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WHO | Influenza at the human-animal interface , Summary and assessment as of 4 December 2014 (and cross reference from APCHA and CHP))

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  • WHO | Influenza at the human-animal interface , Summary and assessment as of 4 December 2014 (and cross reference from APCHA and CHP))

    WHO Monthly Risk Assessment Summary | Influenza at the human-animal interface , Summary and assessment as of 4 December 2014 [n= 676 (398)] ; new cases 8(5)

    Human infection with avian influenza A(H5N1) viruses
    From 2003 through 4 December 2014, 676 laboratory-confirmed human cases of avian influenza A(H5N1) virus infection have been officially reported to WHO from 16 countries. Of these cases, 398 have died.
    Since the last WHO Influenza update on 2 October 2014, eight new laboratory-confirmed human cases of avian influenza A(H5N1) virus infection including five fatal cases were reported to WHO from Egypt.

    All cases had onset of disease in November 2014. Six cases were reported from Menia governorate, and one each from the neighbouring governorates of Beni Sueff and Assiut. The cases were reported in two children who survived, five adults who died and one woman still in critical condition (see table 1). The 2- year-old child was picked up through investigation of the 30-year-old woman, both had contact to the same sick backyard poultry. With the exception of one case, all other cases had exposure to sick and dead poultry in the days before onset of symptoms. Identification of such sporadic cases or small clusters are not unexpected as avian influenza A(H5N1) viruses are known to be circulating in poultry in the country. This is the highest number of laboratory-confirmed human cases of avian influenza A(H5N1) virus reported by Egypt in the month of November. Preliminary laboratory investigation did not detect changes in the viruses isolated from the patients compared to isolates from cases reported previously. Epidemiological and virological investigation in humans and animals is ongoing.
    Overall public health risk assessment for avian influenza A(H5N1) viruses: Whenever avian influenza viruses are circulating in poultry, sporadic infections or small clusters of human cases are possible in people exposed to infected poultry or contaminated environments, especially in households. Human infections remain rare and these influenza A(H5N1) viruses do not currently appear to transmit easily among people. As such, the risk of community-level spread of these viruses remains low.

    Table 1: Laboratory-confirmed human cases of avian influenza A(H5N1) virus infection (2 October – 4 December 2014) Country Province Age Sex Date of onset Date of Hospitalisation Oseltamivir treatment Start date Date of death Exposure to


    Country : Egypt
    Province: Menia
    Age/Sex:3 M
    Date of onset : 11 Nov 2014
    Date of Hospitalisation: 12 Nov 2014
    Oseltamivir treatment Start date: 12 Nov 2014
    Death: NA
    Exposure to : Backyard poultry

    Country: Egypt
    Province: Assiut
    Age/Sex: 19 F
    Date of onset: 7 Nov 2014
    Date of Hospitalisation: 11 Nov 2014
    Oseltamivir treatment Start date: 11 Nov 2014
    Death: 16 Nov 2014
    Exposure to: Backyard poultry

    Country: Egypt
    Province: Menia
    Age/Sex: 30 F
    Date of onset: 11 Nov 2014
    Oseltamivir treatment Start date: N/A
    Date of Hospitalisation: N/A
    Death: 18 Nov 2014
    Exposure to: Backyard poultry


    Country: Egypt
    Province: Menia
    Age/Sex: 2 F
    Date of onset: 12 Nov 2014
    Date of Hospitalisation: N/A
    Oseltamivir treatment Start date: 19 Nov 2014
    Death: N/A
    Exposure to: Backyard poultry

    Country: Egypt
    Province: Menia
    Age/Sex: 43 M
    Date of onset: 20 Nov 2014
    Date of Hospitalisation: 23 Nov 2014
    Oseltamivir treatment Start date: 23 Nov 2014
    Death: 26 Nov 2014
    Exposure to: Ongoing investigation

    Country: Egypt
    Province: Menia
    Age/Sex: 29 F
    Date of onset: 22 Nov 2014
    Date of Hospitalisation: 23 Nov 2014
    Oseltamivir treatment Start date: 24 Nov 2014
    Death: 26 Nov 2014
    Exposure to: Backyard poultry

    Country: Egypt
    Province: Beni Suef
    Age/Sex: 35 F
    Date of onset: 23 Nov 2014
    Date of Hospitalisation:25 Nov 2014
    Oseltamivir treatment Start date: 26 Nov 2014
    Death: 27 Nov 2014
    Exposure to: Contact with birds from street vendor

    Country: Egypt
    Province: Menia
    Age/Sex: 24 F
    Date of onset: 24 Nov 2014
    Date of Hospitalisation: 28 Nov 2014
    Oseltamivir treatment Start date: 28 Nov 2014
    Death: NA
    Exposure to: Backyard poultry






    ---

    Next two reports are for cross reference from APCHA (FAO) and CHP (not including MOH Eygpt reports)

    Animal Production and Health Commission for Asia and the Pacific (APHCA), HPAI Situation Update 04/12/2014 - Issue no. 631

    Clipping:

    Egypt OFFICIAL 13 & 27/11/2014 - Confirmed H5N1 HPAI outbreaks in poultry, Aswan, Asyiut, Cairo, Gharbia, Giza, Ismailia, Luxor, Menia, Menoufia, Qena, Sohag and Suez (FAO Field Officer) Between 11 and 25 November 2014 a total of 21 H5N1 HPAI outbreaks were detected in un-vaccinated poultry (chickens and ducks) in 12 out of Egypt’s 27 governorates. The geographical distributions of the outbreaks are in Lower Egypt: Cairo (1), Gharbia (3), Giza (2), Ismailia (3), Menoufia (1); Upper Egypt: Aswan (3), Asyiut (1), Luxor (1), Menia (2), Qena (1), Sohag (2); and Suez (1) Governorates. The cases in live bird markets were detected through active surveillance and outbreaks in households were reported by Community- Based Animal Health Outreach (CAHO). 01-03/12/2014 -
    Confirmed H5N1 influenza infection in humans, Beni Suef, Menia and Sohag (FAO Field Officer)

    The Ministry of Health reported seven new cases of H5N1 infection in Menia (5), Beni Suef (1) and Sohag (1) Governorates.

    Menia:
    a 2 years-old girl, onset 12 November;

    a 43 years old male, onset 20 November and died on 26 November;

    a 29 years old female, onset 22 November and died on 26 November;

    a 26 years old male, onset 23 November and died on 1 December;

    a 24 years old female, onset 24 November;

    Beni Suef:
    a 35 years old female, onset 23 November and died on 27 November.

    Sohag: a 33 years old female, onset 25 November.

    Among seven cases, five have had prior contact with sick or dead poultry, except the male case from Menia Governorate and the female case in Sohag Governorates, whose contacts are under investigations.

    http://www.mohp.gov.eg/News_webpart/...s3.aspx?ID=580 http://www.mohp.gov.eg/News_webpart/...s3.aspx?ID=584


    ---
    CHP- Avian Influenza Report , VOLUME 10, NUMBER 49 Reporting period: November 30 – December 6, 2014 (Week 49) (Published on December 9, 2014) (pending 2 cases from Sohag)
    Summary

    1. There were eight new human cases of avian influenza A(H5N1) from Egypt reported by the World Health Organization (WHO) on December 4, 2014.
    # 2. From 2008 to 2013, 32 to 73 confirmed human cases of avian influenza A(H5N1) were reported to WHO annually. In 2014 (as of December 6), 27 cases were reported by WHO^.
    3. During this reporting period, there were one new human case of avian influenza A(H7N9) from Guangdong Province notified to the Centre for Health Protection by the Health and Family Planning Commission of Guangdong Province, and two new human cases of avian influenza A(H7N9) from Fujian (1) and Shanghai (1) as reported by the Mainland health authorities. Since March 2013 (as of December 8, 2014), there were a total of 462 cases reported.

    Table 2. Outside Hong Kong: Confirmed human cases of avian influenza A(H5N1) Place of occurrence No. of cases (No. of deaths) Details
    In this reporting period

    Egypt 8(5)

    Egypt: there were eight new laboratory-confirmed human cases of avian influenza A(H5N1) virus infection. Six cases were reported from Menia governorate, and one each from the neighbouring governorates of Beni Suef and Assiut. The cases were reported in two children who survived, five adults who died and one woman still in critical condition. With the exception of one case, all other cases had exposure to sick and dead poultry in the days before onset of symptoms. (WHO, as of 4 December 2014)
    Table 11. Details of the recent confirmed human cases of avian influenza A(H5N1) reported to WHO (September to December 2014) (Sources: WHO) Date of report by WHO Country Province / Region District / City Sex Age Outcome at the time of reporting

    2/10/2014 Egypt Giza - F 2.5 - survived***
    ----
    4/12/2014 Egypt Menia - M 3 - survived
    4/12/2014 Egypt Assiut - F 19 Dead
    4/12/2014 Egypt Menia - F 30 Dead
    4/12/2014 Egypt Menia - F 2 - survived
    4/12/2014 Egypt Menia - M 43 Dead
    4/12/2014 Egypt Menia - F 29 Dead
    4/12/2014 Egypt Beni Suef - F 35 Dead
    4/12/2014 Egypt Menia - F 24 -


    ----
    pending WHO confirmation

    33yo Sohag pending

    3yo Sohag pending (MOH Eygpt report)
    Egypt - Media report of girl, 3, bird flu H5N1 positive - Sohag governorate - FluTrackers



    Please also see:
    Avian Influenza in Egypt , Volume 7, Issue 45 & 46, 16 November 2014 (for the first three cases)

    Volume 7 Issue 45&46 Sunday 16 November 2014
    Egypt has reported 3 sporadic cases of human infections with avian influenza A (H5N1) including one associated death during the current month. The first case is a 3 year old male from Menia district under the Menia governorate. The child developed respiratory symptoms on 11 November and was admitted on the next day. The child has received antiviral medicines on admission and currently in stable condition. The second case is a 30 year old female from Bani Mazar district under the Menia governorate and developed breathing difficulty on 11 November and was admitted to Bani Mazar Hospital. She also received antiviral medicine on the same day and was referred to another hospital in unstable condition. Her condition deteriorated when she developed bilateral pneumonia and currently under intensive care. The third case was a fatal, 19 year old female from Assiut district of Assiut governorate. She developed respiratory symptoms on 7 November and was ad- mitted to Assiut University Hospital 4 days later. She was on artificial ventilation. Although she received double doses of Antivirals on admission, but her condition deteriorated and she died on 16 November.

    These three cases reported from Egypt during the month of November 2014 were unrelated and each had exposure to sick and dead poultry in the days before onset of symptoms. Identification of such sporadic cases are not unexpected as influenza A(H5N1) viruses are known to be circulating in poultry in the country. The current, global public health risk assessment for avian influenza A(H5N1) viruses remains unchanged despite re- porting of these three cases. Whenever influenza viruses are circulating in poultry, which is the case in Egypt, sporadic infections or small clusters of human cases are possible, specially in people exposed to infected poultry or contaminated environments. Human infections remain rare and these influenza A (H5N1) viruses do not currently appear to transmit easily among people. As such, the risk of community-level spread of these viruses remains low. However, vigilance should never be lowered and enhanced surveillance should be continued at the animal-human interface.





    Please also see

    Egypt - 2014 WHO/MoH/Provincial Health Depts H5N1 Confirmed Case List - FluTrackers
    Please see 2013 list here (http://www.flutrackers.com/forum/showthread.php?t=200510). Source is our global H5N1 case list here (http://www.flutrackers.com/forum/sho


    I have a feeling that there may be a repeat case on flu trackers list (possible transaltion problem fro MOH Eygpt) .3 months v.s 2.5 yo***!

    5) #20 Egypt - Female, 3 months, hospitalized with fever, sore throat, cough - improving

    I believe this is the 2.5yo previously reported! Reporting and mete data are all the same from WHO and APCHA!

    see Egypt - 5th H5N1 case announced by various health authorities in 2014 - FluTrackers



    Interesting enough Taiwan CDC has both cases reported in the international messages in the professional version...



    Also slight age disparity
    a 43 years old male, onset 20 November and died on 26 November; reported as 40yo from MOH!
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