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Concerns arise over symptomless Egypt bird flu cases

Re: Concerns arise over symptomless Egypt bird flu cases

I follow the facts where ever they lead. I found this a couple of hours ago and posted on the Egyptian human infection thread:

"...By a specialized committee of the Ministry of Health and Preventive Medicine and Veterinary Medicine to move to the child's home-Shahat, Mohamed Hassan Amer ?years?, which was No. 61 in the cases of bird flu in the province of the lake, immediately confirmed his illness, to examine the house and the houses nearby, Dr. Mohamed Farid , Director of Veterinary Medicine to maintain, the lack of birds at his home. "


http://www.flutrackers.com/forum/showpost.php?p=217993&postcount=299
Actually, SAIDR has also provided verifiable DATA that casts serious doubt on the poultry connection, because as of April third sample test / collections there was no H5N1 positive poultry anywhere near the cluster

(see 2 purple markers with ZERO blue markers nearby)

http://maps.google.com/maps/ms?ie=U...30.439202,30.690308&spn=1.970123,2.741089&z=8

WHO has been blowing smoke for five YEARS about poultry contacts and lack of H2H.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Commentary

WHO H5N1 Transmission Omissions in Beheira Egypt

Recombinomics Commentary 17:44
April 8, 2009

Both boys had contact with sick/dead poultry prior to the illness onset.

Close contacts of both boys have been identified and none has shown symptoms of the infection .

The above comments from the latest WHO update represent glaring commission by omission. The update claims ?contact with sick/dead poultry?, but fails to give results of testing of such poultry. The SAIDR site, which has poultry results through April 3 does not include any confirmed poultry cases in the proximity (see updated map) of the Beheira cluster.

Moreover, the above comments imply that neither confirmed case has transmitted H5N1 to any contact, yet the update fails to mention that the two confirmed cases live "in adjacent houses", and are cousins.

The four day gap in disease onset dates leaves little doubt that the index case infected his cousin, who lives text door. This toddler to toddler transmission is cause for concern, because both cases had mild H5N1, including the index case, who began oseltamivir treatment after the recommended 48 hours after disease onset.

These mild bird flu cases in Egypt are not new, and were cause for concern in 2007, when children between the ages of 3-10 rapidly recovered and were infected with H5N1 sequences that were virtually identical and signaled extensive human to human transmission because the cases with identical H5N1 sequences were not epidemiologically linked.

Although WHO has recently acknowledged concern for silent transmission of H5N1, the above commissions by omission of an obvious case of human to human transmission raises serious pandemic concerns about WHO?s ability to analyze scientific data and transparently present results of such analysis.


.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Close contacts of both boys have been identified and none has shown symptoms of the infection .

Why aren't they looking for extremely mild cases by testing those contacts for antibodies?

I've also wondered the same thing about chickens. Just because there have been no sick/dead poultry doesn't mean they're not the source of an infection, i.e., if the poultry was vaccinated they could still be shedding small amounts of virus.

.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Actually, SAIDR has also provided verifiable DATA that casts serious doubt on the poultry connection, because as of April third sample test / collections there was no H5N1 positive poultry anywhere near the cluster

(see 2 purple markers with ZERO blue markers nearby)

http://maps.google.com/maps/ms?ie=U...30.439202,30.690308&spn=1.970123,2.741089&z=8

WHO has been blowing smoke for five YEARS about poultry contacts and lack of H2H.

Saidr reports are not 100% correct. For instance:

FT has the following report of the positive H5N1 and resultant culling of 4,000 poultry in Menoufia, on or about, March 11, 2009:

"..Veterinary Directorate executed Menofia 4 thousands of birds after the emergence of two things .."

http://www.flutrackers.com/forum/showpost.php?p=213386&postcount=63


Saidr does not have this reported on their site.


http://www.saidr.org/en/animals.php
 
Re: Concerns arise over symptomless Egypt bird flu cases

Saidr reports are not 100% correct. For instance:

FT has the following report of the positive H5N1 and resultant culling of 4,000 poultry in Menoufia, on or about, March 11, 2009:

"..Veterinary Directorate executed Menofia 4 thousands of birds after the emergence of two things .."

http://www.flutrackers.com/forum/showpost.php?p=213386&postcount=63


Saidr does not have this reported on their site.


http://www.saidr.org/en/animals.php
SAIDR is linked to government agencies in Egypt and the listings make it clear that central vet is chasing the CONFIRMED human cases and testing local poultry (after human confirmation). They would VERY MUCH like to show positive poultry in Beheira and Qena, but to date they have failed.
 
Re: Concerns arise over symptomless Egypt bird flu cases

"There is no change in the virus at all in the virus strain in Egypt. It is the same since the beginning of the outbreak. There is no mutation, nothing," he said. (Writing by Cynthia Johnston)

http://www.alertnet.org/thenews/newsdesk/L7467886.htm

There have been genetic changes to H5N1 in Egypt "since the beginning".

"...The ‬ * ‬ Spokesman of the Ministry of the injury, No. * ‬ 63 * ‬ Qaliubiya province, injuring a baby and was preceded by less than two years old in the province, the lake * ‬ *. ‬ warned the collapse of agricultural sources of the poultry industry and the closure of a large proportion of the poultry farms because of fears of disease,* ‬ and the high cost of production, * ‬ and the escalation of prices of chickens, * ‬ and doubling the price of * ?‬ vaccine immunization *? ‬ against the disease, * ‬ and * ‬ useless because of several types of mutation of the virus that causes the disease *"


http://www.flutrackers.com/forum/showpost.php?p=217981&postcount=298
 
Re: Concerns arise over symptomless Egypt bird flu cases

Source: http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/apr0809asymp.html


Egyptian H5N1 cases prompt speculation about silent infections

Robert Roos * News Editor

Apr 8, 2009 (CIDRAP News) ? The recent series of H5N1 avian influenza cases in Egyptian children yet very few in adults has raised concern that some Egyptians may be getting infected without getting sick, according to a Reuters news report published today.

John Jabbour, a World Health Organization (WHO) emerging diseases specialist based in Cairo, said the Egyptian government and the WHO are planning a study to find out if subclinical or asymptomatic cases have been occurring, according to the story.

Jabbour said the occurrence of asymptomatic cases would be worrisome because it could give the undetected virus more time to mutate in human hosts, Reuters reported.

"If there is any subclinical case in Egypt, the aim is to treat immediately to stop the reproduction of the virus," he told Reuters. "Because whether [through] mutation or reassortment, this will lead to the pandemic strain."

The story said that all but two of the 11 Egyptians infected with H5N1 this year have been children under age 3 (the official WHO count for Egypt reached 12 today). In the same period last year, most of the seven Egyptian case-patients were adults and older children, the report said.

Jabbour said the string of cases in children without similar cases in adults had prompted the questions whether adults were being infected without falling ill.

He said the Egyptian study would involve testing the blood of people who were potentially exposed to infected birds but had not gotten sick.

Tim Uyeki, MD, a medical epidemiologist in the Influenza Division at the Centers for Disease Control and Prevention, told CIDRAP News that limited studies in several countries over the past few years have found relatively little serologic evidence of asymptomatic or unrecognized cases of H5N1 virus infection.

When the H5N1 virus first infected humans in Hong Kong in 1997, there were two studies in which investigators looked for H5N1 antibodies in people who had potentially been exposed to the virus, Uyeki said. One study focused on 293 poultry cullers, of whom only nine (3%) were found to have H5N1 antibodies, indicating past infection. In the other study, involving 1,525 poultry workers, an estimated 10% had antibodies.

More recent studies "have either found no evidence of H5N1 virus infection or very low seroprevalence of H5N1 antibodies, around 1% or less, among different exposed populations," Uyeki said. "Since H5N1 virus strains continue to evolve, there's a continued need for these studies in people who have contact with poultry in countries where H5N1 virus strains are circulating in birds, since the risk of transmission to exposed persons could change."

Uyeki also noted that subclinical infection with seasonal influenza virus is known to occur. "But how that relates to H5N1 is unclear," he said.


See also:

Jan 25 2008 CIDRAP News story "Cambodian study hints at subclinical H5N1 cases"
 
Re: Concerns arise over symptomless Egypt bird flu cases

From the referenced Jan 25, 2008 CIDRAP story on Cambodia study:

More cases of mild disease might suggest that the virus is improving its ability to spread among humans, while becoming less virulent

.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Why aren't they looking for extremely mild cases by testing those contacts for antibodies?

I've also wondered the same thing about chickens. Just because there have been no sick/dead poultry doesn't mean they're not the source of an infection, i.e., if the poultry was vaccinated they could still be shedding small amounts of virus.

.

A chicken that have been vaccinated will likely show an antibody response to the vaccination so a false positive is likely.

The humans are tested in this way to show "exposure" because they have not been vaccinated.

PCR would show "active" infection.
 
Re: Concerns arise over symptomless Egypt bird flu cases

I wonder what the definition is of "mild cases":

- a less virulent virus?

- higher resistance at the host?

- both?

No proof so far, we can only speculate?

Is the testing improved in Egypt? New (rapid) testing device used?
 
Re: Concerns arise over symptomless Egypt bird flu cases

My comments in post #23 were about testing the contacts (assumed to be human) referenced in post #22, as part of this sentence...
Close contacts of both boys have been identified and none has shown symptoms of the infection .
The point was the value of testing asymptomatic human contacts.

When I said I was wondering the same thing about chickens, I did not mean to test a vaccinated chicken for what they had been vaccinated for. I was referring to the fact that some assume a chicken cannot be a source if it doesn't show symptoms, when in fact it can because a vaccinated chicken, when infected, still can pass small amounts of virus....hence, the use of sentinel members. it's doubtful that Egyptian backyard flocks maintain sentinel populations.

.
 
Re: Concerns arise over symptomless Egypt bird flu cases

............Is the testing improved in Egypt? New (rapid) testing device used?

From post #1...

The Egyptian study, which Jabbour said should begin in the coming months, would test the blood of people who may have been in contact with infected birds but had not become sick.

We could call it improved, in that they will be testing asymptomatic humans with infected bird contacts.

IF there is a way to test asymptomatic birds for recent infections (like higher antibody levels that would be expected from vaccination) and they did those tests quickly upon human infection, a match should indicate something of value.

.
 
Re: Concerns arise over symptomless Egypt bird flu cases

IF there is a way to test asymptomatic birds for recent infections (like higher antibody levels that would be expected from vaccination) and they did those tests quickly upon human infection, a match should indicate something of value.

In some human diseases you can identify an ongoing infection (of something that would normally test positive due to prior infection) by sequential testing for rising serum levels. I don't know if this would work to sort out antibodies levels in chickens.

.
 
Re: Concerns arise over symptomless Egypt bird flu cases

I think that the actual testing has become lost in the discussion, Silent spread does not have to involve symptomless patients. Much can simply involve the absence of a poultry connection, because H2H spread is not monitored. Thus, those that have symptoms short of serious pneumonia are simply not tested for H5N1.

Similarly, those with symptoms, but lower titers would give a false negative when tested.

Neither of these issues is being addressed when it is assumed that the mild cases are asymptomatic and therefore cannot be identified with PCR.
 
Re: Concerns arise over symptomless Egypt bird flu cases

hat tip Sally -


<table style="text-align: left; direction: ltr;"><tbody><tr><td class="nav" align="center"> After the announcement of our first global
أنفلونزا الطيور..​
Avian flu ..
تعود بشراسة​
Is fiercely
الخبراء: الفيروس نشط..​
Experts: active virus ..
وينتقل بسرعة رهيبة​

And move quickly terrible

</td></tr><tr><td class="auther" align="right">
متابعة: ريهام السعيد​
Follow-up: Reham Al -
</td></tr><tr><td align="right">
جاء احتلال مصر للمركز الأول عالمياً في ظهور حالات أنفلونزا الطيور هذا العام والخامسة من حيث عدد الوفيات كما جاء في تقرير منظمة الصحة العالمية بمثابة الصدمة لكل القطاعات العاملة في هذا المجال.​

The occupation of Egypt to the status of the first in the world, the emergence of bird flu cases this year and fifth in terms of the number of deaths according to the report of the World Health Organization as a shock to all sectors working in this area.
الخبراء أكدوا أن الأمر في غاية الخطورة خاصة أن فيروس أنفلونزا الطيور نشط وينتقل بسرعة رهيبة وأن عودته بصورة أكثر شراسة..​
Experts emphasized that a very serious matter, especially that the bird flu virus active and move quickly back and terrible ferocity more ..
أشاروا إلي أن ثقافة المستهلك الخاطئة بالإصرار علي تناول الدجاج الحي وليس المجمد أو المبرد تساهم في تفاقم الأزمة.​

They pointed out that the consumer culture by insisting on the wrong neighborhood and eating chicken is not frozen or refrigerated contribute to the worsening of the crisis.
طالبوا بتطوير التربية الريفية ومحاربة العشوائية في صناعة الدواجن وإنشاء صندوق بتمويل ذاتي لتعويض أصحاب المزارع المصابة.​

Demanded the development of rural education and to combat outposts in the poultry industry and the establishment of a self-financing fund to compensate the owners of the affected farms.
"المساء" ناقشت القضية مع كافة الأطراف في هذا التحقيق.​

"Evening," discussed the issue with all parties in this investigation.
* د.عبدالعزيز السيد "رئيس شعبة الثروة الداجنة بالغرف التجارية": خطورة الوضع تدعو إلي ضرورة التعجيل بإصدار تشريع من مجلس الشعب خاص بعدم تداول الطيور الحية حتي نحاصر الفيروس لأن الحملات الرقابية والسبل المستخدمة للسيطرة علي محلات بيع الدواجن والأكمنة الموجودة علي الطرق غير فعالة ولا توازي إصدار قانون يجرم ذلك حيث يستطيع المخالف العودة لنشاطه بمجرد انتهاء الرقابة أو مغادرة المفتشين أما القانون فيلقي الاحترام خوفاً من التعرض لعقوبة أو غرامة كبيرة.​
*

D. Mr. Abdul Aziz, "Chief of the Division of poultry with chambers of commerce:" the seriousness of the situation calls for the need to expedite the enactment of legislation to parliament that a special handling of live birds, even as the campaigns Nhasr virus control and the means used to control the stores that sell poultry and ambushes on the roads are not effective equivalent to passing a new law that criminalizes the terms of the offender can return to activity once the inspectors leave the control or the legions of law respect for fear of punishment or a hefty fine.
أشار إلي محاربة العشوائية في صناعة الدواجن وأن تخضع جميع المزارع والمجازر إلي تطوير فعلي وبالنسبة للمزارع لابد من تطبيق نظام الأمن والأمان بصورة منتظمة وأن توضع الطيور الموجودة بها تحت إشراف بيطري وتطعيم الطيور من عمر يوم واحد وكذلك فتح مجازر جديدة لاستيعاب كم أكبر من الطيور.​

Pointed to combat outposts in the poultry industry and to place all the farms and slaughterhouses to develop effective and for the farms to be the application of the safety and security on a regular basis and those birds are under the supervision of the veterinarian and the vaccination of birds from the age of one day opening of the massacres, as well as to accommodate the new larger body of birds.
أوضح أنه يجب أن تحصل التربية الريفية علي حظها من التطوير مشيراً إلي أنه في هذا الإطار سوف تطبق تجربة جديدة من خلال الصندوق الاجتماعي ووزارة الزراعة في إحدي محافظات الوجه البحري وأخري في الوجه القبلي من أجل التعميم..​

He pointed out that education must have their share of rural development, noting that in the framework of this new experiment will be applied through the Social Fund and the Ministry of Agriculture in one of Lower Egypt and the other in Upper Egypt in order to generalize ..
وتقوم التجربة علي منح مربي الطيور عشة مجهزة بدلاً من التربية في البيوت مع مراعاة توحيد نوع وعمر الطيور فمثلاً تربية الحمام يتم فصلها عن البط والفراخ لأن الجينات المختلفة قد تؤدي إلي ظهور الفيروس.​

The grant will experience Aviarist with straw instead of education in the home, taking into account the consolidation of the type and age of breeding birds for example, the bathroom is separated from the ducks and chickens, because different genes may lead to the emergence of the virus.
يقترح إنشاء صندوق خاص بالدواجن يعتمد في تمويله علي الحصول علي أصحاب المزارع بالحصول علي 0.5 إلي 1% من قيمة الدواجن الموجودة موضحاً أن من أكثر أسباب تفشي الفيرس خوف المزارع من كشف نفسه بعد اكتشافه دواجن مصابة فيحاول الهروب بها إلي مكان آخر لبيعها وبذلك ينتقل الفيروس بسرعة لكن هذا الصندوق سيكون ضامناً للمزارع إذا تعرض لمشكلة يجد ما يعوضه.​

Proposed to establish a special fund financed by poultry depends on access to farm owners to obtain 0.5 to 1% of the value of existing poultry, adding that one of the most reasons for the spread of the virus of fear, revealed the same farm after finding a chicken tries to escape with the place of the last sale, so the virus moves quickly However, this fund will be the guarantor for the farmer if he had a problem or get compensated.
* د.عبدالرحمن شاهين "المتحدث الرسمي باسم وزارة الصحة": علي الرغم من أن مصر الأولي من حيث عدد الإصابات في الثلاثة شهور الأولي لعام 2009 لكنها مازالت الأولي في الحالات التي تم شفاؤها حيث إن عام 2008 شهد تعرض 8 حالات للإصابة وتم شفاء 50% منها وهذا العام أصيبت 12 حالة لم يتوف منها شخص واحد وهذا مؤشر جيد علي التقدم والنجاح في العلاج وزيادة الوعي لدي المواطنين بسرعة التوجه إلي المستشفي بمجرد ارتفاع درجة حرارة الجسم.​
*

D. Abdel Rahman Shahin, "the spokesman of the Ministry of Health:" Although Egypt first in terms of the number of casualties in the first three months of 2009, but still in the initial cases that have been cured since 2008 has been 8 cases of infection were recovered 50% and this year was not the case 12 of them died and one person is a good indicator of progress and success in treatment and raise awareness among the citizens to come to the hospital quickly once the high temperature of the body.
أكد أن الأسواق العامة ومحلات الدواجن جميعها تخضع لرقابة وتفتيش يومي للتأكد من أن تداول الطيور الموجودة يتم بصورة سليمة لا تضر المواطن حيث يتم سحب عينات من الدواجن وتحليلها للتأكد من أنها غير مصابة بالفيروس وإذا أثبتت النتائج وجود طيور مصابة يتم إعدامها علي الفور بالطرق السليمة.​

Emphasized that the public markets and poultry shops, all under the control and inspection on to make sure that the circulation of those birds is the sound does not harm people, withdrawing samples from poultry and analysis to ensure that they are not infected with HIV if the results proved the presence of infected birds are culled immediately through sound.
أوضح أنه يتم حالياً إجراء رقابة علي نقل الطيور الحية بين المحافظات وغير مسموح بدخول أو خروج الطيور إلا بتصريح موقع عليه طبيب بيطري.​

He is currently on the transfer of control of live birds between provinces are not allowed to enter or exit the bird, however, a statement signed by a veterinarian.
أكد أن فيروس أنفلونزا الطيور موجود ومتوطن لذلك نتوقع ظهور حالات كل عام حتي يتم القضاء علي الفيروس مشيراً إلي وجود خطة وبرنامج متكامل لمواجهة الفيروس وسيجتمع رئيس الوزراء د.أحمد نظيف اليوم مع جميع الوزراء المعنيين بهذه المشكلة لمراجعة الإجراءات التي تم إنجازها ومتابعة الخطوات القادمة لمواجهة أنفلونزا الطيور.​

Confirmed that the bird flu virus is endemic, and therefore we expect the emergence of cases every year until the elimination of the virus, referring to the existence of a plan and an integrated program to counter the virus and will meet Prime Minister Dr. Ahmed Nazif today with all the ministers concerned in this problem for a review of the actions that have been completed and follow-up to the next steps to address the avian birds.
* د.حسين خلف الله وكيل أول وزارة الزراعة للشئون البيطرية: ذوق المستهلك المصري هو السبب في تفاقم مشكلة أنفلونزا الطيور وتشجيع التجار علي تداول الدواجن الحية حيث يتجه بشكل أكبر نحو محلات بيع الدواجن الحية ويجد البائع أن المجمد والمبرد لا يجد التسويق المناسب مشيراً إلي أن الدواجن المبردة التي يتم ذبحها في المجازر ووضعها في ثلاجات وتظل صالحة لمدة ثلاثة أيام أفضل من الحية في الطعم والقيمة الغذائية.​
*

D. Khalafalla's first undersecretary of the Ministry of Agriculture and Veterinary Affairs: Egyptian consumer taste is the reason why exacerbate the problem of avian influenza and to promote the circulation of traders, where live poultry is more about stores that sell live poultry, the seller finds that the frozen and refrigerated not find the appropriate marketing, noting that chilled poultry to be slaughtered in the massacres and putting them in refrigerators and remain valid for a period of three days is better than living in the taste and nutritional value.
أشار إلي أنه عند ضبط محلات لبيع الطيور الحية يتم إغلاقها وتوقيع غرامة من 200 إلي 500 جنيه كما يتعرض صاحبها للحبس من 6 شهور إلي سنة ورغم كم المحاضر ضد عدد كبير من المحلات إلا أن المخالفات لا تتراجع.​

He pointed out that when shops for the sale of live birds will be closed and a fine of 200 to 500 pounds and is the owner of imprisonment of 6 months to years, despite the records on how many stores but that the irregularities did not back down.
* د.خالد نصر أستاذ التغذية والتغذية الإكلينيكية بطب بطري جامعة القاهرة: فيروس أنفلونزا الطيور نشط وينتشر بسرعة رهيبة فبمجرد خروج أحد الأفراد من مكان به إصابات ودخوله مكاناً آخر ينتقل إليه الفيروس لذلك يجب تطهير جميع العاملين بالمزارع وكل فرد يدخل للمزرعة وكذلك تطهير العلف المقدم للطيور بمضادات البكتريا.​
*

D. Khaled Nasr, Professor of Clinical Nutrition, nutrition, medicine, Cairo University, Boutri: avian influenza virus is spreading fast and active dire Once out of an individual from the place of the injury and he moved to another place for the virus that must be cleared of all farm workers and every individual entering the farm, as well as clearance of feed given to birds anti-bacteria.
أشار إلي أن تربية الدواجن بالبيوت بدأت تزداد من جديد رغم خطورة ذلك والسبب يرجع لارتفاع سعر الدواجن نتيجة زيادة الطلب في مقابل قلة المعروض فأصبحت تتجه بعض الأسر إلي تربية "الكتاكيت" كمحاولة للتوفير وكذلك بدأت محلات الدجاج في العودة للنشاط ويتم بيع الطيور الحية بشكل طبيعي وهذه المشكلة يجب التصدي لها.​

He said the poultry houses have begun to increase again, despite the gravity of the reason is due to the high price of poultry due to the increase in demand in return for a few before heading into some families to educate "the chicks" in an attempt to provide as well as poultry shops began to return to the activity and the sale of live birds is normal and this the problem must be addressed.
* المهندس مصطفي زهران رئيس حي الزيتون: تداول الطيور الحية في الأسواق مازال ممنوعاً والحملات الرقابية والتفتيشية علي المحلات يومية وفي حالة ضبط محل يبيع طيور حية يتم مصادرة الطيور وتوقيع غرامة تصل إلي 1000 جنيه والغلق لمدة أسبوع أما إذا تكرر ذلك وأعاد التاجر نفس نشاطه يتم غلق المحل بصورة نهائية لكن حتي الآن لم يتكرر ذلك بل إن الحي يساعد التجار في الحصول علي تراخيص جديدة لتغيير النشاط فمن يرغب في بيع الطيور المجمدة أو المبردة يتم منحه الترخيص.​
*

Mostafa Zahran, head of Al-Zeitoun neighborhood: the circulation of live birds in the market is still banned and campaigns on the control and inspection shops daily in the case of the place settings sell live birds to be the confiscation of birds and a fine of up to 1000 pounds and sealed for a week if that and repeat the same activity will be the merchant to close the shop once, but so far it has not been repeated, but the district will help traders to obtain new licenses for the change of activity, it is willing to sell chilled or frozen birds to be granted a license.
أضاف أن حي الزيتون يسعي حالياً نحو فتح مجزر آلي لذبح الطيور من خلاله لضمان سلامتها وتقدم الحي بعرض التصميم والتخطيط علي المجلس التنفيذي بمحافظة القاهرة.​

The Zeitoun neighborhood is currently seeking to open up automated abattoir for the slaughter of birds in which to ensure the integrity of the neighborhood offer and provide design and planning to the Executive Board Cairo Governorate.
* صلاح رمضان رئيس حي البساتين ودار السلام: محافظ القاهرة خلال اجتماعه برؤساء الأحياء والشئون الصحية الأسبوع الماضي أصدر تعليمات مشددة بضرورة تكثيف الأكمنة علي مداخل طرق المحافظة ومنع أي محاولة من العربات المحملة بالدواجن من الدخول والتعامل مع محلات بيع الدواجن الحية بالغلق ومصادرة الطيور وتحرير محاضر ضد المخالفين وتحويل المحلات لبيع الطيور المجمدة.​
*

Salah Ramadan, chief of district of orchards and Dar es Salaam: the Governor of Cairo during a meeting with heads of districts and health affairs, last week issued strict instructions to intensify the need for ambushes on the roads to maintain the entrance and prevent any attempt by the vehicles carrying poultry from entering or dealing with the stores that sell live poultry closure and confiscation of birds and the liberalization of the records against offenders and the conversion of stores to sell frozen birds.

http://www.algomhuria.net.eg/almessa/today/third/detail07.asp

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Re: Concerns arise over symptomless Egypt bird flu cases

#35: "the bird flu virus active and move quickly back and terrible ferocity more"


Hmm, by reading the whole gived text translation, the general impression is that the above sentence was used primary for poultry infections only.

It seems clear that their actual wide practice of rear cooling, and trade/smug./stocking/sell/consumption of live/dead poultry at the street level of many already illnessed poultry outcomed in reinfections.

All this, instead of an centralized killing place with subsequent frozing, maked an ideal environment for back and forth renewned poultry infections with the bird flu virus which than decimate more and more new poultry flocks everywhere, which than could not be contained, so "the bird flu virus active and move quickly back and terrible ferocity more" - in poultry flocks, probably not in humans for now.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Yes. Those comments refer to poultry. It gives the background to the general situation in Egypt.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Yes. Those comments refer to poultry. It gives the background to the general situation in Egypt.
But there is no H5N1 confirmed poultry linked to the four most recent human cases.
 
Re: Concerns arise over symptomless Egypt bird flu cases

Both the WHO and Saidr indicate these cases were connected to sick or dead poultry. I understand your comment to mean that you do not believe these statements?

http://www.who.int/csr/disease/avian_influenza/en/


http://www.saidr.org/en/humans.php#050409
Most patients who are tested for H5N1 in Egypt claim a connection to sick or dying poultry (which leads to treatment and testing). Neither WHO nor SAIDR have produced any evidence of H5N1 in poultry in the area of the recent cases in Beheira or Qena (in contrast to earlier cases).

Sick and dead poultry are common worldwide, and the use of the word "connection" by WHO has included prior examples that had nothing to do with H5N1 transmission to confirmed cases.

WHO says dead or dying poultry are "connected" and claims no symptoms in contacts, knowing full well that the two cases in Beheira are neighbors and cousins.

WHO's credibility on H2H has been suspect since 2004 and there is little evidence of change (other than the cluster in Beheira which has SIGNIFICANTLY lowered WHO H5N1 H2H credibility in Egypt).
 
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