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

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

    Looks like Europeans need to worry about reporting accuracy.

    Comment


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

      Commentary


      Alarming Explosion of Mild H5N1 Toddler Cases in Egypt

      Recombinomics Commentary 21:25
      April 3, 2009

      The second H5N1 confirmed toddler in Beheira this week raises concerns that these cases represent an ongoing H5N1 epidemic in Egypt. Although the admission dates for the two cases were just two days apart, it is unlikely that these two cases are directly linked, because the most recent reported cases was in the northern portion of the governorate, and the earlier case lives in the southern area and was likely infected while visiting relatives. However, the two cases this week are in addition to five confirmed cases in March, which included four toddlers. These recent cases extended a trend that began earlier this year, when four other toddlers were confirmed. None of the 11 cases this year have died, and 10 of the 11 were toddlers who were spread throughout the country (see updated map).

      There is no obvious explanation for the explosion in toddler cases this year. In the prior three years there were only six toddler cases, which represented 12% of H5N1 confirmed cases. The frequency in 2009 is almost 10 fold higher. Moreover, since these cases are mild, and are largely limited to those with known poultry links, the number of actual infections is likely much higher.

      The large number of cases suggests that the transmission to humans is more efficient, and mild cases are more likely to spread silently. Mild cases will be more likely to be diagnosed as seasonal flu, and those without a known link to poultry are unlikely to be tested. Moreover, the absence of pneumonia in almost all confirmed cases suggests that many other cases would resolve without Tamiflu treatment.

      The mild cases in the spring of 2009 have similarities to cases in the spring of 2007, although the target population has changed. In the spring of 2007 the case fatality rate was also close to zero (16/17 survived), but most of the cases were children. That outbreak raised concerns that there were many additional children that were H5N1 infected, but not tested. Milder cases spread more easily because infected hosts remain active longer, increasing the number of exposed contacts, especially when the target population is school aged.

      Recovery in the older age groups would lead to protective immunity, which would lower then number of confirmed cases in those age groups. These prior infections would funnel the infections into younger patients who had not been previously exposed.

      The 10 fold jump in toddler cases this year raises concerns that undetected cases are also 10 fold higher than prior outbreaks, signaling a major spread of H5N1 in the human population.

      The explosion of cases in toddlers demands a more aggressive testing of toddlers that do not have poultry contact. Similarly, an aggressive testing program of former at risk groups for detectable levels of neutralizing antibodies is long overdue.

      The explosion of toddler cases strongly suggests that the level of human H5N1 cases in Egypt is markedly higher than the confirmed cases, requiring intensive testing beyond patients with poultry contacts.


      .
      "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

      Comment


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

        Commentary

        Silent Spread of Human H5N1 in Egypt?

        Recombinomics Commentary 11:36
        April 4, 2009

        The reports of two more H5N1 confirmations in toddlers in Behiera, Egypt increase concerns that H5N1 is silently spreading in Egypt. This year there have been 11 confirmed cases in Egypt, and 10 have been toddlers. These cases appear to be mild, and none have died. This situation is similar to the spring of 2007, where there was a spike in mild cases (16/17 survived) and the demographic had changed. Instead of female teenagers and young adults, almost all case were children between the ages of 3 and 10. In addition, most of the cases were from central or southern Egypt, while the more severe cases that preceded and followed the mild cases were in the north. However, the cases this year are spread throughout the country (see updated map).

        The cases in 2007 raised concerns that the number of cases was markedly higher than the confirmed cases because they could easily be misdiagnosed as seasonal flu, and like seasonal flu, could resolve with or without medical attention or anti-virals. Thus, many of the children would recover and not be tested because a seasonal flu etiology would be assumed. Moreover, the children could spread the H5N1 to playmates or classmates, which would produce protective immunity in this population.

        Protective immunity in children would help explain why the mild cases this year are almost exclusively in toddlers. The toddlers either were not born, or were infants in the summer of 2007, which would limit exposure. This year, they would be more active and more likely to come into contact with H5N1. Confirmed cases would be limited to this age group because the prior at risk groups would have some level of immunity, which would keep viral loads below detection limits.

        In addition, the high number of toddler cases would signal a more efficient spread of the virus to humans, which may be linked to prior silent spreading in individuals who had developed some protective immunity.

        The silent spread could have significant consequences. H1N1 has now become Tamiflu resistant, so co-infections involving H1N1 and H5N1 could lead to H274Y jumping to H5N1, conferring resistance. Similarly, increased spread in human hosts could make transmission more efficient due to H5N1 picking up additional changes from H1N1.

        Moreover, the milder, efficiently spread, Tamiflu resistant H5N1 could recombine with more virulent H5N1 to increase virulence, similar to the high CFR in Egypt between the two milder outbreaks, as well as infections preceding the milder cases in the spring of 2007.

        Therefore, aggressive testing of toddlers who have no clear link to poultry is necessary, as is aggressive screening of prior at risk groups for detectable H5N1 antibodies, such as children in southern and central Egypt who accounted for the vast majority of confirmed cases in the spring of 2007.

        The silent spread of H5N1 in human populations sets the stage for increased transmission efficiencies and a serious, if not catastrophic, pandemic.


        .
        "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

        Comment


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

          ....silent spread of H5N1 in human populations sets the stage for increased transmission efficiencies and a serious, if not catastrophic, pandemic.
          If what is spreading silently is a mild strain, isn't that a good sign?

          How could something mild become catastrophic? Would any H274Y recombination impact virulence, independent of the antiviral resistance?



          .
          "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

          Comment


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

            Originally posted by AlaskaDenise View Post
            If what is spreading silently is a mild strain, isn't that a good sign?

            How could something mild become catastrophic? Would any H274Y recombination impact virulence, independent of the antiviral resistance?



            .
            There is a lot of virulent H5N1 in Egypt and elsewhere. Mild H5N1 gets into the human population and increases transmission efficiency, which can then recombine with virulent H5N1 (as in elegant evolution).

            H5N1 knows what it is doing.

            Comment


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

              Let's remember, it's Dr. niman, and Dr. niman only, who is putting the "mild- spin" on things. To conclude that the last two toddlers are infected with a new "mild" strain, that is spreading none the less, is an enormous leap, or a spin of some sort. The toddlers contracted h5n1 because they were playing (or somehow came in contact) with dead fowl. Nothing more, nothing less. Since we have a couple toddlers infected back to back, Dr. Niman is simply playing the "toddler-card", since everybody is aware that pandemics strike the young. He knows it, and he is playing it up. What does it matter since nobody will remember his claims next week?

              We should start another Egypt thread since this one has become less accurate with the wild speculation mixed in.


              Drew

              Comment


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

                If one of the toddlers dies, does that mean we're now back to the lethal strain again?

                What about sequences and data, and facts??? Why hold entire discussions about things that are not true and completely unverified?

                And when we find out there is no mild strain spreading, then what? Should we continue to believe Dr. Niman in the future? If he's wrong about the mild strain circulating, could he also be wrong about all of the clusters he sees in every outbreak too?

                Comment


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

                  Originally posted by Drew View Post
                  Let's remember, it's Dr. niman, and Dr. niman only, who is putting the "mild- spin" on things. To conclude that the last two toddlers are infected with a new "mild" strain, that is spreading none the less, is an enormous leap, or a spin of some sort. The toddlers contracted h5n1 because they were playing (or somehow came in contact) with dead fowl. Nothing more, nothing less. Since we have a couple toddlers infected back to back, Dr. Niman is simply playing the "toddler-card", since everybody is aware that pandemics strike the young. He knows it, and he is playing it up. What does it matter since nobody will remember his claims next week?

                  We should start another Egypt thread since this one has become less accurate with the wild speculation mixed in.


                  Drew
                  Please. 10 of the 11 cases this season were toddlers. Egypt played the "toddler card" in Febraury, when the first four cases in 2009 were toddlers. Now it's 10/11. The data are VERY easy to interpret (no hand waving required).

                  Comment


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

                    Originally posted by Drew View Post
                    If one of the toddlers dies, does that mean we're now back to the lethal strain again?

                    What about sequences and data, and facts??? Why hold entire discussions about things that are not true and completely unverified?

                    And when we find out there is no mild strain spreading, then what? Should we continue to believe Dr. Niman in the future? If he's wrong about the mild strain circulating, could he also be wrong about all of the clusters he sees in every outbreak too?
                    A CFR of ZERO is also an easy call, especially when 11 cases have been confirmed this season (and 16/17 survivors in the spring of 2007 was also an easy call).

                    Clusters are also pretty easy, although there really have been VERY few clusters in Egypt.

                    Nonsense posts aren't also are not hard to call.

                    Comment


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

                      تم أخذ عينات من الحالتين وإرسالها للمعامل المركزية بوزارة الصحة
                      Sampling of cases and sent to labs central Ministry of Health

                      كتبت رباب الجالى
                      Rabab wrote Galy

                      <!-- AddThis Button BEGIN --><SCRIPT type=text/javascript>var addthis_pub="tonyawad";</SCRIPT><SCRIPT type=text/javascript src="http://s7.addthis.com/js/200/addthis_widget.js"></SCRIPT> <!-- AddThis Button END -->
                      اشتبه الأطباء بمستشفى الحميات بالفيوم فى إصابة سيدة وابنتها بمرض أنفلونزا الطيور، وتم أخذ عينات منهما لإرسالها للمعامل المركزية بوزارة الصحة لإجراء التحاليل اللازمة.
                      Hospital doctors suspected fever in Fayoum woman and injuring her daughter from bird flu, has been sampling them to be sent to the central Ministry of Health laboratories for analysis.


                      كانت هيام سيد أحمد (28 سنة) وابنتها ريهام محمد أحمد (10 سنوات) من قرية سرسنا بمركز طامية بالفيوم، قد دخلتا مستشفى الحميات بالفيوم تعانيان من ارتفاع شديد فى درجة الحرارة، واشتبه الأطباء فى إصابتهما بمرض أنفلونزا الطيور، وتم أخذ عينات من الحالتين وإرسالها للمعامل المركزية بوزارة الصحة لإجراء التحاليل اللازمة، والتأكد من إصابتهما بالمرض من عدمه.
                      Mr. Ahmed was Hiyam (28 years) and her daughter, Riham Mohammed Ahmed (10 years) from the village of Srsena status Fayyoum met Monday, had entered hospital suffering from fever Fayyoum very high temperature, and doctors suspected bird flu virus, samples were taken from the cases and send factor of the central Ministry of Health to conduct the necessary tests, and make sure they got sick or not.

                      Comment


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



                        5 cases of detention on suspicion of Qena Bhmyat bird flu

                        السبت، 4 أبريل 2009 - 18:00
                        Saturday, April 4, 2009 - 18:00

                        حاتم الجبلى وزير الصحة
                        The woman and the Minister of Health
                        كتبت هند المغربى
                        Written by India Morocco
                        <!-- AddThis Button BEGIN --><SCRIPT type=text/javascript>var addthis_pub="tonyawad";</SCRIPT><SCRIPT type=text/javascript src="http://s7.addthis.com/js/200/addthis_widget.js"></SCRIPT> <!-- AddThis Button END -->
                        .
                        Detained hospital fevers QENA 5 cases of suspected bird flu patients, entering each of Suad Abdullah Hamid (40 years) and housewife Amira Abdel-Razek and Omaima Abu Hassan Fathi (41 years) and her child, Ahmed Ali (two years), Zeinab Mahmoud Shahwani (40 years ) Aljblao village, where the cases came to the hospital in poor condition, which is suffering from high fever and severe cough and symptoms similar to the disease, and stressed that they all Mkhaltin of birds, many of them died.

                        تم أخد عينات من المرضى وإرسالها للمعامل المركزية للتأكد من إصابتهما بالمرض من عدمه.
                        Samples of the firm was sick and sent to central laboratories to ensure they got sick or not.
                        http://translate.google.com/translat...3Den%26tl%3Dar
                        CSI:WORLD http://swineflumagazine.blogspot.com/

                        treyfish2004@yahoo.com

                        Comment


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

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                          انفلونزا الطيور تداهم الأطفال المصريين
                          Bird flu enters the Egyptian children
                          القاهرة ـ (رويترز) - السبت 04 ابريل 2009
                          CAIRO (Reuters) - Saturday, 04 April 2009
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                          ذكرت الأنباء أمس أن طفلاً مصرياً أصيب بالفيروس المسبب لمرض انفلونزا الطيور، وهذه هي الحالة الثانية والستين التي يتأكد إصابتها بفيروس انفلونزا الطيور في مصر أكثر الدول تضررا بانفلونزا الطيور خارج آسيا، وأعلنت عن سبع حالات إصابة بشرية منذ الأول من مارس.
                          According to reports yesterday that the Egyptian children were the virus that causes bird flu, and this is the case in which the sixty-second confirmed case of bird flu virus in Egypt, the States most affected by bird flu outside Asia, announced the seven human cases since the first of March.
                          والطفل يدعى حسن جميل حسن محمد ويبلغ من العمر 21 شهرا من محافظة البحيرة في شمال مصر وانه في حالة (جيدة) بعد علاجه بعقار (التاميفلو).
                          And children, Hasan Jamil Hassan Mohammed, at the age of 21 months from the lake in the northern province of Egypt and that in the case of (good) after the treatment drug (Tamiflu).
                          وتأتي الإصابة الجديدة بعد عدة أيام من إصابة طفل يبلغ من العمر عامين من نفس المحافظة بنفس الفيروس.
                          The injury comes after several days of a child at the age of two years of the same county the same virus.
                          ولم يعرف كيف أصيب الطفل بالفيروس لكن يعتقد أن أغلب المصريين الذين أصيبوا بانفلونزا الطيور انتقل إليهم الفيروس من طيور منزلية مصابة.
                          It was not known how the virus was a child but it is believed that the majority of Egyptians who were moved by the bird flu virus from infected domestic birds.
                          ومنذ عام 2003 أصاب فيروس انفلونزا الطيور 410 أشخاصاً على الأقل في 15 دولة وأودى بحياة 254 منهم.
                          Since the 2003 avian flu virus has infected at least 410 people in 15 countries and killed 254 of them.
                          وأدى إلى نفوق أو إعدام أكثر من 300 مليون طائر في 61 دولة في آسيا والشرق الأوسط وإفريقيا وأوروبا.
                          And led to the deaths or culling of more than 300 million birds in 61 countries in Asia and the Middle East, Africa and Europe.
                          وتوفي حوالي 23 مصريا بعد إصابتهم بالفيروس وأغلبهم بعد اتصالهم بطيور منزلية مصابة في بلد تعتمد فيه خمسة ملايين أسرة تقريبا على الدواجن التي تربى في المنزل كمصدر مهم للطعام والدخل.
                          He died after about 23 Egyptians infected with HIV, mostly after coming into contact with infected domestic birds in a country where the adoption of almost five million households that kept poultry at home as an important source of food and income.
                          </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>Bird flu enters the Egyptian children
                          القاهرة ـ (رويترز) - السبت 04 ابريل 2009
                          CAIRO (Reuters) - Saturday, 04 April 2009
                          According to reports yesterday that the Egyptian children were the virus that causes bird flu, and this is the case in which the sixty-second confirmed case of bird flu virus in Egypt, the States most affected by bird flu outside Asia, announced the seven human cases since the first of March.
                          والطفل يدعى حسن جميل حسن محمد ويبلغ من العمر 21 شهرا من محافظة البحيرة في شمال مصر وانه في حالة (جيدة) بعد علاجه بعقار (التاميفلو).
                          And children, Hasan Jamil Hassan Mohammed, at the age of 21 months from the lake in the northern province of Egypt and that in the case of (good) after the treatment drug (Tamiflu).
                          وتأتي الإصابة الجديدة بعد عدة أيام من إصابة طفل يبلغ من العمر عامين من نفس المحافظة بنفس الفيروس.
                          The injury comes after several days of a child at the age of two years of the same county the same virus.
                          ولم يعرف كيف أصيب الطفل بالفيروس لكن يعتقد أن أغلب المصريين الذين أصيبوا بانفلونزا الطيور انتقل إليهم الفيروس من طيور منزلية مصابة.
                          It was not known how the virus was a child but it is believed that the majority of Egyptians who were moved by the bird flu virus from infected domestic birds.
                          ومنذ عام 2003 أصاب فيروس انفلونزا الطيور 410 أشخاصاً على الأقل في 15 دولة وأودى بحياة 254 منهم.
                          Since the 2003 avian flu virus has infected at least 410 people in 15 countries and killed 254 of them.
                          وأدى إلى نفوق أو إعدام أكثر من 300 مليون طائر في 61 دولة في آسيا والشرق الأوسط وإفريقيا وأوروبا.
                          And led to the deaths or culling of more than 300 million birds in 61 countries in Asia and the Middle East, Africa and Europe.
                          وتوفي حوالي 23 مصريا بعد إصابتهم بالفيروس وأغلبهم بعد اتصالهم بطيور منزلية مصابة في بلد تعتمد فيه خمسة ملايين أسرة تقريبا على الدواجن التي تربى في المنزل كمصدر مهم للطعام والدخل.
                          He died after about 23 Egyptians infected with HIV, mostly after coming into contact with infected domestic birds in a country where the adoption of almost five million households that kept poultry at home as an important source of food and income. http://translate.google.com/translat...r%26start%3D20
                          CSI:WORLD http://swineflumagazine.blogspot.com/

                          treyfish2004@yahoo.com

                          Comment


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

                            Those toddlers' cases could be mild if they were still getting their mother's milk. It wouldn't be unusual for children to be nursed until the age of 2 or 3, even if it's infrequent, but it would pass on the mother's antibodies.

                            See study here and here.

                            .
                            "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

                            Comment


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

                              5 people in custody on suspicion of Qena bird flu

                              Books Abdalhafez Ghada Mohamed Hamdy Mohamed Kamal Teresa Asamkory and Nasser الشرقاوى 4-5 / 2009

                              Detained in hospital in Qena, Minya, Dakahliya, citizens yesterday on suspicion of bird flu patients, as it continues its efforts GOVERNORATES Investigation of Supply stores to control the trade of live birds, and the campaigns have resulted in the seizure of 31 shops in Alexandria, as well as the execution of 412 birds were seized inside.

                              Held in Qena fever hospital 5 citizens on suspicion of contracting the disease are: Omaima Fatehy «41 years», housewife, and her baby Ahmed Yacoub, two, and Zeinab Mahmoud Alhenwany «40 years», housewife, and Suad Abdullah Hamid, «40 years», The Princess Razeq Abulhasan, «21 years», housewife, on suspicion of having bird flu after an outbreak of similar symptoms of the disease on them.

                              "Dr. Ayman Abdel-Moneim, Under-Secretary, Ministry of Health Rawash, had been taking samples from the detainees and sent to labs central Ministry of Health for analysis, pointing out that most of them in contact with birds, and disease control teams veterinary medicine cleared homes and take samples from birds to the Ministry of Agriculture analysis.

                              In Minya, was arrested Hospital fevers der Moas, Naima Jaber Mohammed Hassanein «11 years», from the village of Albdhirman on suspicion of bird flu, and doctors decided her continued until tests prove positive or negative.

                              In Dakahlia, was detained in Mansoura Chest Hospital on a young man on suspicion of being infected with the disease.

                              http://www.almasry-alyoum.com/articl...ticleID=205713

                              احتجاز ٥ مواطنين فى قنا للاشتباه فى إصابتهم بأنفلونزا الطيور

                              كتب غادة عبدالحافظ ومحمد حمدى وتريزا كمال ومحمد السمكورى وناصر الشرقاوى ٥/ ٤/ ٢٠٠٩

                              احتجزت مستشفيات فى قنا والمنيا والدقهلية، أمس مواطنين للاشتباه فى إصابتهم بمرض أنفلونزا الطيور، فيما تواصل مباحث التموين بالمحافظات جهودها لضبط محال تجارة الطيور الحية، وأسفرت الحملات عن ضبط ٣١ محلا بالإسكندرية، فضلاً عن إعدام ٤١٢ طائرًا تم ضبطها داخلها.

                              فى قنا احتجز مستشفى الحميات ٥ مواطنين للاشتباه فى إصابتهم بالمرض هم: أميمة فتحى «٤١ سنة»، ربة منزل، وطفلها أحمد على يعقوب، عامان، وزينب محمود الشنوانى «٤٠ سنة»، ربة منزل، وسعاد حامد عبدالله، «٤٠ سنة»، وأميرة عبدالرازق أبو الحسن، «٢١ سنة»، ربة منزل، للاشتباه فى إصابتهم بأنفلونزا الطيور بعد ظهور أعراض مشابهة للمرض عليهم.

                              وقال الدكتور أيمن عبدالمنعم، وكيل وزارة الصحة بقنا، إنه تم أخذ عينات من المحتجزين وإرسالها للمعامل المركزية بوزارة الصحة لتحليلها، لافتًا إلى أن معظمهم من المخالطين للطيور، وقامت فرق مكافحة المرض بالطب البيطرى بتطهير المنازل وأخذ عينات من الطيور لتحليلها بوزارة الزراعة.

                              وفى المنيا، احتجز مستشفى حميات دير مواس، نعيمة جابر محمد حسنين «١١ سنة»، من قرية البذرمان للاشتباه فى إصابتها بأنفلونزا الطيور، وقرر الأطباء استمرار احتجازها لحين ثبوت إيجابية التحاليل أو سلبيتها.

                              وفى الدقهلية، احتجز مستشفى الصدر بالمنصورة أمس شابًا للاشتباه فى إصابته بالمرض.

                              Comment


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

                                Originally posted by AlaskaDenise View Post
                                Those toddlers' cases could be mild if they were still getting their mother's milk. It wouldn't be unusual for children to be nursed until the age of 2 or 3, even if it's infrequent, but it would pass on the mother's antibodies.

                                See study here and here.

                                .
                                But only toddlers are testing positive, suggesting they are MISSING antibodies.

                                Comment

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