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...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes -
Re: EGYPT - Jan 6, 2008+
My current count: 5 confirmed cases PLUS 90+ (96+) suspected cases PLUS 1 suspected death PLUS 11+ (23+) negatives = 107+ (125+)
Dr. Niman's count: "I only see 115 minus negatives, so the total suspect cases, including confirmed is below 100."
One news report states that there has been "hundreds of suspected cases in various Egyptian governorates" since Dec. 30. Another mentioned a figure of 143.
Note that the dates below are news report dates, not admission dates.
SUMMARY OF CONFIRMED AND SUSPECTED CASES IN EGYPT SINCE DEC 25
5 Confirmed cases / 4 deaths
Oula Yunis Ali Mohamed (25F) - d. Dec 25, 2007 -- Beni Haroun, Beni Suef governorate
Attorh Hanim Ibrahim [aka Hanem Atwa Ibrahim] (50F) - d. Dec 31, 2007 -- Shatt `Ezbet el-Lahm, Damietta governorate
Nora Aboul Abbas Mohamed (21/22F) -- Barhim near Minuf city, Al Minufiyah
Fatma Fathi Mohamed (25F) - d. Dec 30, 2007 -- Dikirnis, Ad Daqahliyah governorate
Firdaus Mohamed Hadad (26F) - d. Dec 31, 2007 -- Al Minufiyah governorate
Between 90 - 96 suspected cases reported since Dec 30 / 1 suspected death (prolly tested neg) / between 11 - 23+ tested neg (not counted)
Alexandria Governorate (4)
Dec 31 - Faten (23F)
Jan 03 - Mahdi Abdul Aziz Mahmoud Ashour (43M?) - poultry worker - Hospital "Dietetic" Alexandria
Jan 03 - Mohamed Mahmoud Abdel Hameed (20M) - reside Babis
Jan 04 - Anwar Mohammed Abdul Wahid (14)
Beheira Governorate - (8-10)
Dec 30 - Mohamed Khalil Abdul Qawi (40M) - Ezbet "Notes", [Centre Kom Hamada] Kawm Hamadah - admitted to hospital on Dec 28 (Jan 4th report)
Jan 04 - 1 unnamed suspected case admitted Jan 3
Jan 04 - Reza Ibrahim Ibrahim (10M) - Bhmyat Damanhour
Jan 04 - Unnamed woman
Jan 04 - Unnamed woman's daughter (6 months)
Jan 04 - Unnamed - from Blue Dawar village - Alexandria Pathogenesis Hospital
Jan 04 - Unnamed - from Blue Dawar village - Alexandria Pathogenesis Hospital
Jan 05 - Mohamed Fathalla (50F) - sudden rise in temperature, red face and narrow throat - Hospital Dietetic Alexandria
Jan 06 - Rashid Anwarul Abdul Wahid Solomon - student - from village of Apis Azhar rotor, Salt Alexandria Hospital
Jan 06 - Hisham Amr Pasha (3) - Hospital Dietetic Damanhour
Beni Suef Governorate (1+ **)
Jan 02 - Anwar Ali Sayyad (25M) [unemployed] from Shaweesh Ahnassa village
Cairo Governorate (? / 1 neg?)
NEG? - Dec 31 - Salah Eddin Mohamed Ali (43M) - d. Dec 29 - Al Amiriyah - teacher - test results on man?/birds? reported to be neg on Jan 2
Jan 06 - Al Ahram reports unnamed negative(s) in Cairo
Dakahlia Governorate (30+ acc'd to one report / 19-21 on this list / 11 neg?)
Jan 03 - Mr. Sadr mediator (40M) - from the Centre for nitrogen
Jan 03 - Fatma Mohammed Saeed (45F) - from Mansoura
Jan 03 - Abdul Rahman Abdul Rahman (9M) - from the village stone pillars
Jan 03 - Imad Bader Abdul Rahman (40) - from the village stone pillars
Jan 03 - Ibrahim Abdel Razek (50M) - from the village of Kom Derby
Jan 04 - Mr. Alusivi doctor(?) - from the village and they Aldnanic - Mansoura Chest Hosp. [same as Mr. Sadr mediator above?]
Jan 04 - Nima Mohammed Mahmoud Abdul Hamid - Mansoura Chest Hosp.
Jan 04 - Abdul Rahman Ali Bader - Mansoura Chest Hosp.
Jan 04 - Abdul Rahman Hamadi (13M) - son of Abdul Rahman Ali Bader - Mansoura Chest Hosp.
Jan 04 - Ibrahim Abdul Aziz [same as Ibrahim Abdel Razek above?]
Jan 04 - Nuha Mohammed Fathi - from the village Ain pomegranate, Bdkrns
Jan 04 - Solomon Solomon Reza (2) - from the village of Gross Bbalkas - Mansoura Chest Hosp. - admitted Jan 3
Jan 04 - Hamdi Mohamed Awad (8) - from the village of Abu vulnerable Bbalkas - Mansoura Chest Hosp. - admitted Jan 3
Jan 04 - Com Mahmoud Rejab (45F) - admitted Jan 3
Jan 04 - Mr. Omar Almqauri (13M) - student from Mansoura Street Abdel Salam - Mansoura Chest Hosp. - admitted Jan 3
Jan 04 - "Faith" (1) - from the village of Aldnabaiq status, Mansoura - Mansoura Chest Hosp. - admitted Jan 3
Jan 05 - 30+ unnamed suspected cases since Dec 30
Jan 06 - 16 new, unnamed cases admitted Jan 5; 5 still under observation, 11 discharged (neg?)
Damietta Governorate (2)
Jan 03 - Mohamed Fathi (13) - of Damietta
Jan 04 - 5 unnamed suspected cases admitted Jan 3
*A report on the Egyptian government's bf website says that "The government Damitta has taken the brunt of suspected cases." But, we only have 2 listed.
Gharbiyah/Al Gharbiyah Governorate (1 / 6 negatives)
NEG - Jan 01 - Hani El-Ashry - "34 years" policeman (Ali El-Ashry per flubergasted) - from the village of Ameriya, Mahala - Hospital Salt Mahala
NEG - Jan 01 - Huda Khaled (1M?) [aka Hoda Khalid Saeed] - from the village of Aldoakhilih, Mahala - Hospital Salt Mahala
Jan 02 - Sara Adel Aboushadi (child) from "My wedding procession" [Abo_ak_i Hospital pathogenesis Zfti]
NEG (per Carol@SC) - Jan 03 - Aida Abdul Aziz (28F?) - from the village of Al Abualli, Mahala - Hospital Salt Mahala
NEG - Jan 03 - Ahmed Mohammed Salim (24M) - from "the Republic", Mahala - Hospital Salt Mahala
NEG? - Jan 03 - Hatem Mohammed Jamil (52M) - Mahala - Hospital Salt Mahala
NEG - Jan 03 - "Allegedly Saw" Mohammed Shihata (8 months F) - from the village of Mit Taha, Centre Mmas - Hospital Salt Mahala
Jan 04 - Six negatives reported
Giza Governorate (? / ? negatives)
Jan 06 - Al Ahram reports unnamed negative(s) in Giza
Ismailia Governorate (0 / 3 negatives)
NEG - Jan 03 - SM Ezbet - Eid of the village on Eid
NEG - Jan 03 - Salma Ahmed Hussein - from the village of painted Daryll - high temperature and pneumonia, and headache
NEG (per Carol@SC) - Mr. Muhammad M-25
Menoufiya/Al Minufiyah Governorate (12)
Dec 30 - Nader Said Babylonian (5M) - ["Al Btanoun"] Al Batanun
Dec 30 - Ahmad Abdul Mohsen [aka Roqayya Ahmed Abdul Mohsen] (6M) - from a village "Tnbdi hamlet" ["Kafr Tunbdi"] in Shibin Al Kawm center [Kafr Tambidi?]
Dec 31 - Abdul Rahman Ibrahim (57M)
Dec 31 - Abed Rabbo (50M?)
Jan 01 - Adel Mohamed Adel - from [Sers Al-Layan] Sirs al Layyanah
Jan 01 - Doaa - daughter of Adel Mohamed Adel
Jan 01 - Mohamed Said Abdul Rahman - from Barhim
Jan 01 - Karim Mohamed Fawzi - from Kafr Sheikh Khalil village in Shibin Al Kawm
Jan 01 - Hamida Abdul Hafiz Rizk - Aboukls [Abu Kullus] village in the Martyrs
Jan 03 - "Hopes" Mr. Sabbagh (30F?) - from the village "Dkma" - Hospital Dietetic Shebin Mound
Jan 06 - Abdullah morning - from Abussnith Balbageor - Hospital Dietetic Shebin Mound
Jan 06 - Naglaa Mohammed Saeedi - from Shebin Mound - Hospital Dietetic Shebin Mound
*Note that confirmed case Nora Aboul Abbas Mohamed above is also from Barhim, Al Minufiyah.
Minya Governorate (1)
Jan 04 - Zakaria Reham Abdel-Fattah (16F) - resident status La Hqrani place; admitted to Hospital Dietetic Menya
Kafr El-Sheikh Governorate (2)
Jan 03 - "Equity" Mohamed Hammouda (32F) - homemaker - village Smjarat Barahmanih was Hdzhma - Hospital Dietetic Kafr El-Sheikh
Jan 03 - Amal Ibrahim Ghraib (1?) - "Equity's" baby? - village Smjarat Barahmanih was Hdzhma - Hospital Dietetic Kafr El-Sheikh
Port Said Governorate (4)
Dec 31 - Reza Abdalmugod Abdilkadir (25M) - husband of Radwan - "Satisfaction village in south of Port Said"
Dec 31 - Radwan - wife of Reza
Dec 31 - Mohammed (9M) - son of Reza & Radwan
Dec 31 - Rajab (5M) - son of Reza & Radwan
Qalyubia Governorate (7 or 8 / ? negatives)
Jan 01 - Safaa Mohamed Abdul Razek - nurse in the health unit - village of Al Alzm belonging to Shibin El Kanatar center [Shabin al Qanatir]
Jan 02 - Mohamed Talaat Mostafa Aboualfdl (3M) - in Banha Fevers - one of the 2 (3?) mentioned below?
Jan 03 - 2 (3?) new sus cases admitted to Banha Hosptial -- no names [also another report of 2 women being admitted to Banha Hospital]
Jan 06 - Sami Mahdi Mahdi - Banha Hospital
Jan 06 - Gamalat Hassan Ibrahim (M?) - from Kafr "gratitude" - Banha Hospital
Jan 06 - Mariam Omran Abossria (F?) - from "stressing" - Banha Hospita
Jan 06 - Al Ahram reports unnamed negative(s) in Qalyubia
Qena Governorate (5)
Jan 03 - Mohamed Khaled Adli - 4 month old child - Qena "Dietary" Hospital - high temperature
Jan 04 - Jasmine Khaled Adli (1 1/2 F) - in hospital salt Qena - sister of Mohamed above?
Jan 04 - Q. Mustafa Hussein (24F) - mother of Jasmine? - hospital salt Qena
Jan 06 - Mostafa Amr Mustafa (1 1/2 M) - from "the affairs" in the city of Qena - Qena Dietary Hosptial
Jan 06 - Amr Khalid Gharib (4 months) - from "the affairs" in the city of Qena - Qena Dietary Hosptial
Sharkia/Ash Sharqiyah Governorate (5 / 2(+?) neg)
NEG - Jan 01 - Nabil Ahmed Mohamed (8M) - from the village of Hrbit belonging to Aboukbir center
Jan 02 - Samia el-Sayed Awad (55F)
Jan 02 - Menah Mohamed Fathi (3F) - granddaughter of Samia
Jan 02 - Iman Sobhi (25F)
Jan 02 - Mohamed Maher Reda - Iman's son
Jan 03 - Husam Muhammad (4M) - from the village centre Alkhis Abouhmad
NEG - Jan 04 - Hisham Salah Tawfik (4) - from village of Abu Hammad Alhanis
Jan 06 - Al Ahram reports unnamed negative(s) in Sharkia
Sohag Governorate (9 - 10 / ? negatives)
Jan 05 - Hanan Farouk Abodev (25F) - village children Aizaz, status Sohag - Virus Hospital Sohag
Jan 05 - Hanan Mohammed Khalaf (20/22/45?F) - village Aljbab, status suged [Bsouahin Mkhaltat] - Virus Hospital Sohag
Jan 06 - Hussein Kamal Din (65) - village of Umrah, status Sohag
Jan 06 - dear Abdu al (5) - village Ahawaolh status
Jan 06 - "minimum" (3F) - sister dear Abdu al - village Ahawaolh status
Jan 06 - Zeinab (2F) - sister dear Abdu al - village Ahawaolh status
Jan 06 - Mustafa Omar - child - Hospital Dietetic Qena
Jan 06 - Omar Khaled - child - Hospital Dietetic Qena
Jan 06 - Nafisa Ahmed Magali (30) - from "silos tracts" of the West
Jan 06 - "old hopes Morgan" (23) - from the village of Jeridat of the city centre - bolted from the hospital - suspected case?
Jan 06 - Al Ahram reports unnamed negative(s) in Sohag
**Governorate uncertain (10)
Jan 05 - 10 unnamed admitted Jan 4 -- governorate uncertain?
Report says that 16 were admitted in Beni Suef and Sohag on Jan 4. We have 6 named in Sohag. That leaves 10 additional in Beni Suef and/or Sohag.
http://www.flutrackers.com/forum/sho...3&postcount=23...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes -
Re: EGYPT - Jan 6, 2008+
Thanks to commonground, pugmom, Carol@SC, LaidbackAl, flubergasted, Dr. Niman and others for working on sorting out all these suspected cases!
...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock HolmesComment
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Re: EGYPT - Jan 6, 2008+
Originally posted by Theresa42 View PostThanks to commonground, pugmom, Carol@SC, LaidbackAl, flubergasted, Dr. Niman and others for working on sorting out all these suspected cases!
Yes, thanks!Comment
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Re: EGYPT - Jan 6, 2008+
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Bird Flu in Egypt - Statement of Supreme National Committee for Combating Bird Flu, 3/1/2008
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The Supreme National Committee for Combating Bird Flu met on Wednesday 2/1/2008 under chairmanship of Minister of Agriculture and participation of Ministers of Health and Local Development and Governors of Giza,
El-Qalubia, El-Munifia El-Gharbia, El-Sharqia, El-Fayoum and El-Daqahlia and representatives of Ministries of Defense, Interior, Foreign Affairs, Environment and Information.
The meeting discussed all developments of the situation as follows:
*First:
The Committee reviewed different discussions and opinions on the development of the disease in light of the cases of infection and death during December 2007, especially as there are no new cases of infection or death since July 2007.
*Second:
Reports stated that 2006 witnessed (18 injuries including 10 deaths, equaling 55%) while 2007 witnessed (25 injuries including 9 deaths, equaling 36%).
Consequently, the total number of positive cases since the emergence of the disease reached 43 cases; 31 female and 12 males.
Cases were divided according to reason of infection into 2 workers in farms, 40 domestic raising cases and 1 salesperson.
*Third:
The Committee discussed reasons behind cases in the protected farms (34 farms) which concentrated in:
1- A group of fierce viruses attacked the farms.
2- Type and efficiency of the vaccine.
3- Way of preserving and keeping the vaccine.
*Fourth:
The Committee stressed the necessity of intensifying the media campaigns (direct contacts, Radio &TV).
It also stressed the necessity of active detection between Ministry of Agriculture and Ministry of Health, monitoring the poultry production, supporting the central and affiliated laboratories.
All farms proven infected with the bird flu will be shut down for six months and all birds and farm wastes would be destroyed (fertilizer ? tools used inside the infected farms), the Committee said.
Farm owners that do not abide by the protection measures will bear the responsibility of their negligence while maximizing the penalty in case of repetition, the committee said.
The committee also said firm measures will be taken against moving poultry from one governorate to another or from one farm to another.
- Minister of Agriculture said that reasons for spreading the bird-flu disease once again are the negligence of concerned parties and farms owners as well as non-abide by the protection measures.
- Minister of Health noted that decrease of deaths among injuries is attributed to increase of awareness by citizens and taking to hospitals for receiving the therapy following the appearance of the disease symptoms.
He added that citizens must avoid the purchase of poultry from unknown sources confirming safety and efficiency of vaccines.
- Health Minister said that teamwork from Ministry of Agriculture, Ministry of Health and veterinary will be formed to follow up poultry in different locations to detect and face suspected cases.
On his part, Ambassador Ayman el-Qaffas, Head of Egypt's State Information Service and the Supreme Committee Spokesman, said that the international situation of bird-flu is worse than the Egyptian one as the number of cases reached 348 and number of death reached 216, adding that the big percentage of deaths are in Indonesia (94 cases) and Vietnam (47 cases).
He added that the policy of combating bird-flu in Egypt characterizes with transparency and clearness for the sake of the safety of Egyptian citizens.
He said that Minister of Information decided in coordination with Ministers of Agricultural, Health and Environment to intensify the media campaigns in all media outlets, and also direct contact especially through the media centers affiliated to Egypt's State Information Service spread allover Egypt for the sake of citizens' health and for preserving the poultry resources.
He added that SIS has provided nearly 250.000 bulletins to spread guidance information about facing bird-flu disease and ways of protection to be distributed in all governorates of Egypt as well as half a million bulletins and stationeries which includes notes to be distributes to students thus getting them aware of the bird-flu issue, reasons of infection and ways of protection.
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Re: EGYPT - Jan 6, 2008+
The news here is so good compared to **** . Thanks!Last edited by sharon sanders; January 6, 2008, 12:14 PM. Reason: edited to delete unfavorable mention of another forumComment
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Re: EGYPT - Jan 6, 2008+
<TABLE style="BORDER-COLLAPSE: collapse" borderColor=#808080 width="100%" border=0><TBODY><TR><TD vAlign=top width="80%"><TABLE id=table32 dir=ltr style="BORDER-COLLAPSE: collapse" cellPadding=3 width="100%" border=0><TBODY><TR><TD vAlign=top align=left>New conditions on Import of Bird Flu Vaccines
By Metwalli Salem 6/1/2008</TD></TR></TBODY></TABLE><TABLE style="BORDER-COLLAPSE: collapse" cellSpacing=0 cellPadding=5 align=left border=0><TBODY><TR><TD dir=rtl vAlign=top align=left><ARTICLEBODY>Minister of Agriculture and Land Reclamation Amin Abaza unveiled that his ministry would prepare a study to determine the types of serums and vaccines the companies import from outside and set new conditions on private companies importing anti-bird flu vaccines.
He said the most important of these conditions is that the companies must be registered in the World Organization for Animal Health (OIE) and that the vaccine must be effective against the lethal H5N1 strain of bird flu in Egypt.
Commenting on the paper's yesterday exclusive report about the doubts over the validity of vaccines imported by these companies, the minister told al-Masry al-Youm that it is a scientific fact that the vaccine is not 100% effective against the disease, as its efficiency ranges between 75% and 90%, and that the circulation of vaccine is as important as the type of vaccine used in immunization, indicating that the ineffectiveness of vaccines imported from abroad is not in the interest of companies importing the vaccines.
He noted that about more than one billion anti-bird flu doses have been imported either by the state or the private sector since February 17, 2006. "All of these doses have been tested in the ministry's Institute of Veterinary Vaccines," he added.
Abaza stressed that all the vital safety regulations would be strictly applied and stringently enforced through the control of veterinary services affiliated with the General Authority for Veterinary Services, indicating that the increased number of infections in recent weeks were mainly attributable to the fact that many poultry farms are lax in applying vital safety standards, making them believe that they have entirely brought the virus under control.
Abaza accused some owners of farms where bird flu infections are reported of selling the remaining stock in the other coops in several provinces, contributing to the spread of the virus to other areas instead of culling all birds in all the farm's coops. He maintained that this behavior is a crime against citizens and the State.
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Comment
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Re: EGYPT - Jan 6, 2008+
Commentary at
Comment
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Re: EGYPT - Jan 6, 2008+
Poultry dealers play down bird flu resurgence
Despite recent resurgence of avian influenza and its spread in a number of Egyptian provinces, the local poultry sellers have paid scant attention and gone as usual around their business, which provides almost 50 per cent of the animal protein consumed by the the nation."Of course I sell chicken.
I am not afraid of the disease. If I stop selling birds, my children will not eat?" said Om Mohamed, a shop owner at a Cairo market.With the new outbreak of the disease over recent weeks, small-time poultry merchants have refused to close up their shops.
Om Khalid, another Cairo poultry dealer, said: "It's the same story of bird flu every year. The people still eat chicken and the Government doesn't pressure us to close."Last week, Egyptian authorities announced the 19th death blamed on avian flu since the disease was detected here in February 2006.“Poultry is the only protein to which the poor have access," Om Khalid said.
Two years ago, the Government promised compensation for people who had to slaughter their chickens, but it has not worked out the plan yet and has not made any payments, according to Om Khalid.Although the Government had advised people who breed poultry at home to get rid of them especially under the current circumstances, many Egyptians in cities keep birds on the roof for their own consumption or as a source of supplementary income.“I sleep with my birds in the same room, and nothing has happened to me,” Om Khalid said. “Bird flu is nothing but an annual rumour, which the authorities spread to frighten the people and increase the prices of meat and fish.
”The Ministry of Health said on Friday it had carried out tests on eight people, who are suspected of contracting the deadly disease, which killed four women last week. Those four cases were being treated with Tamiflu, which proved to be not effective enough, a doctor, who asked not to be identified, told The Gazette."Therefore the Ministry of Health has to change its treatment strategy," he said.
Some 16 persons, suspected of catching the virus, were taken to hospitals in the Delta provinces of Mansoura and Damanhour yesterday, according to health officials."The H5N1 virus continues to mutate . It will continue to change and resist the effect of Tamiflu" he said, confirming that the mutation of the virus in Egypt probably occurred by chance.
However, he affirmed that the situation in Egypt was not critical, but efforts to wipe out the virus had failed so far because raising domestic fowl is a key source of income and nutrition for about five million households.“Most people infected in Egypt have been in contact with birds kept at home,” the doctor said.
“It is very important that international organisations and the Government should work together because bird flu is going to stay here for some years to come.”
Meanwhile, official sources at the Ministry of Agriculture called for drawing up a 'more realistic' plan, whereby farmers would be given new, vaccinated, poultry when they lose their birds to a culling campaign.Many small chicken breaders are still scared of reporting suspected outbreaks because they lose a source of income and they are afraid of retaliation from their neighbours if poultry is destroyed in their entire village, say observers.
In another development, police arrested 36 poultry dealers while they were trying to sell 1,585 chickens in the Governorate of Alexandria, security sources said.They said that health workers have already culled the chickens and destroyed thousands more eggs, which they planned to sell to the people.
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SiamComment
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Re: EGYPT - Jan 6, 2008+
Suspect H5N1 Cases in Egypt Continue to Grow
Recombinomics Commentary 18:11
January 6, 2008
Harvest 25 new cases with symptoms similar to bird flu in 5 provinces
The above translation describes the daily rise in the number of hospitalized patients with bird flu symptoms (see updated satellite map). However, although the number of new cases increases daily, there have been no new confirmed cases in a week (color coded purple). Some of the earlier cases have been declared negative (color coded yellow in map above), including a number of patients in Daqahliya but most of the cases have not been updated, due in part to their recent admission.
Many of the new admissions form familial clusters (color coded pink), and many new cases are in regions were there was a confirmed case.
It remains unclear if the lack of new confirmed cases is due to delays in testing / confirmation, or if these cases are initially testing negative and are not turning positive because of the implementation of a Tamiflu blanket, which is keeping viral RNA levels below detection. The level of Tamiflu resisatnce also remains unclear because this issue has not been addressed in WHO updates, even though one media report suggested "some" of the recent fatal cases had "moderate" resistance, which would correspond to N294S.
The recent news on fatal cases, plus the repeated detection of H5N1 throughout the country, may be contributing to more hospitalization of suspect patients. In the past the number of suspect patients rose in the spring, when the number of season flu cases increased.
It remains unclear if the new cases are lined to increased awareness or increased infections. More information on negative patients and a status update on those admitted in the past few days would be useful.
Comment
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Re: EGYPT - Jan 6, 2008+
CommentaryOriginally posted by niman View Post
Suspect H5N1 Cases in Egypt Continue to Grow
Recombinomics Commentary 18:11
January 6, 2008
Harvest 25 new cases with symptoms similar to bird flu in 5 provinces
The above translation describes the daily rise in the number of hospitalized patients with bird flu symptoms (see updated satellite map). However, although the number of new cases increases daily, there have been no new confirmed cases in a week (color coded purple). Some of the earlier cases have been declared negative (color coded yellow in map above), including a number of patients in Daqahliya but most of the cases have not been updated, due in part to their recent admission.
Many of the new admissions form familial clusters (color coded pink), and many new cases are in regions were there was a confirmed case.
It remains unclear if the lack of new confirmed cases is due to delays in testing / confirmation, or if these cases are initially testing negative and are not turning positive because of the implementation of a Tamiflu blanket, which is keeping viral RNA levels below detection. The level of Tamiflu resisatnce also remains unclear because this issue has not been addressed in WHO updates, even though one media report suggested "some" of the recent fatal cases had "moderate" resistance, which would correspond to N294S.
The recent news on fatal cases, plus the repeated detection of H5N1 throughout the country, may be contributing to more hospitalization of suspect patients. In the past the number of suspect patients rose in the spring, when the number of season flu cases increased.
It remains unclear if the new cases are linked to increased awareness or increased infections. More information on negative patients and a status update on those admitted in the past few days would be useful.
."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 FoundationComment
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Re: EGYPT - Jan 6, 2008+
With the regular flu season on its way in Egypt conjugate with a wake-up call for the Egyptian via their medias, we should not be surprise to witness a significative upsurge in hospitals emergencies.
I am sure we will witness the same in rich countries, (human nature)
SnowyComment
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Re: EGYPT - Jan 6, 2008+
I don't know whether these informations will aid, but EISS (European Influenza Surveillance Scheme) reports for last week seasonal human influenza activity across Europe a low level of viral detection (mainly H1N1). In Italy National Institute of Health reports for the same period an increased influenza-like-illness activity (around 300 per 100,000 inhabitants), with A/H1N1/Solomon Island-like virus circulation.
The worst class-ages hit are those between 5-14 and 15-65.
Mean temperature across Italy varies between -5 ?C / +5 ?C min and +3 / +20 ?C (too cold in the northern regions, too warm in southern regions).
Concurrent meningococcal meningitis sporadic cases are detected in various parts of the country, that highlights a more virulent influenza strain than previous seasons.
RSV and pneumococcal pneumonia are also detected.
I don't know whether in Egypt seasonal human influenza viruses circulation - at least for the northern Nile Delta provinces - mimics the pattern of southern italian regions or not, at this stage.Comment
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Re: EGYPT - Jan 6, 2008+
Reem Leila of weekly Al-Abram does it again
3 - 9 January 2008
Issue No. 878
Egypt
Fowl reaction
As more victims fall prey to Avian Influenza, Reem Leila highlights the weaknesses of national awareness campaigns to combat the disease
<hr noshade="noshade"> <!-- STORY -->
Two women died of bird flu in Egypt on Monday, bringing to four the number of fatalities from the virus in less than a week in the most populous Arab country. All four cases were women and were believed to have resulted from exposure to sick or dead backyard birds.
Fardos Mohamed Haddad, 36, of Menoufiya province in the Nile Delta, was taken to hospital on Saturday and died early on Monday.
According to the press release issued by the Ministry of Health and Population, Haddad suffered from a high fever, had difficulty in breathing and suffered from a pulmonary infection after coming into contact with birds suspected of being infected with Avian Flu. "She was placed on a respirator but died at dawn on Monday," a statement said. Abdel-Rahman Shahin, the official spokesman of the Health Ministry, said the patient had been exposed to poultry infected with bird flu virus.
"Accordingly, all members of her immediate family and those she had recently come in contact with are being tested for the disease."
The government says it is conducting a vigorous campaign to combat the spread of the virus through vaccinations and raising awareness.
Minister of Health and Population Hatem El-Gabali warned on Sunday against "slackness in the preventive measures taken to fight bird flu especially as winter approaches."
But some experts say the government has not done enough and tends to react rather than act.
Talaat Khatib, a professor of food hygiene at Assiut University, said the government awareness campaign was not comprehensive enough. "Most doctors cannot even recognise the symptoms of bird flu in a human being," Khatib said. "People have become too lax, poultry shops began to reopen and the old slaughtering techniques returned without proper supervision from the authorities," Khatib added. During the summer months, and after Minister of Agriculture and Land Reclamation Amin Abaza became head of the Supreme Council for Combating Bird Flu, Khatib claimed there was a slowdown in the vaccination and awareness campaigns, thus leading to the spread and growth of the deadly virus.
Haddad's death was the third in less than a week and the 43rd case of bird flu in humans in Egypt. On Sunday, Fatma Fathi Mohamed, 25, from the Nile Delta province of Daqahliya, died of the disease just days after the death of Ola Yunes Ali. The two were diagnosed with the disease last week. Hanem Ibrahim, a 50-year-old from Damietta governorate in northern Egypt, was hospitalised on 24 December in critical condition before succumbing to the disease on Monday, bringing the number of fatalities to 19 since bird flu was discovered in Egypt in February 2006.
It is the third winter that the virus has struck after lying low during Egypt's hot summers, when it is much less likely to spread from one carrier to another.
The government has promoted a poultry vaccination programme but coercive measures are hard to enforce.
Prior to these four deaths, no bird flu fatality had been recorded in six months. Shahin has called on the public to remain vigilant and deplored the relaxation of precautions because of the belief that the virus had disappeared.
He called for banning the raising of fowl in towns, transporting them between provinces without authorisation while reinforcing controls on where they are raised and sold. He also warned that sick people denying they have been in contact with contaminated domestic fowl makes it more difficult to detect the virus and to treat it, many times leading to fatalities. Women and children have borne the impact of the virus because of their central family role in taking care of domestic fowl.
The World Health Organisation said earlier this year that countries around the world had improved their defences against bird flu, but that the situation remained critical in Egypt and Indonesia where the risk of the H5N1 virus mutating into a major human threat remains high.
Around five million households in Egypt depend on poultry as a main source of food and income, and the government has said this makes it unlikely the disease can be eradicated. Deaths from bird flu now total more than 210 worldwide since 2003 and has resulted in culling millions of birds after the disease was reported in several African and Asian countries, as well as in Turkey and Azerbaijan.
Health experts fear the virus could mutate into a form that spreads easily from one person to another, possibly triggering a pandemic that could kill millions of people.Comment
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Re: EGYPT - Jan 6, 2008+
The Egyptian bird flu conundrum
Category: Bird flu ? Pandemic preparedness ? Public health preparedness ? Surveillance ? WHO
Posted on: January 6, 2008 3:44 PM, by revere
<!--proximic_content_on-->The big newswires and health agencies are relatively quiet, but word keeps leaking out of Egypt that there are a lot of suspect bird flu cases:CAIRO: Hospitals nationwide reportedly quarantined more human cases suspected of being infected with the H5N1 bird flu virus. According to Al-Masry Al-Youm newspaper, Damietta -- where the latest Bird Flu victim Hanem Atwa Ibrahim, 50, died late on Monday Dec. 31 in a Cairo hospital -- hosts the largest number of cases with five people suspected of carrying the virus, while the Upper Egyptian city of Qena came next, with two cases, followed by El-Beheira with one case. (Egypt Daily Star)This has been noticed on the Flu Boards (see, for example, here
T42! and here) and is the source of understandable anxiety. It is not clear the extent to which the current public awareness campaign is effective in altering behavior but the publicity has also heightened anxiety in the Egyptian public and raised the diagnostic index of suspicion. All of this is appropriate, even though it will also create many new "suspect" caes. However I think there is one element that has been missing in the discussion.
Any kind of influenza infection in humans is potentially serious and life threatening. That's true in the US, where the estimated excess mortality exceeds 35,000 deaths a year, or in Egypt. It is flu season and people will be dying of this nasty virus on a daily basis. Thus a sudden increase in serious and fatal respiratory infections is not evidence H5N1 has run amok. But because there is a lot of flu around, it doesn't mean that finding most or all cases are negative means nothing is happening, either.
Let's do some quick back of the envelope calculations. Egypt's population is about a fifth of the US population, so on that basis alone we might expect 7000 excess deaths from influenza, mostly compressed into a six month flu season. These, of course, are only a fraction of the influenza cases. In the US the case fatality ratio for seasonal influenza is about 0.1%. Let's say it is five times higher in Egypt, 0.5%. That means the number of flu cases is 200 times more, or 1.4 million. Let's say only 20% of these are really sick and are seen by a health care worker. That's still almost 300,000 or close to 50,000 a month coming to medical attention if spread out evenly in the 6 month period (lack of uniformity would of course make some periods look much worse). If we assume that in the same month there are ten clusters of H5N1 of 25 patients each, the probability of a suspect case of influenza being H5N1 is only about 0.5%. There are also a bunch of other viruses that look like influenza, so these would lower the probability even more.
What does this mean? First it means that even if something pretty bad is happening, almost all suspect cases will be negative. Second, that there is so much influenza-like illness at this time of year that there is a real danger true clusters can get lost in the noise. Third, this fact notwithstanding, we shouldn't mistake the noise for a true signal. Just because there is a lot of noise doesn't mean it is hiding a true signal. So far it hasn't been, at least judging from the lack of a prairie fire spread of H5N1 cases anywhere, including Egypt.
The only solution to this knotty problem is to continue intensive surveillance for H5N1 in areas, like Egypt, where there is endemic infection in poultry and other birds. That's why the large number of "suspect cases" is a good thing, not a bad one. Suspicion means there is a greater chance of finding any H5N1 needle that might be hiding in the huge influenza-like-illness haystack.
If there is anything reassuring about this crude analysis it is that a large number of suspect cases doesn't mean something bad is happening. The worrying part is that a lot of negative suspect cases doesn't mean that something bad isn't happening.
This is where we separate the optimists from the pessimists. Meanwhile the realists will be working hard to establish an infrastructure that can make accurate diagnoses of serious pneumonias of unexplained origin. We should be encouraging them and helping them to do it better and faster. We can still look over their shoulders without getting in their way. http://scienceblogs.com/effectmeasur...u_conundru.php
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