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Egyptian man dies of bird flu, 10th death

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  • #16
    Re: Egyptian man dies of bird flu, 10th death

    Originally posted by niman
    Commentary

    H5N1 Cluster in Gharbiya Egypt Cause Concern
    Recombinomics Commentary
    December 30, 2006


    Clinical specimens from the three cases were tested positive for avian influenza A(H5N1) virus by Egyptian Central Public Health Laboratory. The virus was also detected in specimens from two of the three patients by US Naval Medical Research Unit No.3 (NAMRU-3). The samples will be sent to WHO Collaborating Centre for further testing including virus characterization.

    The above comments from the WHO update suggest sequence data on the Gharbiya cluster will be public soon. US NAMRU-3 submitted the HA`sequence,
    A/Egypt/12374-NAMRU3/2006(H5N1). from the first Egyptian H5N1 case for this season on October 13, two days after confirmation. The HA sequence was cause for concern because it included M230I, a change that extended the identity with influenza B to positions 226-230 (QSGRI). This region of identity is cause for concern because influenza B is efficiently transmitted human-to-human and increased efficiency of transfer generates clusters such as the one described above, which is the largest reported to date in Egypt. Moreover, these cases are much earlier than last season, when the first reported case in Egypt was in February.

    Large clusters involving the Qinghai strain are cause for concern because there were several clusters in Turkey, Azerbaijan, and Iraq last season. Changes in the receptor binding domain were found in each cluster. In Turkey, clusters had S227N. In Azerbaijan, clusters had N186K. In Iraq, clusters had N186S and Q196R. All of these changes were in the Qinghai strain, which can readily transport and transmit changes over long distances because the strain is found in long range migratory birds.

    Additional receptor binding domain changes have been found in other H5N1 strains, In China, Shanxi isolates has as many as five changes in or near the receptor binding domain (A188E, A189T, T192I, L194I, R220K, K222Q). Hunan isolates had four changes (D187N, A189E, T192I, L194I). Shantou isolates had three changes (K222R, V223I, S227R). One of these changes (V223I) was in a Qinghai isolate from Mongolia, A/bar-headed goose/Mongolia/1/05. Sequence from this isolate have already been traced from Mongolia to Egypt, so these changes could fly into the Middle East and generate additional combinations of receptor binding domain changes via recombination.

    Therefore, it will be useful to quickly release the recent sequences from the large cluster in Gharbiya.

    .
    "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

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    • #17
      Re: Egyptian man dies of bird flu, 10th death

      Report from the village where the 3 family members recently died...

      babelfished from French:

      Aviary influenza. With three new deaths, virus H5N1 continues to be propagated. In question, lack of sensitizing, the poverty and the inefficiency of the prevention campaigns. Report with Gharbiya, one of the hearths of the disease.

      Fatal laxism
      Semaine du 10 au 17 janvier 2007, num?ro 644

      The day of Wednesday December 27, 2006 upset Kafr Al-Naqib, in the governorship of Gharbiya, the delta of the Nile. This small village of 3,000 inhabitants, neglected a long time by the persons in charge, attracts in a few hours a number impressing of high persons in charge for the ministries for the Interior, Health, Agriculture, the Environment, and social Solidarity, accompanied by the mayor of the village. This agglomeration is in alarm since death, two weeks ago, of three young people resulting from the same family after to be reached virus H5N1 of the aviary influenza. It acts of R?da Abdel-halim Farid, 26 years old, of its s?ur [sister] Intissar, 30 years old, and their cousin Chaf?ya, a 15 year old teenager. Those raised ducks at the house. They decide to cut down poultries at the time of the weddings of Chaf?ya which take place on December 14. The evening, Intissar is the first to be suffered from an excessively high temperature "We do not have a medical unit in our village. Nearest is in the town of Zefta, to 12 km from here. Thus we tried to treat Intissar with residence, but without success. Its [her] health started to worsen so that it did not manage any more to breathe. The following day, R?da and Chaf?ya fell sick too. Three days after, we hospitalized them all in Zefta where they received during one week a treatment against the normal fever...," remembers Abdel-halim, the father of Intissar and R?da, old of 70. He is stopped on several occasions by the lamentations of his paralysed wife, who cries the fate of her two children in particular R?da who, working in a manufacturing plant of bricks, was the only support of his family made up of 10 members.

      The state of the three young people worsens day after day and the fever continues to assemble "Anybody did not imagine [nobody imagined] that they were reached aviary influenza. It is thanks to a radiologist who noticed that the three resulted from the same family and suffered from the same symptoms. They were thus transferred to the Abbassiya Hospital from the feverish diseases in Cairo, where examinations showed that they had contracted the virus. And they took a treatment Tamiflu," continues Abdel-halim by adding that the doctors in Cairo affirmed to him that the late discovery of the virus made the treatment ineffective. However, Tamiflu must be taken under the 48 hours which follow the first symptoms. Reality that the Minister for Health, Hatem Al-Guabali, specified in an official statement on December 27 following the death of R?da. 5 days front, Intissar, connected to the apparatus of artificial respiration, dies and the following day, Chaf?ya undergoes the same fate.

      These three cases changed to ten the number of dead people of the continuations of the aviary influenza. The figures provided by the ministry for Health indicate that 18 people were reached by the virus, of which 8 were restored whereas the others found death. The virus was announced for the first time among the poultries in February 2006, and the first human death was announced on March 18.

      Which alternative to the poultry?

      To the advertisement of died of the three victims, a state of alert was launched in the four corners of Kafr Al-Naqib. The forces of safety buckled the village. Persons in charge for the ministry for Health practised analyses on the inhabitants in particular those which were in contact with the three victims. Medical control proved that all were in good health, the necessary vaccines however were provided to them. Campaigns organized by persons in charge for the veterinary department to the ministries for Agriculture and Environment were launched in all the hearths in order to make sure that their owners do not raise poultries "They invaded all the houses and cut down our poultries and took them to bury them in a large pit dug with 1km of the entry of the village", explains Oum Mahmoud, close to the family of Abdel-halim. Like all the villagers, Oum Mahmoud was accustomed to raising poultries on the roof of its house to consume them or to sell them. Those constitute for it a source of cheap proteins, compared to the meats whose prices are exorbitant "the price of one kilo of meat reached 35 or at least 40 L.E. whereas the price of the duck which weighs 4 kilos does not exceed the 20 IT", add it, while affirming that the persons in charge let it [him] cut the throat of itself [himself] its [his] poultries without gloves and any medical measurement.

      Just like the inhabitants, unquestionable poulterer lost, in a few minutes, their only source of income. It is the case of Hag Abdel-fattah, which had the only site for the sale of chickens "For fear me am confiscated my poultries, I cut the throat of myself 150 ducks that I keep for the sale. That made two weeks that I do not work more, just as three others of my employees", denounces it. "The government compensates only the owners for the farms and the authorized buildings of sale. But, we, who work in the villages, we do not form part of this category. I do not know how we will live, my family is made up of seven members...", rises it.

      During two weeks, vehicles furrowed the village inviting the villagers to put a term at the domestic breeding of the poultries. A public awareness campaign was launched in the mosques and to the house of the mayor of the village to push the inhabitants to be put an end to this practice. A campaign which somewhat calmed down today. The villagers have lived for these two last weeks in panic. It is not the fear of being reached virus, but that to lose their poultries, their only livelihood. So some hasten to get rid of their chickens, others continue the breeding clandestinely. And the easy ways vary: "Instead of the roofs or of the courses, as usual, they hide their poultries in the rooms to be laid down, under the beds, in the cupboards or even in the furnaces with the risk to endanger their health. It is the only means so that our poultries are not discovered by the persons in charge. Without them, we will be completely stripped because nobody compensates us", affirms one of the inhabitants. Although the preventive countryside ceased, the villagers are always with the aguets. As soon as a foreigner is seen in the village, the inhabitants who are in the street precipitate to inform the neighbors who still keep their poultries.

      With two kilometers of Kafr Al-Naqib, the scene is completely different: in the village of Dahtoura, the inhabitants do not have any concern. They raise their poultries publicly. One can even easily see the women washing the linens on bank of the Nile, accompanied by the poultries "Why to hide them or cut the throat of them as long as they are in good condition? The persons in charge for the preventive countryside, in its way towards Kafr Al Naqib, saw us and did not say anything. The day when the virus will have reached our village, we will occupy ourselves of that", concludes slightly Fatma, a villager of Dahtoura. [C'est la vie....]

      H?ba Nasreddine

      ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

      Comment


      • #18
        Re: Egyptian man dies of bird flu, 10th death

        So, more information on the onset dates/dates of admission for the Farid family members:
        They decide to cut down poultries at the time of the weddings of Chaf?ya which take place on December 14. The evening, Intissar [30F] is the first to be suffered from an excessively high temperature "We do not have a medical unit in our village. Nearest is in the town of Zefta, to 12 km from here. Thus we tried to treat Intissar with residence, but without success. Its [her] health started to worsen so that it did not manage any more to breathe. The following day [Dec 15?], R?da and Chaf?ya fell sick too. Three days after [Dec 17?], we hospitalized them all in Zefta where they received during one week a treatment against the normal fever...," remembers Abdel-halim, the father of Intissar and R?da, old of 70.
        ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

        Comment


        • #19
          Re: Egyptian man dies of bird flu, 10th death

          Originally posted by Theresa42
          Report from the village where the 3 family members recently died...

          babelfished from French:


          The state of the three young people worsens day after day and the fever continues to assemble "Anybody did not imagine [nobody imagined] that they were reached aviary influenza. It is thanks to a radiologist who noticed that the three resulted from the same family and suffered from the same symptoms. They were thus transferred to the Abbassiya Hospital from the feverish diseases in Cairo, where examinations showed that they had contracted the virus. And they took a treatment Tamiflu," continues Abdel-halim by adding that the doctors in Cairo affirmed to him that the late discovery of the virus made the treatment ineffective. However, Tamiflu must be taken under the 48 hours which follow the first symptoms. Reality that the Minister for Health, Hatem Al-Guabali, specified in an official statement on December 27 following the death of R?da. 5 days front, Intissar, connected to the apparatus of artificial respiration, dies and the following day, Chaf?ya undergoes the same fate.


          H?ba Nasreddine

          http://hebdo.ahram.org.eg/arab/ahram.../10/egypt4.htm
          The above comments support the collection of swabs from patients BEFORE Tamiflu treatment in Cairo.

          Comment


          • #20
            Re: Egyptian man dies of bird flu, 10th death

            My distillation of the dates derived from all of the posts.

            Intissar:
            Onset date: 12/14/2006
            First hospitalization date: 12/17/2006 in Zefta
            Moved to Sadr Abbassiya Hospital: ?
            Died: 12/24/2006

            Reda:
            Onset date: 12/15/2006
            First hospitalization date: 12/17/2006 in Zefta
            Moved to Sadr Abbassiya Hospital: 12/20/2006?
            Died: 12/27/2006

            Shafika:
            Onset date: 12/15/2006
            First hospitalization date: 12/17/2006 in Zefta
            Moved to Sadr Abbassiya Hospital: 12/20/2006?
            Died: 12/25/2006
            http://novel-infectious-diseases.blogspot.com/

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