs, MOHP
Samir Refaie, Head of Epidemiology and Surveillance Unit, MOHP

The above comments are from the SAIDR site in Egypt, which provides detail on human and avian H5N1 outbreaks. The detail helps with some confusion in media reports, which noted that the index case developed symptoms during a visit to his grandparents in Menoufiya, where he was subsequently hospitalized. That report was followed by a confirmed case in Beheira, who was said to be the next door neighbor of the index case (which is supported by the above report indicating both cases were in the Kom Hamada district), raising concerns of human to human transmission.

The above detail changes the disease onset date of the index case to March 27, indicating symptoms began in Beheira prior to his trip to his grandparents and subsequent hospitalization in Menoufiya (see updated map). The earlier onset date also indicates Tamiflu treatment began more than 48 hours after disease onset, yet the patients is currently in ?general good condition? and there were no indications that he developed pneumonia or was placed on a ventilator, supporting a ?mild? H5N1 infection. The earlier date also creates a 4 day gap between the disease onset date of the index case and his neighbor, strongly suggesting that the index case infected his neighbor.

The likelihood of next door neighbors developing H5N1 five days apart is remote. Although there has been a spike in confirmed cases in toddlers, the overall number of cases is low and two independent introductions into neighbors is unlikely. This cluster also increases concerns that the number of cases is markedly higher than the confirmed cases because the cases are mild, and only cases with a poultry contact are tested for H5N1. Therefore, cases that resolve without treatment, or after treatment for seasonal flu, would not be counted as a confirmed case.

This cluster also discounts the media myth that transmission is limited to blood relatives. Although there are multiple clusters that do not involve blood relatives, this cluster increases that number, and supports the likelihood of additional unreported cluster due to an absence of testing in patients without a poultry connection.

The human to human transmission would be further supported by a close similarity between sequences from the neighbors, as was seen in the outbreak of mild H5N1 in the spring of 2007. That outbreak involved older children, but the H5N1 infections were also mild and the number of infections was also likely to have been much higher than the confirmed cases of which 16/17 survived.

Therefore, release of sequence data from the Beheira cluster would be useful as would aggressive testing of toddlers who have symptoms but lack a poultry connection.

.

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Commentary

http://www.recombinomics.com/News/04060903/H5N1_Egypt_Poultry_NOT.html

[Laidback Al]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Originally Posted by Laidback Al View Post
The name and location of the actual village where the two infected children (cases #61 and #62) who were neighbors in Beheira would be helpful.

The first child (case #61) was reported (post #150 and #156) to be from the “Department of Liberation” or “Directorate of Liberation” (مديريةالتحرير , also translates as editorial department). Post #176 notes that the second child (case #62) is also from Directorate of Liberation, Badr Center. The saidr reports cited by Niman (post #234) indicate that these two individuals were from Kom Hamada [Center Kom Hamada?].

The map from the Beheira governorate web site below shows the location of both Badr Center [Directorate of Liberation?] and Kom Hamada Center. The two centers are adjacent to each other in the southeastern portion of the governorate. A more exact village name and location would be beneficial.

map link: http://www.behera.gov.eg/division.htm

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

Originally Posted by Laidback Al View Post
The name and location of the actual village where the two infected children (cases #61 and #62) who were neighbors in Beheira would be helpful.

The first child (case #61) was reported (post #150 and #156) to be from the “Department of Liberation” or “Directorate of Liberation” (مديريةالتحرير , also translates as editorial department). Post #176 notes that the second child (case #62) is also from Directorate of Liberation, Badr Center. The saidr reports cited by Niman (post #234) indicate that these two individuals were from Kom Hamada [Center Kom Hamada?].

The map from the Beheira governorate web site below shows the location of both Badr Center [Directorate of Liberation?] and Kom Hamada Center. The two centers are adjacent to each other in the southeastern portion of the governorate. A more exact village name and location would be beneficial.

map link: http://www.behera.gov.eg/division.htm

[ATTACH]3057[/ATTACH]

This site has Kom Hamada marked on a Google map

http://www.traveljournals.net/explore/egypt/map/m462486/kom_hamada.html

The key however, is the fact that the SAIDR site has them both coming from the same district, confirming that they are neighbors.

[sharon sanders]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

2009 / 4 / 6 -- 07:25 GMT

Egypt topped the list of countries worst hit by bird flu in 2009, after the Ministry of Health reported 9 injuries since the beginning of this year, compared with 8 cases over the past year.

The Egyptian Ministry of Health on Sunday, wounding a child in the age of six virus (H 5 to 1) strain of bird flu, bringing the total number of people who have contracted the disease since it appeared for the first time in Egypt in 2006 to 63 people.

In addition, said Dr. Abdel Rahman Shahin, spokesman of the Ministry of Health, said that despite the high number of casualties, Egypt is the least in the proportion of deaths, adding that among the 63 cases of which 23 occurred only event of the death, admitting that the virus is endemic in Egypt, and that he and eradicate it takes many years and perhaps decades, and the risk of it mutating into a form more virulent, "and is strongly," he said there was no way now to get out of the crisis, but the transformation of society to the frozen birds.

In Qena, the Directorate of Health announced a state of emergency in a hospital after the fever in the central laboratories of the Ministry of Health wounded girl, "Israa Saad Shafi," which showed symptoms of the disease last Monday and was taken to the hospital.

In Alexandria, was executed by the Directorate of Veterinary Medicine million birds because of the lack of certificates to prove they are free of the disease have been seized in raids on intensive farms, bird shops in the east and west of the city.

In Fayoum, said Dr Hussein Sophie Abu Talib, Under-Secretary, Ministry of Health, the death of the girl child بسملة Mohammed "45 days" in hospital after the transfer of the Tamiflu drug to the hospital yesterday evening fevers Fayyoum first, on suspicion of


http://alalam.ir/newspage.asp?newsid...20090406114607

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

This site has Kom Hamada marked on a Google map

http://www.traveljournals.net/explore/egypt/map/m462486/kom_hamada.html

The key however, is the fact that the SAIDR site has them both coming from the same district, confirming that they are neighbors.

The second key comes from the bird outbreaks, which are also detailed on the SAIDR site and there have not been any reports from Kom Hamada, although there are seven reports for Beheira since March 1. Thus, there is quite a bit of reported H5N1 in poultry in the general area, but not at the cluster location.

For Egypt, confirmation of two toddlers four days apart at the same location is VERY unusual. However, it is likely that the unusual part is the CONFIRMATION.

[Sally Furniss]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

The government is considering compensation ?farm? affected by the avian flu .. And suspected infection Rawash

Day wrote Abduljawad, Mohamed Hamdi Mohamed Asamkory 4-7 / 2009

Hospital admitted QENA held yesterday at the El-Shafei Bkhittp ?45 years?, the mayor of the hamlet, the village of solar modules, after her symptoms similar to bird flu, the government is considering establishing a fund to compensate affected farmers.............

http://www.almasry-alyoum.com/article2.aspx?ArticleID=206024

[HenryN]

Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+

The second key comes from the bird outbreaks, which are also detailed on the SAIDR site and there have not been any reports from Kom Hamada, although there are seven reports for Beheira since March 1. Thus, there is quite a bit of reported H5N1 in poultry in the general area, but not at the cluster location.

For Egypt, confirmation of two toddlers four days apart at the same location is VERY unusual. However, it is likely that the unusual part is the CONFIRMATION.

Updated map with the 7 outbreaks in Beihera since March 1. None of these are close to the human cluster

http://maps.google.com/maps/ms?ie=UTF8&hl=en&msa=0&msid=106484775090296685271.00045e1b927e68d58eab0&ll=31.001743,30.27832&spn=0.979361,1.521606&z=9